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為什么阿根廷人喜歡看心理醫生

Do Argentines Need Therapy? Pull Up a Couch
為什么阿根廷人喜歡看心理醫生

BUENOS AIRES — The cafe, just north of a leafy district affectionately nicknamed Villa Freud, was almost empty. Roberto Álvarez sipped his espresso, furrowed his brow and began ticking off the names of psychologists he had seen over the past decade. He stopped counting only when he noticed that he was running short of fingers.

布宜諾斯艾利斯——這個綠樹成蔭的地區被人們親切地稱為“弗洛伊德別墅”(Villa Freud),北邊有家咖啡館,里面幾乎空無一人。羅伯特·阿爾瓦雷斯(Roberto Álvarez)喝了一口濃咖啡,皺起眉頭,開始歷數他過去幾十年看過的心理醫生的名字。他數著數著停了下來,發現自己的手指不夠用了。

“Let me tell you something about us Argentines,” said Mr. Álvarez, a 51-year-old construction worker, after a tangent on Jacques Lacan, the famous French psychoanalyst who sometimes conducted sessions with patients in taxicabs. “When it comes to choosing a psychologist, we are like women searching for the perfect perfume. We try a bit of this and a bit of that before eventually arriving at the right fit.”

“讓我告訴你我們阿根廷人的特點,”阿爾瓦雷斯說,這位51歲的建筑工人此前談論了雅克·拉康(Jacques Lacan),這位著名的法國心理學家有時候會在出租車上對病人進行心理治療。“說到挑選心理學家,我們就像尋找完美香水的女人。試試這個,試試那個,最終總能找到合適的人選。”
 

盡管精神分析療法在美國和其他國家式微,但是在阿根廷依然盛行,比如布宜諾斯艾利斯的這家診所。

Indeed, Argentines often manage a smile upon hearing that psychoanalysis has been on the wane in the United States and other countries, rivaled by treatments that offer shorter-term and often cheaper results than years invested in sessions of soul-searching. Even as Argentines grapple with high inflation and an economic slowdown, many seem to know precisely what they want (at least in one area of their lives): psychoanalysis, and plenty of it.

實際上,聽到精神分析療法在美國和其他國家式微,阿根廷人總會擠出一絲微笑,相比長達數年探索靈魂的精神分析療法,其他療法療程更短,費用通常更為便宜。即使阿根廷人備受高通脹和經濟衰退的困擾,許多人依然清楚地知道,至少在自己生活的領域他們想要什么:大量的精神分析。

The number of practicing psychologists in Argentina has been surging, to 196 per 100,000 people last year, according to a study by Modesto Alonso, a psychologist and researcher, from 145 per 100,000 people in 2008. That compares with about 27 psychologists per 100,000 people in the United States, according to the American Psychological Association.

阿根廷執業心理醫生的人數一直大幅增長,根據心理學家、研究員莫德斯托·阿隆索(Modesto Alonso)的統計,阿根廷每10萬人擁有的心理醫生人數從2008年的145名增長到去年的196名。美國心理學會(American Psychological Association)的數據顯示,美國每10萬人大約擁有27名心理醫生。

Those numbers make Argentina — a country still brooding over its economic decline from a century ago — a world leader, at least when it comes to people’s broad willingness to bare their souls.

這些數字讓阿根廷——這個國家依然對一個世紀前的經濟衰退耿耿于懷——處于世界領先地位,至少在人們愿意袒露自己的靈魂方面位居前列。

“There is no taboo here about saying that you see a professional two or three times a week,” said Tiziana Fenochietto, 29, a psychiatrist doing her residency at the Torcuato de Alvear Hospital for Psychiatric Emergencies, a public institution. “On the contrary,” said Ms. Fenochietto, who has been in therapy herself for the past eight years, “it is chic.”

“說到你每周去看兩三次心理醫生,在阿根廷沒什么見不得人的,”29歲的心理醫生蒂齊亞諾·費諾基耶托(Tiziana Fenochietto)說,她在托爾夸托·德·阿爾韋亞爾精神病醫院(Torcuato de Alvear Hospital for Psychiatric Emergencies) 做住院醫師,這是一家公立醫療機構。“恰恰相反,”費諾基耶托說,過去八年她本人也一直在接受心理治療,“這樣做很時髦。”

One need not wander far in this city to get a grip on the resilient obsession with neuroses of various stripes. The name Villa Freud is a nod not only to the Austrian founding father of psychoanalysis, but also to the number of psychologists who ply their trade in the buildings along the elegant streets around Plaza Güemes, in northern Buenos Aires.

我們在這座城市里走不了多遠,就能發現人們對各種心理疾病不同程度的癡迷。弗洛伊德別墅這個名字不僅是向奧地利精神分析之父致敬,還是對為數眾多的心理醫生的認可,他們聚集在布宜諾斯艾利斯北部的格爾梅斯廣場附近,在優雅的街道兩旁的建筑里進行心理咨詢。

A short cab ride away, in the theater district along Avenida Corrientes, lines form each night where the local adaptations of two hit plays have opened side by side: “Freud’s Last Session,” currently an imagined debate between Sigmund Freud and C. S. Lewis, and “Toc Toc,” about obsessive-compulsive disorder.

搭乘出租車走一小段路,就到了科連特斯大街旁的劇院區,目前有兩部戲的阿根廷改編版正在聯袂上演,每天晚上都有人排隊等待入場觀看,一部是《弗洛伊德的最后對話》(Freud’s Last Session),它虛構了西格蒙德·弗洛伊德(Sigmund Freud)和C.S.劉易斯(C. S. Lewis) 之間的辯論,另一部是《強迫癥》(Toc Toc) ,圍繞強迫癥患者展開情節。

Slip into many bookstores here, and tomes abound written by Argentines about the psychological ills that plague people, and their cures. Malele Penchansky’s “Universal History of Hysteria” and Alejandro Dagfal’s “Between Paris and Buenos Aires: The Invention of the Psychologist” are among the offerings. A new prizewinning Argentine comic book, “Repairer of Dreams,” even blends psychoanalysis into the tale of a dystopian city called Polenia.

隨意走進各家書店,阿根廷人撰寫的精裝書比比皆是,介紹了困擾人們的心理疾病及其治療方法。其中有馬萊萊·潘查斯基(Malele Penchansky)的《癔病通史》(Universal History of Hysteria),亞歷杭德羅·達格法爾(Alejandro Dagfal)的《巴黎與布宜諾斯艾利斯:心理學家的發明》(Between Paris and Buenos Aires: The Invention of the Psychologist)。有本新近獲獎的阿根廷漫畫《補夢人》(Repairer of Dreams)融入了精神分析學,講述了一個叫做“波勒尼亞”(Polenia)的反烏托邦城市的故事。

Psychoanalysis is not just for Argentina’s moneyed classes, with some psychoanalysts in the state medical system offering patients free sessions. And while some private health plans do not pay for psychoanalysis, insurance programs for some unionized workers cover dozens of therapy sessions a year.

精神分析不僅針對阿根廷的富裕階層,公費醫療體系里的一些心理醫生也為患者提供免費咨詢。盡管有些私人醫療計劃不涵蓋精神分析的費用,但是部分工會工人的保險計劃包括了每年幾十次的心理咨詢。

“We say no to charity and yes to equal opportunity,” said Adriana Abeles, president and founder of the Fields of Psychoanalysis Foundation, which carries out research, trains students of psychoanalysis and provides therapy. When patients cannot afford to pay, they can volunteer in exchange for their sessions, doing jobs like repairing furniture, cooking or painting walls.

“我們并不是做慈善,而是為人們提供公平機會,”阿德里安娜·埃伯利斯(Adriana Abeles)說,她是精神分析基金會(Fields of Psychoanalysis Foundation)的會長和創始人,這個基金會主要進行心理研究,培訓精神分析專業的學生,提供心理治療。在患者無力支付費用的時候,他們可以通過做義工來交換心理咨詢,比如做修家具、做飯或刷墻這類活兒。

The country’s growing supply of psychologists also means that consumers have considerable bargaining power. While some of the top analysts here charge the equivalent of hundreds of dollars per session, many work on a sliding scale in accordance with their patients’ incomes, offering sessions for as little as $15 an hour.

阿根廷的心理學家日益增多,也意味著消費者有相當大的議價能力。盡管有些頂尖醫生每次心理咨詢要收取相當于幾百美元的費用,不過許多醫生還是會根據病人的收入靈活收費,咨詢費用最低為每小時15美元。

Despite the continued boom in psychoanalysis, Argentina is not impervious to global treatment trends. Techniques like cognitive behavior therapy, which claim to offer shorter-term results, have gained ground here, and some health insurance plans frown upon the costs involved in drawn-out psychoanalytic counseling. Drug treatments have also made inroads, and some therapists in Argentina have expanded online offerings, turning to technologies like Skype.

雖然精神分析療法依然盛行,不過阿根廷難免也會受到全球治療趨勢的影響。認知行為治療等技術在阿根廷獲得了生存的土壤,這種療法宣稱見效時間更短,而有些健康醫療保險計劃不愿意涵蓋長期精神分析咨詢的費用。藥物治療也取得了進展,有些阿根廷治療師增設了在線服務,通過Skype網絡電話等技術提供咨詢。

But Andrés Raskovsky, president of the Argentine Psychoanalytic Association, recently asserted that psychoanalysis had little risk of extinction in Argentina since seeing a psychologist twice a week is still viewed as being affordable for much of the population.

但是阿根廷心理學會(Argentine Psychoanalytic Association)主席安德烈·拉什科夫斯基(Andrés Raskovsky)近來表示,精神分析療法在阿根廷幾乎沒有絕跡的危險,因為每周看兩次心理醫生,依然是大部分人能負擔得起的花費。

Theories abound as to why hang-ups, and the professional class that treats them, seem to flourish here.

至于心理問題的原因及專業的治療方法,各種理論比比皆是,依然在阿根廷非常盛行。

Martín, the main character in “Sidewalls,” a critically acclaimed 2011 romantic comedy about life in the shoe box apartments of Buenos Aires, offers this theory: “Apathy, depression, suicide, neuroses, panic attacks, obesity, fear of heights, muscular tension, insecurity, hypochondria, sedentary behavior — all are the fault of architects and construction entrepreneurs.” (Martín, of course, in a scene worthy of a Woody Allen film, professes to suffer from all of them “except for suicide,” and rarely leaves his high-rise building except to attend therapy.)

馬丁(Martín)是阿根廷電影《在人海中遇見你》(Sidewalls)的主角,這部2011年上映的浪漫喜劇廣受好評,講述了人們在布宜諾斯艾利斯膠囊公寓中的生活,影片提出了下面這個理論:“冷漠、抑郁癥、自殺、神經官能癥、恐慌癥、肥胖癥、恐高癥、肌肉緊張、精神不安、疑病癥、久坐不起——這些是建筑師和建筑企業家造成的毛病。”(當然,出現在類似于伍迪·艾倫電影場景中的馬丁宣稱,他受到上述所有疾病的困擾,“唯獨自殺例外”,他很少離開自己居住的高層住宅,只在接受心理治療時出門。)

Others look to Argentina’s past for explanations, and not just the sadness bred by the faded glory of a nation that was once wealthier than many European ones.

其他人從阿根廷的歷史中尋找解釋,認為這跟這個國家的歷史地位有關,阿根廷曾經比許多歐洲國家都要富裕,但昔日輝煌不再,因此讓國民感到悲傷。

The country, some say, was long vulnerable to melancholia, or at least an acceptance of sharing those troubles with a patient listener. With its history of immigration, largely from Europe, Argentina has a tradition of drawing inspiration from European intellectual trends, including the rise of Freudian psychology a century ago. Spanish immigrants who sought opportunities away from the fascist rule of Francisco Franco were pivotal in establishing psychoanalysis in the 1940s as a respected profession in Argentina. Nowadays, some of the top psychoanalysts here are Jewish, most of them descendants of European Jews.

有些人說,這個國家長期受到抑郁癥的影響,此外,阿根廷人普遍愿意向耐心的聽眾分享自己的煩惱。從移民歷史來看,阿根廷的大部分居民來自歐洲,具有從歐洲思想趨勢汲取靈感的傳統,包括一個世紀前弗洛伊德心理學的興起。20世紀40年代,為了尋找機會擺脫弗朗西斯科·佛朗哥(Francisco Franco)的法西斯統治,西班牙人移民到阿根廷,在把精神分析塑造成阿根廷受人尊敬的職業方面起到了重要作用?,F在,阿根廷的一些頂級心理學家是猶太人,他們大多是歐洲猶太人的后裔。

Others have sought to tie the appeal of psychoanalysis to the nation’s music, like the tango, which can plumb decidedly dark themes. (There is even something here called “psychotango,” which explores the use of psychoanalytic thinking and dance as a tool for “self-transformation.”)

其他人把精神分析的吸引力歸結于阿根廷的音樂,比如探戈,這種舞蹈顯然能夠探索黑暗的主題。(阿根廷甚至有稱為“心理探戈”的學說,探討把精神分析和舞蹈作為“自我轉變”的手段。)

But Mariano Ben Plotkin, author of “Freud in the Pampas,” a book about the emergence of psychoanalysis in Argentina, said the reasons were much more complex. “Sure, we have the tango, but the Portuguese have the fado,” said Mr. Plotkin, referring to the mournful music of Portugal, a country with fewer psychologists per capita.

但是,馬里亞諾·本·普洛特金(Mariano Ben Plotkin)認為原因要復雜得多,他的著作《潘帕斯草原的弗洛伊德》(Freudin the Pampas)講述了精神分析學在阿根廷的興起。“當然,我們有探戈,不過葡萄牙人也有法多”,普洛特金說,法多是葡萄牙的悲歌,而這個國家人均擁有的心理醫生比阿根廷少得多。

Instead, Mr. Plotkin, whose own parents sent him to a psychoanalyst several times a week when he was a child, attributes the rise of psychoanalysis in Argentina partly to its reception by a large, relatively well-educated middle class in the 1960s.

在普洛特金小時候,他的父母每周都會帶他看幾次精神分析專家,精神分析在阿根廷大行其道,一方面要歸功于20世紀60年代大量受過良好教育的中產階級對心理學的接受。

Despite the rise of rival treatments, Mr. Plotkin said he remained sanguine about what he called the “hegemonic” position of psychoanalysis in Argentina’s psychological community. After all, ordinary Argentines readily employ psychological terms that in other countries would be the preserve of psychology majors, and can hold forth on the difference of Freudian and Jungian methods.

普洛特金說,盡管出現了其他治療方法,他依然對精神分析在阿根廷心理學界占有“壟斷”地位感到樂觀。畢竟,連普通阿根廷人都可以輕松地運用心理學術語,滔滔不絕地談論弗洛伊德和榮格(Jung)理論的差異,而這在其他國家是心理學專業人士的專利。

Respect for psychoanalysis extends to other realms as well. It is embedded in various state institutions; parents of children at public schools, upon being asked to attend meetings regarding their child’s behavior, for instance, are sometimes surprised to learn that one of first discussions is with a psychoanalyst employed by the school system.

人們對于心理學的尊重延伸到了其他領域。心理學深入到不同的國家機構;比如,公立學校學生的家長會受邀參加會議,評估孩子的行為,有時候家長會驚訝地得知,他們首先要做的是和學校聘請的心理學家進行初步討論。

And in a sign of its wide acceptance, President Cristina Fernández de Kirchner and her cabinet chief took time out in April to meet with leaders of the World Psychoanalysis Association, which was convening then in Buenos Aires.

作為廣泛接受心理學的標志,2012年4月份,阿根廷總統克里斯蒂娜·費爾南德斯·德基什內爾(Cristina Fernández de Kirchner)和她的內閣部長抽出時間,會見了世界精神分析學會(World Psychoanalysis Association)的領導人,當時他們正在布宜諾斯艾利斯召開會議。

Opening a newspaper or cultural supplement here often feels like leafing through decades-old editions of The New Yorker, when cartoons were drenched in psychoanalytic jargon.

打開阿根廷的報紙或文化副刊,感覺就像翻閱幾十年前的《紐約客》(The New Yorker) 雜志,上面的漫畫充斥著精神分析術語。

Diego Sehinkman, a psychologist who writes a weekly column for the newspaper La Nación in which he describes imaginary therapy sessions with politicians across the spectrum, said: “We are fascinated in Argentina with peering into the suffering of people in power. Especially those who have made us suffer a bit.”

心理學家迭戈·賽因克曼(Diego Sehinkman)每周為阿根廷《國民報》(La Nación)撰寫專欄文章,描寫形形色色的政治家接受虛構的心理咨詢治療的情景,他說,“我們阿根廷人喜歡看到位高權重的人飽受折磨,尤其是那些讓我們遭受痛苦的人。”
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