Reevaluation of the Schreber Case 史瑞伯案例的重新评估 One of the significant developments in more contemporary efforts to understand the problem of paranoia has been the effort to critically reevaluate Freud's formulations. This has in part taken the form of carefully reevaluating the Schreber case in the light of more extensive evidence that is now available to us(McCawley,1971). As we have seen, there were some straws in the wind suggesting that the derivation of paranoia from homosexuality was not altogether adequate, but these impressions lacked any solid footing until the text of the Memoirs was made more generally available. 在理解偏执问题的当代努力中，一个重要进展是批判性地重新评估弗洛伊德的理论。这在一定程度上采取了这样一种形式，即根据我们现在可获得的更广泛的证据仔细地重新评估史瑞伯的案例(McCawley,1971)。正如我们所看到的，有一些迹象表明，从同性恋中衍生出偏执是不完全正确的，但是这些印象缺乏任何坚实的基础，直到《回忆录》的文本被更广泛地传播。 This was accomplished by the publication of the English translation of the Memoirs by MacAlpine and Hunter (Schreber,1955). Surveying the literature at that time, they concluded that by and large the literature on paranoia had tended to carry along and uncritically endorse Freud's formulations. Basing their own analysis of the case on the full text of the Memoirs and its associated documents rather than on the extracts provided by Freud, MacAlpine and Hunter came to the conclusion: 这是由麦卡派恩和亨特出版的《回忆录》英译本完成的(Schreber,1955)。通过研究当时的文献，他们得出结论:总的来说，关于偏执的文献倾向于继承并不加批判地支持弗洛伊德的理论。麦卡派恩和亨特根据回忆录的全文及其相关文件，而不是根据弗洛伊德提供的摘录，对该案例进行了分析，得出结论: We have interpreted Schreber's psychosis as a reactivation of unconscious, archaic procreation fantasies concerning life, death, immortality, rebirth, creation, including self-impregnation, and accompanied by absolute ambisexuality expressed in doubt and uncertainty about his sex. Homosexual anxieties were secondary to the primary fantasy of having to be transformed into a woman to be able to procreate(Schreber,1955,p.395). 我们已经把史瑞伯的精神错乱解释为对生命、死亡、不朽、重生、创造(包括自我受孕)的无意识的、古老的生殖幻想的重新激活，并伴随着对他性别的怀疑和不确定。相较于主要的幻想，即必须转变成一个女人才能生育，同性恋的焦虑是次要的(Schreber,1955年，第395页)。 They felt that the confusion and ambiguity in sexual identity should be clearly differentiated from the passive homosexual wishes implied in Freud's use of the term. 他们认为，性别认同中的困惑和模糊应该与弗洛伊德使用该术语时所暗示的被动同性恋意愿明确区分开来。 Since then the Schreber case has come in for searching reevaluation and reformulation. Niederland pointed out that both of Schreber's illnesses were precipitated by his being elevated to a position of power and influence, and he felt that this was indicative of Schreber's dread of taking the father's position. The father was a primary figure in Schreber's psychosis and the frustrated needs were primarily dependent ones (Niederland,1951). Schreber's delusional language was anal-sadistic in its origin, reflecting, rather than castration fears, the earlier pregenital fears centering around loss of the love object through the subject's own destructive rage. This reflected the intense ambivalence of the early libidinal object relationship and it was this ambivalence that was defended against by projection. The projection involved a symbolization and condensation in which previous libidinal ties were condensed into the concept of God, and thus lost libidinal objects were replaced by a verbal abstraction which restored the primary dependent relationship in a less threatening form, but at the same time at the sacrifice of reality. The Memoirs themselves represent a restitutive attempt to establish reality contact, and this was evidently successful until the death of Schreber's mother and the illness of his wife, at which point he again relapsed and died in the insane asylum four years later. 从那时起，史瑞伯案例就开始寻求重新评估和重新解释。尼德兰指出，史瑞伯的这两种病都是由于他被提升到有权势的地位而引起的，他觉得这表明史瑞伯害怕继承父业。父亲是史瑞伯精神错乱的主要人物，受挫的需求主要是依赖的需求(Niederland,1951)。史瑞伯的妄想性语言在其根源上是一种肛门施虐，反映的不是阉割恐惧，而是前性器的早期恐惧，其核心是由于主体自身的破坏性愤怒而导致的爱的客体的丧失。这反映了早期力比多客体关系中强烈的矛盾心理，投射正是为了防御这种矛盾心理。投射涉及符号化和凝缩(前力比多联结被凝缩进神的概念),从而失去的力比多客体被一个语言抽象所取代，其以一种不太危险的形式恢复了主要依赖关系,但同时牺牲了现实性。《回忆录》本身代表了一种建立现实联系的恢复尝试，这显然是成功的，直到史瑞伯的母亲去世，他的妻子生病，此时他再次复发，四年后死在精神病院。