Psychoanalytical Understanding of Mutuality on Illness : Focus on a Very Early Stage of Life

人が生きていく上で他者との「関係の相互性」は極めて重要である。その在りようは，患者の内的世界における対象関係に依拠している。本論文では，疾病の背後に「関係の相互性」の問題が潜んでいることを論じた。まず，人のこころにある対象関係の起源に関して精神分析的文献を概観し，人生の最早期，つまり誕生前後の母親と新生児の「関係の相互性」が，赤ん坊の内的世界の形成に最も重要であることを示した。次に，文献から3つの症例を提示し，先天性の疾患によって養育者と患者の「関係の相互性」が影響された様を描写した。患者が内在化した最早期の「関係の相互性」の在りようは，治療者との間に強力に反復され持ち込まれた。最後に，赤ん坊の自己の発達や人生を鑑みる時，日常の中で誰もが経験する疾病に着目し，疾病の背後にある「関係の相互性」を扱うことが，セラピストの重要な課題であり，患者の苦難に満ちた存在の在りように貢献する可能性を示した。The mutuality between oneself and others is crucial for human beings. Object relations in the inner world will determine the mutuality in a patient’s particular life works. This paper discusses the problems of mutuality behind physical illness. A review of the psychoanalytical literature indicated that one’s object relations are formed at a very early age, almost as early as birth. The mutuality between a mother and her newborn baby is essential to the development of the baby’s inner world. Three cases from the literature are presented to show how each patient’s congenital disease influenced the mutuality between the patient and his/her mother. Internalized mutuality in each patient’s mind is powerfully repeated onto the relationship with the therapist. In conclusion, we as psychotherapists especially need to recognize how suffering from illness influences mutuality. Considering the gross effects on the baby’s development of the self and future life, it is vital to deal with the influence of illness as a common event in daily life on mutuality and contain the overwhelming emotions that the patient projects onto us, which had not been fully understood before