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发帖数: 996 | 1 Religion and Psychiatry
Irvin Yalom
宗教与精神病学
欧文亚隆
The American Psychiatric Association awarded Irvin Yalom the 2000 Oscar
Pfister prize (for important contributions to religion and psychiatry.) Here
is his acceptance speech delivered at the American Psychiatric Association
annual meeting in May 2000 at New Orleans. A version of this lecture has
been published in the American Journal of Psychotherapy (number three –
2002)
美国精神卫生协会将2000年奥斯卡菲斯特奖颁给欧文亚隆，奖励他在宗教与精神病学方
面做出的重要贡献。下面是他在2000年5月新奥尔良举行的美国精神卫生协会年度会议
上发表的获奖演说。此演说曾发表在美国心理治疗期刊2002年第三期上。
When Dr. Harding first notified me that the committee on psychiatry and
religion had honored me with this wonderful award I experienced an onslaught
of feelings, primarily great pleasure and also pride at being in the
company of former recipients, all of them thinkers I have much admired. I
was particularly delighted to learn that the first recipient of the Oscar
Pfister prize was one of my mentors, Jerome Frank, whom I am pleased to
inform you is, at the age of 93, as thoughtful, curious, and coherent as
ever.
当哈丁博士告诉我精神病学与宗教委员会将这个大奖颁给我的时候，我感觉心如潮涌，
主要是喜悦，还有为成为获此殊荣者中的一员而感到的骄傲，之前获奖的那些思想者
我都非常崇敬。我尤其高兴地得知首届奥斯卡菲斯特奖获得者是我的导师之一， 杰罗
姆弗兰克，我很高兴地告诉大家，他现在已93岁高龄，而他的多思、好奇和连贯一如既
往。
But there were also other feelings – more complicated, quirky, dark,
difficult to express. “Religion? Me? There must be some mistake.” Hence,
my first words of reply to Dr. Harding were: “Are you sure. You know I
regard myself as a practicing atheist?” His immediate response to me was:
“We believe that you’ve dedicated yourself to religious questions.” The
graciousness of his reply disarmed me and brought to mind many conversations
with my former therapist and, later, my dear friend, Rollo May, who
insisted on regarding my textbook, Existential Psychotherapy, as a religious
book. I remember, too, that Lou Salome referred to Nietzsche as a religious
thinker with an anti-religion perspective.
此外，还有很多其他感受——更加复杂、诡异、黯淡，更难以表述。“宗教？我？一定
是搞错了。”因此，我对哈丁博士的第一个答复是：“你确定？你知道我一直把自己
看作是现实的无神论者。”他立刻回答我：“我们认为你一直献身于解决宗教问 题。
”他的这个美妙的回答让我立刻投降，我想到我和我过去的治疗师之间的很多次谈话，
以及后来，我亲爱的朋友罗洛梅坚持认为我的教材《存在主义心理治疗》 是一本论述
宗教的书。我还想到，露‧莎乐美曾说尼采是位反宗教的宗教思想家。
My talk today will focus on the issues raised by these dissonant feelings
and especially on some of the existential therapeutic issues that, as Dr.
Harding points our, are often considered to be religious in nature.
今天我的讲话将集中于这些纷繁的感受引发的一些问题，尤其是那些有关存在主义心理
治疗方面的问题，因为，正像哈丁博士指出的，这些问题本质上是与宗教相关的。
I’ll also sketch out some comparisons between existential psychotherapy and
religious consolation. I believe these two approaches have a complex,
strained relationship. In a sense, they are cousins with the same ancestors
and concerns: they share the common mission of ministering to the intrinsic
despair of the human condition. Sometimes they share common methods – the
one to one relationship, the mode of confession, of inner scrutiny, of
forgiveness of others and self. In fact, more and more as I’ve grown older,
I consider psychotherapy as a calling, not as a profession. And yet, still,
it is true that the core beliefs and basic practical approaches of
psychotherapy and religious consolation are often antipodal.
我还想对存在主义心理治疗和宗教慰藉做些简要的对比。我相信这两方面有一种复杂的
关系。从某种意义上说，它们是有着共同祖先、共同关注点的表亲：它们共同承担着
处理人类固有的绝望的任务。有时它们还使用同样的办法——一对一的关系，忏 悔、
内省、原谅自己和他人的模式。事实上，随着年龄增长，我越发把心理治疗看作是一种
感召，而不是职业。尽管如此，心理治疗与宗教慰藉在核心信念和基本实 行方式上还
是完全不同的。
It is true that throughout history, or at least from the first to the mid
17th century, the thinkers who were most concerned about issues of existence
were rooted in the religious wisdom traditions – not necessarily that
their insights emanated from fundamental religious beliefs but that the
religious institutions provided the sole arena which promoted and supported
such intellectual activity. One can delineate both positive and negative
aspects to this phenomenon: positive in that religious institutions
encouraged and sponsored (indeed, for many centuries, were the sole sponsors
of) philosophical inquiry, negative in that religious institutions often
restricted what could be thought and which problems could be examined.
的确，在历史长河中，至少在17世 纪中叶之前，关注存在的那些思想家们都是根植于
传统宗教智慧的——不是说他们的洞见一定来自于基本的宗教信仰，而是说宗教机构是
宣扬和支持那些智力活动的 唯一场所。我们可以从正反两方面来看待这一现象：积极
的一面是宗教机构鼓励并资助（在很多世纪里，是唯一的资助者）哲学探究，消极的一
面是宗教机构经常对 那些事情可以思考、哪些问题可以检验加以限制。
Nietzsche once said, (BGE)
尼采曾说：
“Gradually it has become clear to me what every great philosophy so far has
been: namely, the personal confession of its author and a kind of
involuntary and unconscious memoir.; also that the moral (or immoral)
intentions in every philosophy constituted the real germ of life from which
the whole plant has grown.”
“渐渐地我开始清楚，到目前为止每种伟大的哲学思想是什么：即作者个人的自白和一
种非自愿非自觉的回忆录；我也清楚地看到那些每种哲学中的道德的（或不道德的）意
向构成了整株植物赖以生长的胚芽。”
Though such perspectivism runs the risk (which Nietzsche was delighted to
take) of denying the possibility of any fixed truth, still I take his words
seriously and I’ll sketch in the origins of my own religious point of view
and intellectual positions.My early religious training was a pedagogical
disaster – my family’s orthodox Jewish synagogue was cloaked in rigid
unyielding, authoritarianism which I found highly distasteful. In the long
run, that was decisive for me because I lost any possibility of faith early
in life. Schopenhauer reminds us that religious faith, if it is to thrive,
has to be planted and take root in childhood. In his words, “The capacity
for faith is at its strongest in childhood; which is why religions apply
themselves before all else to getting those tender years into their
possession.” Hence, I’ve never been burdened with early planted faith and
I’ve taken the position that faith, like so many other early irrational
beliefs and fears, is a burden.
尽管这种观点存在着否认终极真理存在的可能性的风险（尼采是很乐意承担风险的），
我还是认真接受他的话，下面我就简要描述一下我自己的宗教观点和立场的来源。我
的早期宗教培训是一场教学灾难——我家庭的正统犹太教堂披着严格僵化的权威 主义
外衣，这很不合我的胃口。在很长时期内，那对我有着决定性影响，因为我在生命的早
期失去了任何信仰的可能性。叔本华提醒我们，宗教信仰如果要生长繁 茂，一定要种
植并扎根在童年时期。用他的话说：“信仰的能力在童年时是最强大的，这就是为什么
各种宗教要把占据幼年时期当成它们的首要任务。”我没有早期 就根植的信仰，并且
采取了一种立场，认为信仰和许多其他早期的不合理信念与恐惧一样，是一种负担。
Again in Schopenhauer’s term, “Religion is truth expressed in allegory and
myth and thus made accessible and digestible to mankind at large.” But
when short-sighted religious teachers either personally mistake the allegory
and the metaphor for historical truth or may make a deliberate choice to
teach in that fashion and substitute biblical authority for all forms of
reason, they run the risk of alienating certain students, and I was one of
those who were alienated early.
叔本华还说过：“宗教是用寓言和神话表达的真理，为此可以让多数的人理解和接受。
”但是，当短视的宗教导师或者个人化地错解了真理的寓言，或者因为各种原因故意采
用那样一种方式去取代圣经的权威，他们很可能会失去一些学生，而我就是其中之一。
Gradually my understanding of existence led me more and more to a scientific
, materialistic world view. I resonate greatly with the views of
Schopenhauer, Voltaire, Nietzsche, Freud. In fact, recently while preparing
these remarks I reread Freud’s writings on religion (The Future of an
Illusion) and was at first surprised to see how closely I agreed with him
until it occurred to me that these very writings had, no doubt, been
instrumental in shaping my own beliefs. I grew to believe that religious and
the scientific world view were incompatible – I felt sympathetic to
Schopenhauer’s metaphor of religion being like a glow worm that was only
visible in the darkness. Schopenhauer predicted, incidentally, that once the
light of scientific insight dispelled the darkness of ignorance, religions
would shrivel. Given the current resurgence of religious belief in the
United States, it’s very curious how far off the mark was this prediction.
渐渐地，我对存在的理解把我带到了一个更科学更唯物的世界观中。我非常认同叔本
华、伏尔泰、尼采、弗洛伊德的观点。事实上，在我最近准备这些讲话时，我重读了弗
洛伊德有关宗教的著作（《一种幻象的未来》），起初我惊讶于我与他的观点 的相似
，直到我突然意识到，这些作品毫无疑问就是我塑造自己的信仰的工具之一。我一直相
信宗教和科学世界的观点是不相容的——我认同叔本华的比喻：宗教就 像萤火虫，只
能在黑暗中才能看到。叔本华曾预测，一旦科学的洞见之光驱散了无知的黑暗，宗教就
会萎缩。尽管宗教信仰近来在美国有所复苏，他的预见还是令人 惊讶。
I also find myself much in agreement with the views expressed so well in
Francis Crick’s (the DNA Nobel laureate) recent book (The Astonishing
Hypotheses). The first lines of his book are:
我同样很同意弗朗西斯克里克（DNA领域的诺贝尔奖获得者）在新书《令人惊奇的假设
》中很好地诠释的观点。书的开头是这样写的：
“The astonishing hypotheses is that you, your joys, your sorrows, your
memories, and your ambitions, your sense of personal free will, are in fact
no more than the behavīor of a vast assembly of nerve cells and their
associated molecules.”
“这个令人惊奇的假设是：你、你的快乐、你的悲伤、你的记忆、你的雄心以及你的个
人的自由意志，事实上都只不过是一大堆神经细胞和与之相连的分子的活动。”
I believe that... extraordinary claims require extraordinary evidence
我相信这个假设……不寻常的主张需要不寻常的证据
I might add to this list of human experiences that are the result ultimately
of electro-chemically powered neuronal behavīor such other experiential
phenomena as the sense of the Atman, the divine spark, the Buddha nature,
the soul, the sacred ground, as well as longings for satori, nirvana,
enlightenment, salvation. To my mind, this materialistic, or let’s refer to
it as a naturalistic, view of mind is lamentable, humbling, and distasteful
, yet obvious and inescapable. I can tell you that I very much want to
contain the divine spark, I crave to be part of the sacred, to exist
everlastingly, to rejoin those I’ve lost – I wish these things very much
but I know these wishes do not alter or constitute reality. I believe that
these extraordinary claims require extraordinary evidence – and I mean by
that evidence beyond pure experience which as we therapists know is fragile,
fallible, rapidly shifting, and vastly influenceable.
在这个最终源于电子-化 学能量推动的神经元活动的一系列人类体验列表中我还可以加
上其他经验现象，比如内在本源的概念、神圣的火花、佛性、灵魂、圣地，以及对顿悟
、涅磐、启示、 救赎的渴望。对我而言，这种唯物主义的，或者说是自然主义的观点
是可悲的、令人羞耻的、不愉快的，但同时也是明显的、无法逃避的。我可以告诉你们
我非常想 拥有神圣的火花，我恳求成为神圣的一部分，可以永远地存在下去，可以重
新加入那些我已经失去的——我非常希望能如此，但是我知道这些愿望不能改变或构建
现 实。我相信这些不寻常的主张需要不寻常的证据——我指那种超越单纯体验的证据
，我们治疗师都知道那些单纯体验是脆弱、可能出错、经常变化、易受影响的。
The current writers on this topic who seem to express my own position most
clearly, who express the scientific position while retaining the sense of
awe and mystery inherent in life (much like Santayana and Spinoza/s atheism
(or pantheism), and which retain a true piety toward the universe and
respect for other’s belief systems) are individuals such as Carl Sagan in
his book The Demon Haunted World and Chet Raymo, the distinguished physicist
(and Catholic) in his book Skeptics and True Believers.
在当代讨论这个主题的作家中，最清晰地阐述我的立场——相信科学，同时又保留对生
命本质的敬畏感和神秘感（很像桑塔亚纳和斯宾诺莎的无神论或泛神论，对宇宙和他
人的信念体系怀有虔诚和尊敬）——的人有《鬼魂出没的世界》的作者卡尔萨根 和《
怀疑论者与真实的信仰》的作者，著名的物理学家（也是天主教徒）切特雷蒙。
It’s not easy to acknowledge one’s lack of belief in this country today –
where over 80% of Americans profess on the Gallup poll to believe in life
after death. These figures are, as we know, vastly higher than reported
rates from any other nation. Anywhere from 40 to 70 percent of people in
France, Sweden, Denmark, Austria, Great Britain, the Netherlands, Japan and
the Czech Republic believe that there is, alas, no life after death. Only 3%
of Americans will say they don’t believe in God in contrast to 6-7 times
that number in European countries. Though it is difficult for me not to feel
peripheralized when reading these national polls about religious belief,
still I believe that my views differ little from those of the overwhelming
majority of the academics and therapists with whom I associate.
今天在这个国家承认自己缺乏信仰不是一件容易的事——盖洛普调查显示超过80%的美
国人相信死后生命的存在。这个比率比我们所知道的任何其他国家的比率都要高很多。
法国、瑞典、丹麦、澳大利亚、英国、荷兰、日本、捷克等国都有40%-70%的人认为死
后是没有生命存在的。在美国，只有3%的人会说他们不信仰上帝，而在欧洲国家，这一
比例会高六七倍。尽管这些调查结果的显示让我很难不把自己看作是局外人，我还是相
信我的观点和那些我接触到的绝大多数学者和治疗师的观点没什么不同。
My college education was a science-based, premedical curriculum permitting
only a few electives that I invariably devoted to courses in literature. I
was a voracious reader of fiction, still am, and in my adolescence was
transfixed by those novelists – especially the great Russian and French
existential writers – who explored fundamental questions of death, meaning,
freedom, and relationship.
我的学院教育是以科学为基础的医学预科课程，只有几门选修课，而我每次都会选文学
课。我当时是一个痴迷于小说的贪婪的读者，现在仍是。在我青春期的时候，那些揭示
死亡、意义、自由、关系等基本命题的伟大的俄国和法国的存在主义作家尤其给我震撼。
In my psychiatric training, the eclecticism of the psychiatric residency
curriculum at Johns Hopkins where I encountered such teachers as John
Whitehorn and Jerome Frank suited me well. I entered into a long personal
orthodox analysis but felt dissatisfied with the rigid and impersonal
posture of the analyst. And felt dissatisfied, too, with the then narrow and
reductionistic analytic belief system – at times analytic doctrine felt to
me uncomfortably similar to a religious fundamentalist venue.
在我接受精神病学培训期间，约翰霍 普金斯大学的精神卫生住院医师培训宣扬折中主
义，从中我接触到了像约翰怀特霍恩那样的老师，而杰罗姆弗兰克很适合我。我接受了
一个长程的正统精神分析，但 是对分析师僵硬、缺乏个人情感的状态感觉失望。同时
让我失望的是，在当时那个狭窄且日益萎缩的精神分析信念体系下，精神分析的信条有
时候给我一种类似正统 宗教主义者管辖地的不舒服的感觉。
In my 2nd year of training Rollo May’s book “Existence” was published and
had an enormous impact upon me, opening up a whole new perspective on
viewing and ameliorating despair. My daily discussions with my wife who was
writing her doctorate dissertation in comparative literature on Kafka and
Camus contributed to my increasing interest in existential writers and while
a third year resident I enrolled in my first course in philosophy. From
that point on I have spent considerable time in independent and guided
philosophical study, concentrating on those philosophers exploring the human
condition – hard to know how to refer to them – no philosopher ever
embraced the term, existentialist – perhaps, the older term lebens-
philosoph (life philosopher) is best. I’ve been particularly drawn to the
presocratics, the stoics, Lucretius, Schopenhauer, Sartre, Camus, Heidegger,
Nietzsche, Corlis Lamont, and Santayana.
在我接受培训的第二年，罗洛梅的《存在》出版了，它对我产生了巨大影响，为我开启
了审视和改善我的绝望的新窗口。我的妻子当时正在写关于卡夫卡和加缪的比较文学
的博士论文，与她的讨论增加了我对存在主义作家的兴趣，于是我在第三年选修 了哲
学。从那一刻起到现在，我花了大量的时间进行独立的或跟从导师的哲学研究，主要关
注那些揭示人类状态的哲学家——不知道该怎样称呼他们——没有哪个哲 学家确定过
这个名称，也许可以叫存在主义者，最好用更老一点的词，生命哲学家。我也曾特别关
注过前苏格拉底派、斯多葛学派、卢克莱修、叔本华、萨特、加 缪、海德格尔、尼采
、考利斯拉蒙特以及桑塔亚纳。
But philosophy has always served me more for confirmation than for
inspiration. My major teachers were always my patients and for decades I
fashioned my clinical work to help me explore relevant philosophic issues. I
learned early on that a therapist cannot easily address raw existential
issues: they are so anchored to dread that they appear evanescently only to
be quickly replaced by the distractions of quotidian life. Consequently I
began to search for and concentrate my clinical practice on those patients
who, for one reason or another, were forced to confront fundamental issues
of life and death. One of the great advantages of being a member of the
Stanford University academic faculty was that I had the resources and
freedom to select my patients carefully and without regard to economic
remuneration. These were of course in the halcyon pre-managed care days, the
days before university hospitals, one after the other, began filing for
bankruptcy.
但是哲学对我的意义更多是确认，而不是启示。我的老师更多来自我的患者，在这几十
年中，我坚持用我临床工作的方式帮助我探索相关的哲学课题。很早我就意识到治疗
师是不可以轻易地不经加工地提出存在主义命题的，因为它们与恐惧有着太紧密 的联
系，以至于刚一出现就会迅速地被日常生活中的事物所取代而迅速消失。于是，我开始
寻找并将我的临床实践专注于那些由于某种原因不得不面对生死的基本命 题的病人。
成为斯坦福大学教员的最大好处就是我有足够的资源和自由去认真选择我的病人，而不
必担心经济报酬的问题。当然，这些工作都是在平静的前管理保健阶段，在没有入院之
前，一个接着一个，开始
For a number of years I chose to treat patients who were forced on a daily
basis to confront finitude – these were individuals with metastatic cancer
and I worked with them first in individual therapy and then gradually
developed the courage to treat them in a group setting. Later I concentrated
on grief, both spousal and parental, and focused especially on the ways in
which grief confronts us not only with loss but with our own mortality.
在很多年里，我选择治疗那些每天都要面对生命的有限性的人——那些转移性的癌症患
者，我开始是以个体方式进行，后来逐渐鼓起勇气为他们做团体治疗。再后来我又专注
于处理那些失去配偶或父母的悲伤，尤其关注那种不仅包含对丧失也包含对我们自身终
极命运的悲伤。
Eventually I grew to believe that I had something to say about an
existential approach to therapy and spent years writing a text on the
subject – a text with the arresting, dramatic title of Existential
Psychotherapy. The term is a vague one and before proceeding farther allow
me to offer a fairly uninformative definition of existential psychotherapy.
最终我认为我在存在主义治疗方面有了一些积累可以与大家分享，于是花费了几年的时
间写下这个主题的教材——书名生动引人《存在主义心理治疗》。这个名称比较模糊，
在继续讲述之前，请允许我对其做一个粗浅的定义。
Existential psychotherapy is a dynamic therapeutic approach which focuses on
concerns pertaining to existence.
存在主义心理治疗是一种专注于与存在相关的思虑的动力治疗方法。
I warned you the definition would be uninformative. Let me dilate it by
clarifying the phrase “dynamic approach.” Dynamic has both a lay and a
technical definition. The lay meaning of dynamic (derived from the Greek
root, dunasthi – to have power or strength) implying forcefulness or
vitality (to wit, dynamo, a dynamic football runner or political orator) is
obviously not relevant here. But, if that were the meaning of dynamic, then
where is the therapist who would claim to be other than a dynamic therapist,
in other words, a sluggish, or inert therapist?
我说过这个概念是很粗浅的，缺乏实际意义的。让我再详细阐释一下“动力治疗方法
”。动力既有通俗的概念也有专业的概念。通俗的概念（来自希腊语的“根”，表示有
力量）表示有活力、有力量，显然这与我们要说的意思无关。但是，如果那就 是“动
力”的含义，那么有哪个治疗师会愿意声称自己不是一个有动力的治疗师，换而言之，
是个迟缓的，有惰性的治疗师呢？
No, I use “dynamic” in its technical sense which retains the idea of force
but is rooted in Freud’s model of mental functioning which posits that
forces in conflict within the individual generate the individual’s thought,
emotion, and behavīor. Furthermore – and this is a crucial point – these
conflicting forces exist at varying levels of awareness; indeed some are
entirely unconscious.
不，我使用“动力”一词是想用它专业的概念，它保留力量的含义，但是是源于弗洛伊
德的精神功能模式，认为个体内在冲突产生的力量引发个体的思维、情感和行为。进而
言之——这一点至关重要——这些冲突力量存在于不同的意识层面，事实上，有一些是
完全无意识的。
So, existential psychotherapy is a dynamic therapy which, like the various
psychoanalytic therapies, assumes the presence of unconscious forces which
influence conscious functioning. However, it parts company from the various
psychoanalytic ideologies when we ask the next question: what is the nature
of the conflicting internal forces?
因此，存在主义心理治疗是一种动力治疗，像各种精神分析治疗一样，假定存在着无意
识力量影响着意识功能。然而，当问到下一个问题的时候，二者就分道扬镳了：这些内
在的冲突力量的本质是什么？
The existential psychotherapy approach posits that the inner conflict
bedeviling us issues not only from our struggle with suppressed instinctual
strivings or internalized significant adults or shards of forgotten
traumatic memories, but also from our confrontation with the “givens” of
existence.
存在主义心理治疗方法认为令我们苦恼的内在冲突问题不仅来自我们与被压抑的本能欲
望或者内化的重要成人或者被忘记的创伤经历的斗争，还来自我们与存在的“给定”的
对峙。
And what are these “givens” of existence? If we permit ourselves to screen
out or ‘bracket’ the everyday concerns of life and reflect deeply upon
our situation in the world, we inevitably arrive at the deep structures of
existence (the “ultimate concerns,” to use theologian Paul Tillich’s
salubrious term). Four ultimate concerns, to my view, are highly germane to
psychotherapy: death, isolation, meaning in life, and freedom. These four
themes form the spine of my textbook and I shall elaborate upon them as I
proceed today.
什么是存在的“给定”呢？如果我们允许自己把对生命的日常思虑像影像一样呈现出
来，然后深入反思我们在世界上所处的形势，我们就会不可避免地达到存在的深层结构
（引用神学家保罗特里茨的健康术语说叫“终极关切”）。在我看来，四种终 极关切
与心理治疗密切相关：死亡、孤独、生命的意义和自由。这四个词构成我的课本的主干
，在我今天接下来的演讲中，我将对其详细阐释。
What does Existential therapy look like in practice? To answer that question
one must attend to both “content” and “process” – the two major
aspects of therapy discourse. “Content” of course is just what it says –
the precise words spoken, the substantive issues addressed. “Process”
refers to an entirely different and enormously important dimension: the
interpersonal relationship between the patient and therapist. When we ask
about the ‘process’ of an interaction, we mean: what do the words (and the
nonverbal behavīor as well) tell us about the nature of the relationship
between the parties engaged in the interaction?
在实践中存在主义治疗是怎么样的？要回答这个问题，我们必须关注“内容”和“过程
”这两个心理治疗谈话的重要方面。“内容”当然指说了什么——使用的具体语言，
表达的实际问题。“过程”指的是一个完全不同并且非常重要的维度：患者与治 疗师
之间的人际关系。当我们询问一个互动行为的“过程”，我们指的是：语言和非言语行
为向我们揭示了互动各方之间关系的哪些本质？
If my own therapy sessions were observed, one might often look in vain for
lengthy explicit discussions of death, freedom, meaning, or existential
isolation. Such existential content may only be salient for some patients (
but not all patients) at some stages (but not all stages) of therapy. In
fact, the effective therapist should never try to force discussion of any
content area: therapy should not be theory-driven but relationship-driven.
如果观察我的心理治疗，你可能常常看不到关于死亡、自由、意义和存在的孤独的长篇
直接讨论。那些存在主义的内容只对某些患者（不是所有患者）在治疗的某些阶段（
不是所有阶段）比较易见。事实上，有效的治疗师任何时候都不应该努力设定谈 话的
内容领域：治疗不该是理论导向的，而应是关系导向的。
But observe these same sessions for some characteristic process deriving
from an existential orientation and one will discover another story entirely
. A heightened sensibility to existential issues deeply influences the
nature of the relationship of the therapist and patient and affects every
single therapy session.
但是，还是同样的这些治疗，如果去观察源于存在主义的典型过程，你就会发现完全不
同的情况。对存在主义课题的提升的敏感度深刻地影响着治疗师和患者之间的关系，也
影响着每一次会谈。
Perhaps I can best elaborate upon that with some comments upon the basic
nature of the therapeutic relationship. What’s the best term for our
relationship with those we treat? Patient/therapist, client/counselor,
analysand/analyst, client/facilitator, or the latest – and, by far, the
most repulsive – user/provider? The choice is uncomfortable for me because
none of these phrases accurately conveys my sense of the therapeutic
relationship. Though I, for convenience, refer to the patient/therapist
alliance, inwardly I believe there is something to be said for thinking of
patients and therapists as fellow travelers, a term which abolishes
distinctions between “them” (the afflicted) and “us” (the healers).
或许我可以用一些对于治疗关系的基本本质的论断对此做出更好的阐释。最好地描述我
们与我们治疗的那些人之间的关系的词汇是什么？患者/治疗师，客户/咨询师，精神分
析接受者/精神分析师，客户/辅助者，或者是最近出现的——也是目前为止最让人排斥
的——享用者/提供者？这种选择对我来说很不舒服，因为这里面没有一组能准确传达
我对治疗关系的感觉。尽管为了方便，我使用了患者/治疗师这一组，在内心里，我认
为还需要表达出把双方看作旅伴的感觉，一个能消除“他们”（痛苦者）和“我们”（
治疗者）之间差别的术语。
Andre Malraux, the French novelist, described a country priest who had taken
confession for many decades and summed up what he had learned about human
nature in this manner: “First of all, people are much more unhappy than one
thinks ... and there is no such thing as a grown-up person.” Everyone –
and that includes therapists as well as patients – is destined to
experience not only the exhilaration of life, but also its inevitable
darkness: disillusionment, aging, illness, isolation, loss, meaninglessness,
painful choices, and death.
安德烈马尔罗，法国小说家，描写过一个乡村牧师，他倾听了几十年忏悔之后，这样总
结他从中了解到的人性：“首先，人们比我们以为的更不快乐……并且没有一个人是
所谓成熟完善的。”每个人——包括治疗师和患者——都注定不仅要体验生命的 愉快
，也不可避免要体验它的阴暗面：幻灭、衰老、疾病、孤独、丧失、无意义、痛苦的抉
择，还有死亡。
No one put things more starkly and more bleakly than Schopenhauer:
没有人比叔本华的表述更透彻更黯淡：
“In early youth” Schopenhauer says, “as we contemplate our coming life,
we are like children in a theater before the curtain is raised, sitting
there in high spirits and eagerly waiting for the play to begin. It is a
blessing that we do not know what is really going to happen. Could we
foresee it, there are times when children might seem like condemned
prisoners, condemned, not to death, but to life, and as yet all unconscious
of what their sentence means.”
“在青少年时期”叔本华说，“我们预期未来的生活，就像剧场里孩子在大幕拉开之前
，兴奋渴望地等待剧目开演。我们不知道后面会发生什么，这是我们的幸运。如果我们
能预见未来，我们就会像被判了刑的孩子，不是死刑，而是终生监禁，但却完全不明白
这个刑罚是什么意思。”
Though Schopenhauer’s view is colored heavily by his own personal
unhappiness, still it is difficult to deny the inbuilt despair in the life
of every self-conscious, free-thinking individual. My wife and I have
sometimes amused ourselves by planning imaginary dinner parties for groups
of people sharing similar propensities – for example, a party for
monopolists, or flaming narcissists, or artful passive-aggressives we have
known or, conversely, a “happy” party to which we invite only the truly
happy people we have encountered. Though we’ve encountered no problems
filling all sorts of other whimsical tables, we’ve never been able to
populate a full table for our ‘happy people’ party. Each time we identify
a few characterologically cheerful people and place them on a waiting list
while we continue our search to complete the table, we find that one or
another of our happy guests is eventually stricken by some major life
adversity – often a severe personal illness or that of a child or spouse.
尽管叔本华的观点染上了浓烈的个人苦闷经历的色彩，我们还是很难否认每一个有自我
觉察、自由思想的个体对于生命的内在绝望。我与妻子有时会自娱地计划一些想像中
的为类似人群举办的晚宴——例如，我们认识的一些独占论者，或者热恋的自我 陶醉
者，或则刁专的被动攻击者，又或者，相反的，办一个“快乐”晚宴，只邀请我们遇到
过的真正快乐的人。尽管我们可以毫不费力地为其他古怪的派对邀请到足 够的人，我
们从来都没能为“快乐”派对邀请到足够的人。每当我们确认了几个典型的开心的人，
把他们放到邀请列表里，等待继续搜寻到可以填满桌子的人，我们 就发现我们的某个
开心客人遭到了某种大的生活不幸的打击——常常是自己或孩子或配偶生了大病。
This tragic but realistic view of life has long influenced my relationship
to those who seek my help. During my training I was often exposed to the
idea of the “fully analyzed therapist,” – remember that fairy tale? But
as I have progressed through life, formed intimate relationships with a good
many of my therapist colleagues, met the senior figures in the field, have
been called upon to render help to my former therapists and teachers, and
have, myself, become a teacher and an elder, I have come to realize the
mythic nature of this idea. We are all in this together and there is no
therapist and no person immune to the inherent tragedies of existence.
这个悲哀的，但却现实的生活观长期影响着我与那些向我寻求帮助的人之间的关系。在
我接受培训期间，我常常接受到所谓“被彻底分析过的治疗师”的概念——还记得那
个童话吗？但是，随着我生活阅历的增长，我与很多治疗师同行建立了亲密的关 系，
遇到了此领域中德高望重的人物，被要求为我从前的治疗师和老师提供帮助。我知道我
们都是一样，没有一个治疗师也没有一个人对存在的固有悲剧具有免疫 力。
When I speak of the ultimate concerns, of death, meaning, freedom, isolation
, I am obviously veering close to the domain which is the stuff of every
religious tradition. It is indisputable that religious belief and practice
has been ubiquitous throughout the ages – has there ever been a culture
discovered without some form of religious observation? Sometimes it is
suggested that the omnipresence of religious belief constitutes confirmation
or validation of an omnipresent divinity.
当我谈到死亡、意义、自由、孤独这些终极关切的时候，很明显我接近了宗教的领域。
毫无疑问，宗教信仰和宗教实践在各个时代普遍存在——至今为止有哪一种文化是看不
到任何宗教的痕迹的吗？有时，人们会说宗教信仰的普遍存在证明了的确有一个无所不
在的神存在。
As many do, I take the reverse position – in other words, that, throughout
history, every being in every culture has had to deal with the ultimate
concerns and has sought some way to escape the anxiety inbuilt in the human
condition. Every human being experiences the anxiety accompanying thoughts
of death, meaninglessness, freedom (that is, the fundamental lack of
structure in existence, das nichts) and fundamental isolation – and
religion emerges as humankind’s basic attempt to quell existence anxiety.
Hence the reason that religious belief is ubiquitous is that existence-
anxiety is ubiquitous. Rather than being created by Gods, it seems obvious
that we create Gods for our comfort and, as philosophers have pointed out
since the beginning of the written word, we create them in their own image.
As Xenophanes, the Presocratic free-thinker, wrote 2500 years ago, “If Lion
could think, their Gods would have a mane and roar.”
和很多人一样，我持相反的观点——换句话说，纵观历史，每种文化中的每个人都不得
不面对那些终极关切，于是他们要寻求某种方式去逃脱根植于人类处境之中的焦虑。
每个人都要体验那些与死亡、无意义、自由（意味着在存在中缺乏结构的基本状 态）
以及基本孤独相伴随的焦虑——于是宗教就随着人们对抗存在焦虑的愿望应运而生。因
此，宗教信仰普遍存在的原因是存在焦虑的普遍存在。很明显是我们为了 安慰自己而
创造了上帝，而不是上帝创造了我们，正像刚有文字记载时就有哲学家指出的那样，我
们在自己的想像中创造了他们。正像前苏格拉底时代的自由思想家 色诺芬尼在2500年
前写下的：“如果狮子会思考，它们的上帝会有鬃毛和狮吼。”
Let me turn now to a consideration of some psychotherapeutic as well as
religious efforts to assuage existence anxiety. Consider first the ultimate
concern of meaninglessness.
现在让我来谈谈一些心理治疗以及宗教对减轻存在焦虑所做的努力。首先看看终极关切
中的无意义这个主题。
We humans appear to be meaning-seeking creatures that have the misfortune to
be thrown into a world devoid of intrinsic meaning. One of our major life
tasks is to invent a purpose in life sturdy enough to support a life. And
then next we have to perform the tricky maneuver of subsequently denying
personal authorship of this purpose so as to conclude that we “discovered”
it – that it was “out there” waiting for us.
我们人类似乎是寻求意义的生物，而很不幸，我们却进入了一个本质上缺乏意义的世
界。我们的生命使命之一就是为生命找一个足够有说服力的目标以支撑我们生命的延续
。然后，我们又不得不随之耍个花招来否认我们自己就是这个目标的创作者， 于是我
们说我们“发现”了它——它一直“就在那里”等着我们。
Our ongoing search for substantial purpose in life systems often throws us
into a crisis. More individuals seek therapy because of concerns about
purpose in life than therapists often realize. Jung, for example, estimated
that one third of his patients consulted him for that reason. The complaints
take many different forms: for example, “My life has no coherence,” “I
have no passion for anything,” “Why am I living? To what end? Surely life
must have some deeper significance.” “I feel so empty – watching TV every
night makes me feel so pointless, so useless.” “Even now at the age of
fifty I still don’t know what I want to do when I grow up.”
我们不停地寻求生命体系的实质目标的过程常常令我们陷入危机。为了寻求生命的意义
而接受心理治疗的个体往往比治疗师意识到的要多。荣格就估计他的患者中为这个原
因找他咨询的人占三分之一。此类抱怨有很多形式，比如：“我的生活缺乏连贯 性”
，“我对任何事都没有激情”，“我为什么活着？结局是什么？生命当然要有更深层的
意义”，“我觉得很空虚——每晚看电视让我觉得很无聊，很没用”，“ 即使现在我
到了50岁，我还是不知道我长大了想干什么”。
I recently read a beautiful book called “The Listener,” the memoirs of
Alan Wheelis, the San Francisco psychoanalyst and
marvelous lyrical writer. One passage relevant to this discussion has stuck
in mind. The author is walking with his dog, Monty:
最近我读了一本很美妙的书“倾听者”，是圣弗朗西斯科的精神分析师兼抒情诗人艾伦
威利斯写的回忆录。其中一段与我们的话题相关的描述让我印象深刻。作者当时在遛他
的狗，蒙迪：
If then I bend over and pick up a stick, he is instantly before me. The
great thing has now happened. He has a mission. It never occurs to him to
evaluate the mission. His dedication is solely to its fulfillment. He runs
or swims any distance, over or through any obstacle, to get that stick.
如果那时我弯腰拾起一根树棍，他会立刻跑到我面前。最重要的事就这样发生了。他有
一个使命。他从不去评估这个使命，他的全部目的就是完成这个使命。他会跑或游很远
的距离，克服或穿越一切障碍，去拿到那个树棍。
And, having got it, he brings it back: for his mission is not simply to get
it but to return it. Yet, as he approaches me, he moves more slowly. He
wants to give it to me and give closure to his task, yet he hates to have
done with his mission, to again be in the position of waiting.
一旦拿到木棍，他就会把它叼回来，因为他的使命不只是拿到他，还要带回来。但是，
在他向我跑来的时候，他越跑越慢。他想把树棍给我，完成任务，但是又不喜欢完成使
命后的状态，那时他又要继续等待了。
For him as for me, it is necessary to be in the service of something beyond
the self. Until I am ready he must wait. He is lucky to have me to throw his
stick. I am waiting for God to throw mine. Have been waiting a long time.
Who knows when, if ever, he will again turn his attention to me, and allow
me, as I allow Monty, my mood of mission?
他和我一样，必须让自己服务于某种超越自身的事。在我准备好之前，他只能等待。他
很幸运有我为他扔树棍。我也在等着上帝为我扔树棍，等了很久。谁知道要等多久，他
才会把注意力转向我，像我满足蒙迪那样，满足我完成任务的心愿呢？也许这一刻永远
也不会来。
Why does that passage stay with me? It’s so seductive to think of a
preordained concrete assignment for life. Who among us has not had the wish:
if only someone would throw me my stick. How reassuring to know that
somewhere there exists a true, a real, an ordained, pre-assigned purpose-in-
life rather than only the incorporeal, gossamer, invented purpose-in-life
which it seems to me inevitably follows from the ultimate vision of our
solar system lying in ruins.
为什么这段话会留在我的脑海里？想到有一个预先设定的具体的生命使命是件多么有诱
惑力的事啊。我们中有谁没有过这样的愿望：如果有人给我扔木棍该多好。要是知道
在某处存在着一个真实的、规定的、预先布置好的生命目标，我们会安心很多， 而不
是像现在，只有虚无缥缈的、创造出来的生命目标，在我看来，这目标必定来自于对太
阳系最终毁灭的景象的恐惧。
The problem of life meaning plagues all self-reflective beings. And, of
course, religious revelation which communicates God’s ultimate personal
purpose for us is, no matter how difficult, no matter how lengthy,
deliciously welcome. How much more comforting is the religious solution to
the problem of meaning than the more rational but bleak message sent us by
nature, a message that reminds us of our miniscule place in the cosmos and
in the great chain of being? I once saw a memorable and jarring cartoon
containing several panels, each depicting some species, for example, an
earthworm, a fish, a bird, a snake, a cow. In each panel one of these
creatures was depicted as chanting the same refrain: “Eat, survive,
reproduce. Eat, survive, reproduce.” The last panel depicted a man in Rodin
’s “thinker” posture and chanting to himself, “What’s it all about?
What’s it all about?” All the other life forms seem to get the picture but
we humans just cannot get our minds around it and instead demand and then
legislate the existence of some higher purpose or mission.
生命意义的问题困扰着所有喜欢自我反思的人。当然，能传达上帝对我们每个人的特定
目标的宗教启示不论多困难、多冗长，总是让人欢迎的。在关于意义的问题上，宗教
的解决方式要比自然给我们的理性而黯淡的信息令人舒服得多，自然的信息只会 让我
们意识到我们在宇宙中、在生物链中的渺小地位。我看到过一套尖锐的、发人深省的漫
画，这漫画由几幅小图组成，每幅图上都画着几种生物，例如：蚯蚓、 鱼、鸟、蛇、
牛。在每幅画中都有一个生物在反复唱着这样的内容：“捕食、生存、繁殖。捕食、生
存、繁殖。”最后一幅画画了一个人摆着罗丹的“思想者”的姿 势，自言自语地重复
着：“这些都是为了什么？这些都是为了什么？”其他物种似乎都自得其乐，只有我们
人类总是无法释然，一定要得到、继而严格确认某种更高 级的目标或使命的存在。
Most clinical and theoretical explorations into sturdy and satisfying life-
purpose projects point to such goals as hedonism, altruism, dedication to a
cause, generativity, creativity, self actualization. It seems evident to me
that life-purpose projects take on a deeper, more powerful significance if
they are self-transcendent – that is, directed to something or someone
outside themselves – the love of a cause, the creative process, the love of
others or a divine essence.
多数医学上和理论上对令人满意的生命目的的探索得到的成果集中于：快乐主义、利他
主义、奉献于某一事业、生产、创造、自我实现。在我看来很明显，生命目的如果能
超越自我——即指向身外的事物——像对事业的热爱、创造的过程、对他人或某 神圣
本体的爱，就会更深刻、更富有意义。
The precocious success of today’s young hi-tech millionaires has often
generated a life crisis that is instructive about the limitations of non-
self-transcendent life meaning systems. These individuals begin their
careers with clear vision – they are intent on making it: earning heaps of
money, living the good life, receiving the respect of colleagues, retiring
early. And an unprecedented number of young people in their thirties have
done exactly that – until of course the end of the good times in the recent
market collapse. But then the question arises: “What now? What about the
rest of my life – the next forty years?”
今天，高科技领域里的年轻新贵们的过早成功常常引发生命危机，这对非超越自我的生
命意义体系的有限性是个有益的启示。这些个体在开始创业时目标非常明确——他们
要做到这些：挣大量的钱，过很好的物质生活、赢得同事的尊重、可以早些退 休。空
前多的年轻人在三十多岁时就达到了这些目标——当然，是在近期的市场崩盘前的黄金
时期结束之前。但是，这个问题紧接着就出现了：“现在呢？我后半辈 子（接下来的
四十年）要干什么？”
Most of the young hi-tech millionaires that I have seen continue doing much
of the same: they start new companies, they try to repeat their success. Why
? They tell themselves it is to prove it was not a fluke, to prove they can
do it alone, without a particular partner or mentor. They raise the bar. To
feel that they and their family are secure, they no longer need one or two
million in the bank – they need five, ten, even twenty-five million to feel
secure. They realize the pointlessness and irrationality in earning more
money when they already have more than they can possibly spend but they do
not stop. They realize they are taking away time from their families, from
things closer to the heart, but they cannot give up playing the game – “
the money is just lying out there” they tell me, “all I have to do is pick
it up.” They have to make deals. One real estate entrepreneur told me that
he felt he would disappear if he stopped. Many fear boredom – even the
faintest whiff of boredom sends them right back to the game.
我看到的多数年轻的高科技新贵们接下来做了同样的事：开新公司，他们想要重复他们
的成功。为什么？他们告诉自己这是为了证明他们的成功不是出于侥幸，没有某个合
作伙伴或导师的帮助，他们也可以独自做到。他们提升标准。让自己和家人有安 全感
的标准不再是银行里有一两百万存款，他们需要五百万，一千万，甚至两千五百万才能
觉得安全。他们意识到当他们已经拥有花不完的钱时继续挣更多的钱是无 意义也不理
性的，但他们就是不能停下来。他们意识到他们在从家人、从更贴近他们内心的事物那
里抢走时间，但是他们无法放弃这个游戏——“钱就在那里”，他 们告诉我，“我要
做的就是把它们捡起来。”他们不得不做生意。一个房地产商告诉我他觉得如果他停下
来他就会消失。很多人害怕无聊——即使最微弱的无聊感也 会让他们立刻回到那个游
戏中。
Unlike my approach to other existential ultimate concerns (death, isolation,
freedom) I find that, in my clinical practice, purpose-in-life is best
approached obliquely – it is best not to pursue purpose explicitly but to
allow it to ensue from meaningful and authentic engagement, from plunging
into an enlarging, fulfilling, self-transcending endeavor. We therapists do
most good by identifying and helping to remove the obstacles to such
engagement. The explicit pursuit of purpose-in-life is, as the Buddha taught
, not edifying: it is best to immerse oneself into the river of life and let
the question drift away. Incidentally, I’ll point out in passing that one
of the great privileges of our profession as therapists is that it
inoculates us against a crisis of purposelessness – that is a complaint I
very rarely hear voiced by experienced therapists.
与处理其他存在主义终极关切（死亡、孤独、自 由）的方式不同，在临床实践中我发
现，生命的意义最好间接处理——最好不要追究明确的目的，而是允许允许它在有意义
的、可信的投入之后自然出现，这种投入 可以是一种扩大、完成或自我超越的努力。
我们治疗师在这里能给予的最大帮助是确认并帮助清除这种投入之前的障碍。正像佛教
所说的，直接追寻生命的意义是无 益的：最好的办法是让自己浸入生命之河中，让这
个问题自己漂走。需要顺带指出，我们做治疗师这个职业获得的重大特权之一就是免受
无意义危机的困扰——我极 少听到有经验的治疗师发出这方面的抱怨。
I’ll turn now from meaninglessness to another ultimate concerns:
Existential Isolation. First we need to discriminate between the several
uses of isolation in our profession.
现在我要从无意义转向另一个终极关切：孤独。首先我们需要对我们职业中对孤独这一
词汇的几种用法做一区别。
There is Intra-psychic isolation which refers to separation from oneself. It
’s an old concept – think of Binswanger’s descrīption of Ellen West
where in a discussion of how she no longer knows her own opinion he says: “
This is the loneliest state of all, an almost complete separation from one’
s autonomous organism.” Freud described the defense mechanism of isolation
as the process of stripping off affect from the memory of some unpleasant
event and interrupting its associations so it is isolated from ordinary
processes of thought. Many therapists, for example Fritz Perls, often
described the therapeutic goal of helping patients reintegrate split-off
parts of themselves. Indeed, Perls christened his approach, Gestalt therapy,
to emphasize his dedication to the aim of “wholeness.” (Note the common
etymological root of whole, heal, healthy, hale.)
一种是心灵内部的孤独，指与自己隔离。这是一种旧有的概念——想想宾斯旺格对艾伦
维斯特的描述，在讨论到她如何不再了解她自己的观点时，他说道：“这是所有情形
中最为孤独的状态，与一个人自身的机体几乎完全分离。”弗洛伊德把隔离这种 防御
机制描述为：一种脱掉不愉快记忆的影响、阻止它的联结以使它与日常的思维过程相分
离的过程。很多心理治疗师，如弗里茨佩尔斯常常把心理治疗的目标描述 为帮助个案
把他们自身分裂的各部分重新整合起来。事实上，佩尔斯把他的治疗方法命名为格式塔
治疗就是为了强调他对治疗目标“完整”的投入。（注意完整—whole这个词的常见词
根含义：治疗、健康、强壮）
And there is Interpersonal Isolation which is commonly experienced as
loneliness, a ubiquitous issue in therapy. Loneliness issues from a variety
of sources – social, geographic, cultural factors, the breakdown of
intimacy sponsoring institutions in our society, lack of social skills,
personality styles inimical to intimacy – for example, schizoid,
narcissistic, exploitative, judgmental. We therapists are accustomed to
working with loneliness and are, I am persuaded, particularly effective
treating profound loneliness in a group therapy setting.
另一种指人际间的隔离，通常被体验为孤独，一种治疗中非常普遍的问题。孤独的问题
来自很多方面——社会的、地理的、文化因素上的、我们社会亲密关系支持体制的崩
溃、社交技能的缺乏、个人对亲密感的敌意模式——例如：精神分裂、自恋、剥 削性
、评判。我们治疗师都很习惯于处理孤独，并且，我相信，我们在团体治疗的情境中处
理深层的孤独会取得更好的效果。
Finally, in addition to intra-psychic and interpersonal isolation, there is
Existential Isolation which cuts even deeper; it is a more basic isolation
which is riveted to existence and refers to an unbridgeable gulf between
oneself and others, a separation not only between oneself and others but
between self and world. It is a phenomenon that, in my experience, is
experienced most keenly by patients facing death for it is as that time that
one truly realizes that one was born alone into the world and must exit
from the world alone. We may want others to be with us at death, we may die
for another or for a cause but no one can, in the slightest degree, have one
’s solitary death taken from him or her. Though we may wish that others
accompany us in death (as did rulers in several cultures of antiquity) still
dying remains the loneliest of human experiences. Consider the Everyman
drama still performed after seven centuries. Remember that when Everyman was
visited by the angel of death, he pleaded for respite or delay. When that
was refused he pleaded to be allowed to take company on his trip. The angel
of death agreed, “Sure, if you can find someone.” And for the remainder of
the drama Everyman searched for a travel companion. All his friends and
relatives declined with the flimsiest of excuses. A cousin had a cramp in
the toe. Finally he turned to allegorical figures – beauty, wisdom, wealth
– but even they declined to accompany him. With one exception – the moral
of this Christian morality play – in the final denouement Good Deeds
accompanied Everyman on his final journey.
最后，除了心灵内部和人际间的隔离，还有存在主义的孤独，这个含义更加深刻，它是
一种由存在本身决定了的孤独，指自身与外界之间无法逾越的鸿沟，这种隔离不只存
在于自身与他人之间，也存在于自身与世界之间。以我的经验看，这种现象在个 案面
临死亡时体验得最为深刻，因为在那个时刻，人们才真的意识到人是独自来到这个世界
的，也只能独自离开这个世界。我们可能会希望在死亡的时候有人陪伴， 我们可以为
某个人或某个理由死去，但是没有人有任何可能性逃避掉孤独死去的命运。尽管我们可
能希望其他人陪我们死去（就像古代很多文化中的君主一样），但 死亡仍然是人类最
孤独的体验。想想历经7个世 纪仍在上演的戏剧“普通人”。当普通人拜访死亡天使的
时候，他祈求获得暂缓。当这个请求被拒绝，他请求允许在这条路上有人陪伴。死亡天
使同意了，“当然可 以，如果你能找到这样的人的话。”在戏剧的剩余部分，普通人
一直在找这个旅伴。他的所有朋友和亲人都用最没有说服力的借口拒绝了他。一个表兄
弟的借口是脚 趾抽筋。最终他求助象征人物——美丽、智慧、财富——但是甚至他们
也拒绝陪伴他。只有一个例外——这部基督教道德剧中的道德——在最后的结局中，美
德陪伴 普通人走上了他最终这段路。
Religious consolation and psychotherapy have each developed its methods of
quelling the dysphoria of the various forms of isolation. The Oxford English
dictionary informs us that one of the roots of the word “religion” is re-
ligare – to tie or to bind. The Romans used the term religare to connote a
variety of ties – to family, to ancestors, to the state. That meaning –
tying or binding together or let us refer to it as connectivity – vividly
illuminates the similar missions of psychotherapy and religion. In fact,
connectivity is a good common denominator for all the present forms of the
contemporary spiritual search.
宗教慰藉与心理治疗在压制各种形式的孤独感引发的烦躁不安方面都发展出了自己的方
法。牛津英语词典告诉我们宗教（religion）这个词的一个词根是re-ligare，意思是
绑缚或捆绑。《罗马书》中用religare这个词暗示各种不同的绑缚——与家庭、与祖先
、与国家。这个意思——绑缚在一起，或者让我们说成是联结——生动地阐明了心理治
疗与宗教相似的使命。事实上，联结是目前的所有形式的精神探索的一个很好的共同点。
In any discussion of religion and psychiatry that term “connectivity” has
great value. Therapists place nothing above the goal of connecting with
patients as deeply and authentically as possible. The professional
literature regarding the therapist-patient relationship is replete with
discussions of encounter, genuineness, accurate empathy, positive
unconditional regard, ‘I-thou encounter.’ And group therapists place the
highest priority on establishing group cohesiveness. Once the group is
cohesive each of the members is more able to examine and strengthen his/her
relationship with each other member. In coping with death members of my
groups for cancer patients often spoke of the great comfort they experienced
from being with others who, by virtue of facing the same situation,
provided a deep connection. One of these patients offered a lovely descrī
ption of “connectivity”: “I know we are each ships passing in the dark
and each of us is a lonely ship but still it is mighty comforting to see the
bobbing lights of the other nearby boats.”
在任何有关宗教和心理治疗的讨论中，“联结”这个词都有着特别的价值。心理治疗师
把与案主建立尽可能深厚、切实的联结当做至高无上的目标。专业著作中认为治疗师-
案 主之间的关系中应充满面对、真实、准确的共情、积极的无条件关注，“你我相遇
”。团体治疗师把建立团体内聚力放在首位。一旦团体内聚力建立起来，团体中的 每
个成员就会更有能力检验和加强与其他各成员的关系。在我与癌症病人治疗团体成员的
相处中，常常听他们说到跟其他成员在一起让他们体验到怎样的安慰，他们 因为敢于
面对同样的困境而建立起了深层的联结。其中一位患者对“联结”提出了一种很可爱的
描述：“我知道我们每个人都是在黑暗中行进的一条船，我们都是各 自独立的船，但
是看到旁边船上摇摆的灯光还是让我感到莫大的安慰。”
In work with the spousally bereaved I’ve been struck by the despair
emanating from the rupture in connectivity which extends even beyond the
experience of loss. Widows and widowers speak of the pain of living an
unobserved life – of having no one who knows what time they come home, go
to bed, or woke up. And who has not seen individuals continue a highly
unsatisfying relationship precisely because they crave a life witness? And
how often do we therapists provide help from becoming our patient’s life
witness?
在针对丧偶者的工作中，我强烈感受到那种由于联结的断裂所引发的绝望，那种感觉甚
至超越了丧失的体验。丧偶者谈到过着无人关注的生活的痛苦——没有人知道他们什
么时候回家，什么时候睡觉或醒来。谁没见过尽力维持非常糟糕的关系的人呢？ 他们
这样做就是因为渴望有一个生活的目击者。我们治疗师又有多少时候是通过成为案主生
活的目击者而给他们提供帮助的？
Religion provides powerful forms of connectivity. A religious person is
offered the consolation of a personal eternally observing deity, who is not
only aware of his/her existence but also promises ultimate reunion – with
lost loved ones, with the Godhead, with the universal life force. And of
course it is readily apparent that organized religion provides connectivity
through community: the church provides a stable congregation of like-minded
individuals, sponsors enormous numbers of small groups including social
groups, special interest groups, bible study, book groups, marriage
encounter groups, singles groups. Large numbers of individuals undoubtedly
join the religious community for reasons of social connectivity rather than
allegiance to the substance of a particular religious doctrine.
宗教为人们提供了多种有力的联结形式。宗教信徒会得到一个人性化的、永恒的关注自
己的神，这个神不仅知道他/她 的存在，还承诺最后的重聚——与失去的爱人、与神性
、与宇宙的生命力重聚。当然，很明显，有组织的宗教还会通过团体提供联结：教堂为
有着相似意愿的个体提 供稳定的聚会的场所，兴办无数的小团体，包括社交团体，特
别兴趣团体，圣经学习团体，读书会，婚姻会心团体，单身团体。毫无疑问，很多人加
入宗教团体是为 了建立社交联结，而不是出于对某一特定的宗教教义的忠贞。
Death is the most obvious, intuitively apparent ultimate concern. Though
some therapists, whenever possible, avoid the subject in therapy following
Adolph Meyer’s adage, “Don’t scratch where it doesn’t itch,” most
therapists realize that concerns about death are always there, percolating
under the surface. Death haunts us as nothing else; we’ve been preoccupied
with its dark presence, often just at the rim of consciousness, since early
childhood and we have erected denial-based defenses against death anxiety
that play a major role in character formation. Many philosophers have
discoursed on the interdependence of life and death: to learn to live well
is to learn to die well and conversely to learn to die well is to learn to
live well.
死亡是最外显、最直观的终极思虑。尽管有些治疗师跟从Adolph Meyer的 格言“不要
在不痒的地方瘙痒”，大多数治疗师都意识到关于死亡的思虑一直都在，渗透于表层之
下。死亡比任何其他东西更像幽灵般萦绕着我们，从我们童年早期 就以黑暗的形式占
据了我们的内心，通常是在意识的边缘状态出现，我们对死亡焦虑都建立了以否认为主
的防御机制，这在我们的性格形成中起到重要作用。很多哲 学家论述过生与死的相互
依赖关系：学习好好地生就是学习好好地死，反过来，学习好好地死就是学习好好地生。
A confrontation with death often creates a dramatic perspective-altering
opportunity. Heidegger spoke of two modes of being. First, an “everyday”
mode in which we marvel at the way things are in the world. This is a state
of forgetfulness of being, of fleeing, of being tranquilized by the
cornucopia of objects surrounding us. And, second, an “ontological mode,”
a state of mindfulness of being in which we live authentically and marvel
that things are, marvel at the very suchness of things. In this state the
individual is primed for life-change.
濒临死亡时，常常会出现戏剧化的改变视角的机会。海德格尔说到两种存在模式。一种
是“日常”模式，在这种模式中，我们对这个世界上的事物充满惊奇。这是一种对存
在、对逃离、对从周遭的丰富事物中获得安宁的体验的健忘状态。另一种模式是 “本
体模式”，在这种模式中我们关注存在本身，这个存在就是我们的真实生活和对事物的
惊奇。在这种状态中，我们就在为生命改变做着准备。
How do we move from the everyday state to the ontological state? Jaspers
described the major vehicle as the “boundary experience” – a jolting,
irreversible experience which shifts the individual from the everyday mode
to a more authentic mode. Of all the possible boundary experiences,
confrontation with death is by far the most potent.
我们怎样才能从日常状态变为本体状态呢？雅思帕斯将主要的途径描述为“边界体验”
——一种震动的、不可逆反的体验，将个体从日常模式转变为一种更可信的模式。在所
有可能的边界体验中，濒临死亡的体验是目前来看最有力的。
Time and again, we see individuals who in a confrontation with death make
dramatic life changes. It is a familiar theme in great literature (for
example, Scrooge in The Christmas Carol and Tolstoy’s Pierre in War and
Peace, or Ivan Ilych). Cancer patients have described the experience of
reprioritizing life values and trivializing the trivia in life, of saying “
no” to the things that are unimportant, of turning full attention to loving
ones about them, to the rhythms of the earth, changing seasons, to concern
about the model of dying they set for others. In a macabre manner, cancer
cures psychoneurosis and death bestows an unmistakable bitter-sweet
poignancy to life. Still another way to put it is that though the
physicality of death destroys us, the idea of death can save us.
一次又一次，我们看到濒临死亡的个体发生重大的生命转变。这也是一个很熟悉的文学
主题（比如，《圣诞颂歌》中的Scrooge， 托尔斯泰的《战争与和平》中的皮埃尔，还
有伊凡伊里奇）。癌症患者描述过他们的体验：重新定位生命价值，不计较生活中的琐
事，对不重要的事情说“不”，全 神贯注与身边相爱的人、大地的节奏、变换的四季
、思考要为他人树立怎样的死亡的模式。癌症用一种恐怖的方式治愈了神经症，死亡安
置了苦乐参半的辛酸。还可 以换种说法，即尽管肉体的死亡摧毁了我们，死亡的观念
却能拯救我们。
But I’ve so often heard patients lament, “What a pity I had to wait for
wisdom until now, till my body was riddled with cancer.” This statement
poses a major challenge for therapists: how do we find the leverage for such
change in the absence of imminent death – in our everyday practice with
our everyday patients? Therapists with a sensibility for existential issues
may be able to utilize other less visible, more subtle boundary experiences-
for example, life era markers, retirement, the aging body, children leaving
home, the death of the other. Even such a trivial event as a birthday may
be an important route into deeper ground. We generally celebrate such days
but brief reflection upon the matter raises the question of what the
celebration is about – isn’t its function really to deny and to neutralize
the grim reminder of the inexorable rush of time?
然而，我总是听到患者悲叹：“真遗憾，我不得不等到现在才等到智慧，等到我的身体
被癌症所困。”这种悲叹为治疗师提出了一个重要挑战：在没有濒临死亡的情况下，
我们如何才能在日常的对普通案主的治疗实践中找到促成这种改变的杠杆？对存 在主
义课题比较敏感的治疗师可能能够利用其他不那么显著的，更加细微的边界体验——比
如，生命里程碑、退休、身体的衰老、孩子离开家、他人的死亡。即使像 生日那样很
小的事件也可以成为进入深层内心的重要路径。我们通常会庆祝那样的日子，但是，简
单反省一下，就会提出这样的问题：为什么要庆祝——难倒它的作 用实际上不是在否
认和压制那种对无情逝去的时间的残酷提醒吗？
Most religious doctrines, it seems to me, may make use of some of these
therapeutic approaches but for the most part the believer is offered
powerful consolation through the denial of the finality of death – through
the idea of the survival of the soul, through judgment, redemption, and
paradise, through reunion with loved ones, and with God, through
reincarnation, through merging with the universal life force.
在我看来，多数宗教教义运用了这些治疗方法中的一部分，但是最重要的是，通过否认
死亡的结局——通过灵魂不灭、审判、救赎、天堂、与爱人和上帝重聚、再生、与宇宙
生命力融合等的观念——宗教信仰者得到了最有力的安慰。
Do I try to impose my views on belief upon my patients? Of course not – my
task is to be of help and that means to be as empathic as possible to
patient’s belief system – (look out patient’s window – elaborate).
我试图用我的有关信仰的观点影响我的案主吗？当然不——我的任务是提供帮助，这意
味着要尽可能地神入案主的信念体系（用心地从案主的视角看世界）。
But even more than empathy is required: it is important that the therapist
be well-informed about the patient’s religious views – such edification
may flow from the patients themselves or from the therapists’ independent
study. I’ve sometimes worked with priests or nuns and urged them to look
more deeply into their religious beliefs in order to obtain the comfort that
should be provided therefrom. Sometimes part of the therapist’s task is to
lay bare the rationalizations that have permitted individuals to
reprioritize and elevate certain religious practices over other more central
ones – for example when excessive service to the letter of ritual takes
precedence over expression of love, charity, and community.
但是仅有神入还不够：治疗师对案主的宗教观点详细了解是很重要的——这种启示可以
来自个案本身，也可以来自治疗师的独立学习。我有时会与牧师和修女一道工作，这
时我会促进他们更深入地关注他们的宗教信仰，以便获得他们本来可以从中得到 的安
慰。有些时候，治疗师的一部分责任是明白地指出合理化过程使得有些人在排列优先顺
序时把一些宗教惯例排到了其他更核心的事物之前了——例如：对宗教仪 式表面意义
的过渡关注优先于对爱、慈善和分享的表达。
That’s how I respond outwardly to an individual’s great reliance on belief
in the absence of my own. And my inward, silent response? What is that like
? Often I experience sheer amazement at the power and persistence of our
need to believe. It does not go away: our need to believe in something
beyond biology is so remarkably tenacious that we are everywhere surrounded
by not only a variety of religious beliefs with many of them insisting upon
the uniqueness of one particular set of beliefs, but we are also surrounded
by the presences of less thoughtful and more patently irrational beliefs:
past-life channelers, abduction by extraterrestrials, clairvoyance, psychic
surgery, ghosts, witches, astrology, TM levitation, astral traveling,
dowsers, necromancy, miracles, after-death experiences, I Ching, Feng Shui,
Angels, healing crystals, palm reading, astrology, aura reading,
psychokinesis, poltergeists, exorcism, Tarot cards, precognition,
synchronicity and I’m sure each of you could add to this list. To repeat my
earlier statement, such extraordinary claims demand extraordinary proof and
no such extraordinary proof has ever been posited.
这是我通常对特别依赖宗教信仰的人的表面回答。在我内心深处的无声的回答是什么
呢？我们对信仰的需要的力量与执着常常让我感到震惊。它不会消失：我们信仰某种超
越生物之上的东西的需求是如此的顽强，以至于不论在哪里我们都会被各种不 同的宗
教信仰包围，而其中很多信仰体系坚持认为自己的这套信仰是独一无二的。但同时，我
们也会被一些相对浅薄或明显不合理的信念包围：前世时光隧道、来自 宇宙的诱导、
透视能力、精神手术、鬼魂、巫婆、占星术、TM悬 浮、星界旅行、（特异功能）探矿
、巫术、奇迹、死后体验、易经、风水、天使、疗病水晶、掌读、气味阅读、心灵制动
、敲击作响闹恶作剧的鬼、咒语、塔罗牌、 预知、同步性……我确信你们中任何一个
人都可以往这个单子里添加新项目。我再重复一下我前面说过的观点，这种超常的主张
需要有超常的证据，而那样超常的证 据从来都没出现过。
And sometimes I feel a deep sorrow for the underlying fragility of the human
condition which begets our gullibility and our powerful need to believe
that, like nascent oxygen, must and will instantaneously adhere to something
. Sometimes I fear the future because of the dangers that irrational belief
creates for our species. It is supernatural belief, not absence of belief
that may destroy us. We need only look to the past to trace out the huge
swaths of destruction that unyielding conviction has caused. Or look to
contemporary conflicts in the Mideast or the Indian
subcontinent where conflicting and unyielding fundamentalist belief systems
threaten millions. I love Nietzsche’s aphorism that it is not the courage
of one’s convictions that matters but the courage to change one’s
convictions.
有时候我对人类状况的潜在脆弱感到一种深深的悲伤，这种脆弱导致我们的轻信以及对
信仰的强烈需求，就像初生态氧一样，必须并且会立刻粘附到某种东西上。有时候我
为未来恐惧，因为不合理的信仰会给我们人类带来危险。超自然的信仰，而不是 缺少
信仰，会毁掉我们。我们只要回首过去就可以追踪到执着的信仰造成的巨大破坏的痕迹
。或者看看当前中东或印度次大陆的冲突，在那里，相互冲突的、固执的 正统教派信
仰体系正威胁着成百万人的生命。我很喜欢尼采的警句：重要的不是信仰的勇气，而是
改变信仰的勇气。
There are times when I feel (but keep to myself) sorrow as I consider the
amount of an individual’s life that can be spent in bondage to obsessive-
compulsive behavīor, and to practices of prolonged meditation or excessive
preoccupation with ritualistic practice. What is lost is some part of human
freedom, creativity and growth.
有些时候，我感觉（但我把它留在心底）难过，因为我想到一个人的相当一部分生命会
处在强制性的行为、拖延时间的冥想或过度的仪式化实践的束缚中。我们失去的是一部
分人类的自由、创造力和成长。
In his four noble truths the Buddha taught that life is suffering, that
suffering originates from craving and attachment, and that suffering can be
eliminated by detachment from craving through meditative practice.
Schopenhauer took a similar position – that the will is insatiable and that
as soon as one impulse is satisfied we enjoy only a moment of satiation
which is instantly replaced by boredom until another desire seizes us.
在四大真理中，佛教导我们：生命是苦难，这种苦难源自渴望和依赖，消除苦难的办法
是通过冥想练习超越渴望。叔本华也有类似的观点——欲望是永不满足的，一旦我们的
一种冲动得到了满足，我们享受到片刻的满足后，这满足就立刻被无聊取代，直到另一
个欲望抓住我们。
To me, these views feel unnecessarily pessimistic. I appreciate the
suffering in human existence but I never experience that suffering as so
overwhelming that it demands the sacrifice of life. I much prefer a
Nietzschian life-celebratory, life engagement, amor fati (love your fate)
perspective. My work with individuals facing death has taught me that death
anxiety is directly proportional to the amount of each person’s “unlived
life.” Those individuals who feel they have lived their lives richly, have
fulfilled their potential and their destiny, experience less panic in face
of death. Therapists have much to learn from Nikos Kazanzakis, the author of
so many great life-celebratory works of art, for example, Zorba the Greek
and The Greek Passion. Kazanzakis was, like Nietzsche, an anti-religion
religious man whose grave (placed just outside the city walls of Heraklion
on Crete, because of excommunication from the church)
bears his chosen epitaph, “I want nothing, I fear nothing, I am free.” I
love the advice he offers in his major work, A Modern Sequel to the Odyssey.
His advice for life is: “Leave nothing for death but a burned-out castle.
” It’s not a bad guideline for our life – and for our work in therapy.
对我而言，这些观点过于悲观。我感激人类存在中的痛苦，但我从未感受到那种会导致
牺牲生命的无法抵抗的痛苦。我很喜欢尼采的生命庆祝、生命契约、热爱命运的视角
。我对濒临死亡的个体的治疗工作让我了解到死亡焦虑与每个人的“没有活过的 生命
”直接相关。那些感觉自己生活丰富多彩、实现了他们的潜能、完成了他们的使命的人
在死亡面前感受到较少的恐慌。治疗师需要从Nikos Kazanzakis那里学习很多东西，他
是大量伟大的生命庆祝艺术作品的创作者，例如Zorba the Greek以及The Greek
Passion。像尼采一样，Kazanzakis是一位反宗教的宗教人士，他的坟墓（因为被逐出
教会，他的坟墓就坐落在克里特岛的Heraklion的城墙之外）上刻着他自己选的墓志铭
：“我什么都不想要，我什么都不害怕，我是自由的。” 我非常喜欢他在他的一个主
要作品《奥德赛的现代版结局》中提到的建议。他对生命的建议是：“除了一个烧毁的
城堡，什么都不要留给死亡。”这对我们的生命是一个不错的指引，对我们的治疗工作
也是如此。
Copyright © 2000 Irvin D. Yalom, M.D. |
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