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新式夫妻治疗要先讨论性问题

更新时间:2015-7-14 8:37:18 来源:纽约时报中文网 作者:佚名

First Comes Sex Talk With These Renegades of Couples Therapy
新式夫妻治疗要先讨论性问题

Is the classic post-coital question “Was it good for you, too?’ ” outmoded?

房事后的那个经典问题“你也爽吗?”已经过时了吗?

A recent conference would indicate yes. Last month, the New York Center for Emotionally Focused Therapy held a symposium in New York called “Sex and Attachment: Coming Together.”

前不久举办的一个研讨会表明,的确如此。上个月,纽约情感治疗中心(New York Center for Emotionally Focused Therapy)在纽约举办了一个研讨会,名叫“性与依恋:共生共存”(Sex and Attachment: Coming Together)。

The event, with workshops on polyamory, sex-therapy interventions and compulsive sexual behavior, sold out to 400 clinicians, with a waiting list.

那次研讨会包括多配偶关系、性治疗干预和强迫性性行为等分组讨论。400名临床医生将研讨会入场券一抢而空,还有人申请候补席位。

In March, the Psychotherapy Networker Symposium in Washington, D.C., the largest gathering of therapists in North America, offered nine workshops dealing with sexuality, sexual orientation and gender identity. Five years ago, there were only two.

今年3月在华盛顿特区举办的心理治疗工作者研讨会(Psychotherapy Networker Symposium)是北美最大规模的治疗师聚会,共有九项专题讨论,包括性行为、性取向和性别身份。五年前,只有两项专题讨论。

In traditional couples therapy, which is about 50 years old, sex has often been shoved to the sideline. Practitioners are trained to work on underlying relationship issues, like blame or communication, many discussing sex only if the couple wants to talk about it.

夫妻治疗约有50年历史,在传统治疗中,性爱经常被置于次要地位。治疗师接受的培训是重点分析潜在的夫妻关系问题,比如责备或沟通,很多治疗师只在夫妻想谈论性爱时才谈论。

But in the last decade, as coupledom itself has been legally redefined, a chorus of provocative voices in couples therapy has emerged, emphasizing the importance of good sex in relationships and sometimes suggesting the radical idea that couples fix the sex before tackling other issues.

但是在过去十年里,夫妻关系本身已经在法律上被重新定义,所以夫妻治疗中出现了一片质疑之声,有些人强调良好的性爱在夫妻关系中的重要性,甚至有激进观点认为,夫妻在解决其他问题之前应该先解决性问题。

These renegades of couples therapy — such as Suzanne Iasenza, Margie Nichols, Jean Malpas, Marty Klein, Joe Kort, Arlene Lev, Marta Meana and Tammy Nelson — have become popular speakers at conferences like “Sex and Attachment.” They speak on topics like affairs, “gender-queerness,” transsexual identity, kink, BDSM (bondage/discipline, domination/submission, sadism/masochism) and pornography to audiences more accustomed to a language of betrayal and forgiveness.

传统夫妻治疗法的叛逆者——比如苏珊·伊森扎(Suzanne Iasenza)、玛吉·尼科尔斯(Margie Nichols)、珍·马尔帕斯(Jean Malpas)、马蒂·克莱恩(Marty Klein)、乔·科特(Joe Kort)、阿琳·列夫(Arlene Lev)、玛尔塔·梅亚纳(Marta Meana)和塔米·纳尔逊(Tammy Nelson)——已经成为“性与依恋”等研讨会上的热门发言人。他们谈论婚外情、“性别酷儿”(gender-queerness)、跨性别身份、性怪癖、BDSM(绑缚与调教、支配与臣服、施虐与受虐)和色情,而听众们过去听到的更多是背叛和原谅等话题。

The den mother of the group is Esther Perel, 56, the internationally known, Belgian-born author of “Mating in Captivity,” who asserts that mystery and distance could benefit long-term monogamy.

这个叛逆者群体的女导师是56岁的埃丝特·佩雷尔(Esther Perel)。她生于比利时,因《说对爱,表对情,婚姻不灭灯》(Mating in Captivity)一书蜚声世界。她认为,神秘和距离可能有益于保持长期的一夫一妻关系。

Ms. Perel, based in Manhattan, is writing a book tentatively called “Affairs: Cheating in the Age of Transparency,” and gave a TED talk about the topic in March that has been viewed about two million times. Her newest provocation is the idea that trauma-based language around affairs is limiting.

如今,佩雷尔在曼哈顿工作,她正在写一本书,暂时命名为《婚外恋:透明时代的欺骗》(Affairs: Cheating in the Age of Transparency)。今年3月,她在TED大会上发表了一个关于这个话题的演讲,约被观看了200万次。她最新的挑衅性观点是,关于婚外恋的创伤看法具有局限性。

“An affair is an act of betrayal and also an experience of expansion and growth,” Ms. Perel said in an interview. “It is a relational trauma, but it isn’t a crime. The family can often come out of it stronger and more resilient, and often an affair will draw the couple out of a place of deadness.”

“婚外恋是一种背叛行为,但也是扩展和成长的经历,”佩雷尔接受采访时说,“它会给夫妻关系带来创伤,但它不是罪行。家庭通常能从婚外恋中获得重生,变得更强壮、更有活力,婚外恋往往能把夫妻双方从一潭死水中拉出来。”

Ms. Perel holds occasional individual sessions in which, by request, she will keep secrets from the other partner in couples work. The goal is for both partners to be honest with the therapist, if not (yet) each other. “Because we agree on this in advance,” Ms. Perel said, “if something comes out and it has to do with an affair, I am never in an ethical breach.”

佩雷尔偶尔进行单独治疗,她会按照要求保守一方的秘密,不让配偶知道。目的是让双方都能对心理医生说实话——如果双方(还)不能坦诚相见的话。“因为我们提前就此达成了共识,”佩雷尔说,“所以即使曝出与婚外恋有关的事,也不会令我处于违背道德的位置。”

Another emerging voice on infidelity is Dr. Nelson, 52, a New Haven-based couples and sex therapist and author of “The New Monogamy: Redefining Your Relationship After Infidelity.” She encourages couples to write their own monogamy rules, which can include extramarital sex on weekends or extramarital sex but only together.

另一位对不忠提出新看法的人是52岁的纳尔逊博士。她是纽黑文市的夫妻关系和性治疗师,曾出版《新式一夫一妻制:在不忠发生后重新定义你们的关系》(The New Monogamy: Redefining Your Relationship After Infidelity)。她鼓励夫妻双方制订自己的一夫一妻规则,可能包括周末婚外性关系或者仅在双方都参与时发生婚外性关系。

“I describe monogamy as honest, perpetual dependency of some type,” Dr. Nelson said. “It can be whatever a couple wants, but it has to be fluid and flexible and the couple has to keep renewing it, like a license.”

“我把一夫一妻制看作某种诚实的、永恒的依赖关系,”纳尔逊说,“它可以是夫妻想要的任何一种形式,但它必须具有流动性和灵活性,夫妻必须不断更新它,就像更新一个许可证。”

Dr. Iasenza, 59, a psychotherapist in New York, is known for her expansive approach to gender, sexual orientation and pleasure.

59的伊森扎是纽约的心理治疗师,她以对性别、性取向和愉悦的广泛研究而闻名。

She shows her clients sexual-response models like the Basson model, which contradicts the orgasm-focused, human sexual response cycle developed by Masters & Johnson (excitement, plateau, orgasm, resolution), positing that a partner can initiate sex for reasons aside from excitement, and arousal may precede desire. (This may be a mind-blowing idea for women who feel, especially after 10-plus years of marriage, that waiting for desire is like waiting for Godot.)

她向客户们展示巴松模型(Basson Model)等性反应模型。巴松模型否定了马斯特斯&约翰逊研究小组(Masters & Johnson)开发的以性高潮为中心的人类性反应周期(兴奋、稳定、高潮和消退),认为其中一方可以不是因为兴奋而发起性爱,性刺激可以早于欲望(对某些女人来说,等待欲望就像等待戈多,尤其是那些结婚十多年的女人,所以这个观点可能会让她们十分兴奋)。

Dr. Iasenza also schedules private sessions with each partner, taking sexual histories and giving them homework to write sexual “menus” (lists of turn-ons), which they later share with each other.

伊森扎还与夫妻双方各自安排私人治疗,了解他们以往性生活的情况,让他们回去各自写下“菜单”(列出能激发他们性欲的方式),之后让他们分享菜单。

To understand why sex-forward couples therapists may still be considered renegades in the era of shows like “Girls” and “Transparent,” it may help to know that concept of couples therapy is only slightly older than the Sexual Revolution. It was pushed to the fore in the early 1960s by Don D. Jackson, Virginia Satir and Jay Haley at the Mental Research Institute in Palo Alto, Calif., and Murray Bowen at Georgetown University Medical Center.

为什么在《都市女孩》(Girls)和《透明家庭》(Transparent)等电视剧流行的时代,重点关注性爱的夫妻治疗师却仍可能被认为是离经叛道呢?要知道,夫妻治疗这个概念只比性革命(Sexual Revolution)早一点。20世纪60年代早期,加利福尼亚州帕洛阿尔托精神研究院(Mental Research Institute)的唐·D·杰克逊(Don D. Jackson)、弗尼吉娅·萨特尔(Virginia Satir)和杰伊·黑利(Jay Haley)以及乔治敦大学医学中心(Georgetown University Medical Center)的默里·鲍恩(Murray Bowen)把夫妻治疗提升到重要地位。

Sex therapy, invented by Masters & Johnson, evolved separately — and neither William Masters nor Virginia Johnson were couples therapists or mental-health providers of any kind. Today, there is only one certification program for sex therapists, the American Association of Sexuality Educators and Counselors, which means aspiring sex therapists may find access to courses and supervisers a challenge.

马斯特斯&约翰逊小组发明的性治疗另行发展。威廉姆·马斯特斯(William Masters)和弗尼吉娅·约翰逊(Virginia Johnson)既不是夫妻治疗师,也不是任何一种精神健康治疗师。美国如今只有一个性治疗师认证机构——美国性教育者和咨询师协会(American Association of Sexuality Educators and Counselors)——那意味着有抱负的性治疗师可能不是那么容易找到培训课程和指导老师。

And though the association requires its certified sex therapists be licensed social workers or psychologists first, couples therapists are not required to have any training in sex. Ms. Perel, for example, said she received exactly one hour of education on sex in her psychotherapy training, which led her to become certified in sex therapy in 2010, more than two decades later.

虽然该协会要求,获得认证的性治疗师必须首先是持证社会工作者或心理医生,但是夫妻治疗师不是必须接受过性培训。比如,佩雷尔说,她只在心理治疗培训中接受过整整一小时的性教育。20多年后的2010年,她获得了性治疗认证。

Margie Nichols, 68, a psychologist and sex therapist, received zero hours of course as a clinical psychology student. She went on to found the Institute for Personal Growth in Highland Park, N.J., in 1983, then one of few mental-health centers for gays and lesbians. Today, the institute, which also has centers in Jersey City and Freehold, also counsels transgender people, but half of the clients are what Dr. Nichols calls “mainstream.”

68岁的玛吉·尼科尔斯是一位心理医生和性治疗师。她读临床心理学时,没有上过任何性教育课程。1983年,她在新泽西州的海兰帕克创立了个人成长研究院(Institute for Personal Growth),那是当时的少数几个为同性恋设立的精神健康中心。如今,该研究院也为跨性别者提供咨询,但是一半的客户是尼科尔斯所说的“主流人士”。该研究院在泽西城和弗里霍尔德也设有研究中心。

Because her practice is diverse, she often finds herself looking to one group to help her with another. Her perspective, she said, is “G.G.G.,” which comes not from the annals of Freud but a 2006 column by the Seattle-based syndicated sex columnist Dan Savage. It means a person should strive to be good in bed, giving to the partner and game for anything — within reason.

她遇到过各种各样的客户,所以她发现自己经常用一组客户的经历来帮助另一组客户。她说自己支持“G.G.G.”,这个术语不是来自弗洛伊德(Freud)的笔记,而是来自西雅图性专栏作家丹·萨维奇(Dan Savage)2006年的一个专栏。他的专栏在多家报刊上同时发表。G.G.G.代表的是Good, Giving, and Game,意思是应该努力在床上好好表现,多为伴侣付出,敢做任何事情——当然要在理性范围之内。

Dr. Nichols says kinky couples have the best sex of any long-term couples she sees. Because of this, she finds herself “selling” their principles to vanilla (non-kinky) heterosexuals.

尼科尔斯博士说,在她见到的所有长期夫妻中,稍微有点怪癖的夫妻拥有最好的性爱。所以,她发现自己在把他们的理念“推销”给不那么变态的正常异性恋夫妻。

“Kinky couples plan sex,” she said, “and simmer for days in advance. They emphasize quality of encounter over frequency of encounters. They practice variety and exploration. They don’t judge a partner’s desires. They discuss and negotiate sexual acts, and they make a clear demarcation between ‘normal’ couple zone and ‘sex zone,’ allowing them to be totally immersed in an erotic space.”

她说,“稍微有点怪癖的夫妻提前几天计划性爱,让性欲在心里积聚。他们强调性爱的质量而非频率。他们尝试和探索新花样。他们不评判伴侣的欲望。他们讨论和协商性爱行为,他们明确区分‘正常’夫妻关系地带和‘性爱地带’ ,允许自己完全沉浸在色情空间里。”

One of the thornier issues affecting modern couples (kinky or not) is Internet pornography.

影响现代夫妻(不管是否有怪癖)的一个更棘手的问题是互联网色情。

Marty Klein, 65, a marriage and family therapist and sex therapist in Palo Alto, questions the existence of pornography addiction and says no one has the right to a pornography-free home without consulting their mate.

65岁的马蒂·克莱恩是帕洛阿尔托的婚姻家庭治疗师和性治疗师。他认为不存在所谓的色情内容上瘾症,认为在没有与配偶商议之前,谁也没权利要求家里没有色情内容。

“Many couples haven’t come to terms with the question, ‘Is it O.K. if my husband or wife masturbates?’ ” he said. “If you haven’t come to terms with that, or with the fact that most adults have sexual fantasies, then how can you have a productive, collaborative conversation about pornography? The country is flooded with high-quality free porn, and the problem is that people are anxious and secretive because they’re getting the message, ‘If you watch that stuff, I’ll kill you.’ ”

“很多夫妻还没有对这个问题达成共识:‘如果我的丈夫或妻子自慰,我能接受吗?’”他说,“如果你不能对此妥协,不能屈服于大部分成年人都有性幻想这个事实,你们怎么能就色情内容进行富有成效的、合作性的对话?这个国家充满高质量的免费色情资料,问题是人们很担心,只敢偷偷摸摸地看,因为他们得到的信息是,‘如果你看那种东西,我会杀了你。’”

He takes a more tolerant approach. “I say to the couple, ‘Let’s talk seriously about how come two people who love and like each other don’t have sex any more.’ ”

克莱恩采取更宽容的方式。“我对夫妻们说,‘让我们认真谈谈,两个相互爱慕、喜欢的人为何不再做爱了。’”

Not surprisingly, Dr. Klein’s approach has detractors. Sue Johnson, 58, the developer of Emotionally Focused Therapy and clinical psychologist in Ottawa, specializing in couples, said that if pornography “takes over your life, it is going to wreck your relationship, just like any other addiction.”

不出意料,有人反对克莱恩的方式。58岁的休·约翰逊(Sue Johnson)是渥太华研究夫妻关系的临床心理医生,也是情感疗法(Emotionally Focused Therapy)的开发者。她说,如果色情“主导你的生活,它会毁掉夫妻关系,就像其他任何上瘾症一样”。

As for infidelity, she said, “the idea that an affair is a solution to a lack of engagement and connection with your partner, that’s the craziest solution I’ve ever heard.”

关于不忠,她说,“有人认为,婚外恋是解决与伴侣缺乏亲密感的一种办法。那是我听过的最荒唐的观点。”

Dr. Johnson’s program, as well as other couples therapist certification programs like Imago, emphasize safety, loyalty and attachment as the foundations of intimacy. (The work is about strengthening underlying bonds, not hoisting up the bondage.)

休·约翰逊博士的项目以及Imago等夫妻治疗师认证项目强调安全感、忠诚和依恋,认为这些是亲密感的基础(治疗的重点是强化潜在情感联系,而不是加强束缚)。

But some of the renegades think that strong attachment is an ineffective way of creating sparks in the bedroom.

但是有些离经叛道的治疗师认为,强烈的依恋对在床上点燃激情的火花不太有效。

“Couples therapy is very feminized,” Dr. Nelson said. “It’s all about teaching men to be more like women. He should pay attention to her feelings, and if she’s upset, there’s something wrong. We ask him to engage with her like she’s his best friend and then we wonder why she doesn’t want to have sex with him.”

“夫妻治疗过于女性化,”纳尔逊说,“全是在教男人如何变得更像女人。丈夫应该关注妻子的感受,如果她不高兴,肯定是出了什么问题。我们要求丈夫像对待最好的朋友那样对待妻子,然后我们还想弄清为什么妻子不想跟丈夫做爱。”

Sex therapy, she said, has been focused on performance, functioning and pharmaceuticals. But the worlds are starting to fuse. “As we get more really good couples therapists in the field of sex therapy it expands the field and we get more crossover.”

纳尔逊说,以前性治疗关注的重点是表现、功能和药物。但是性治疗和夫妻治疗这两个领域开始融合。“随着性治疗领域出现更多真正优秀的夫妻治疗师,这个领域会得到扩展,我们会获得更多跨界经验。”

When she trains therapists, Dr. Nelson said, “I tell them to ask in the first session, ‘When was the last time you had sex and how was it?’ We’re talking about couples here. Why would you not talk about sex? I tell them, ‘If you’re not talking about sex, you’re perpetuating the idea that they shouldn’t be, and that just won’t help.’ ”

纳尔逊说,在培训治疗师时,“我要求他们在第一次治疗时问这个问题:‘你们上次做爱是什么时候?感觉如何?’我们是在讨论夫妻关系,你为什么不讨论性呢?我对他们说,‘如果你不讨论性,你就是在维护这种观点:他们不该讨论性,那没什么用。’”

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