Early Views 早期观点 It was Freud, of course, who provided the decisive influence on contemporary thinking about paranoia. He defined paranoia as the characteristic mechanism and related the paranoid state to basic conflicts over homosexual impulses. Although these elements are considered to be the mainstays of Freud's formulation, his ideas on the subject were considerably more complex and underwent a definite developmental progression. 当然，是弗洛伊德对当代对偏执的思考产生了决定性的影响。他将偏执症定义为一种特征机制，并将偏执状态与同性恋冲动的基本冲突联系起来。尽管这些要素被认为是佛洛伊德理论的主要支柱，但他在这一主题上的思想要复杂得多，而且经历了一个明确的发展过程。 In his earliest writing on the subject, the unpublished Draft H which he sent to Fliess in 1895, Freud places paranoia alongside obsessional ideas as an intellectual disorder and calls it an intellectual psychosis. He emphasizes the analogy between hysteria and obsessive states on one hand, and paranoia on the other, as pathological modes of defense(Freud,1950[1892-99], pp.206-207). He says very simply, "People become paranoiac over things that they cannot put up with, provided that they possess the peculiar psychical disposition for it"(Freud,1950[1892-99],p.207). The patient he describes spared herself the reproach of being a bad woman by projecting it outside. Whereas she would have had to accept the judgment pronounced from within, she could now reject one that was directed at her from the outside. 在他关于这个主题的最早的著作中，1895年他寄给弗里斯的未发表的草稿H中，弗洛伊德把偏执和强迫性想法放在一起作为一种智力障碍，并称之为智力精神病。他强调一种类比，一边是歇斯底里和强迫性状态，另一边是偏执，作为病态的防御模式(弗洛伊德，1950[1892-99]，页206-207)。他说得很简单，“只要人们有这种特殊的心理倾向，他们就会在他们不能忍受的事情上变成偏执”(弗洛伊德，1950[1892-99]，第207页)。他所描述的病人为了免除自己作为一个坏女人的耻辱，把它投射到外面。虽然她必须接受来自内部的判决，但她现在可以拒绝来自外部的判决了。 Paranoia was visualized as a defense against self-reproach, and the model Freud used was one he had developed from his study of hysteria, namely, that of repression of a painful idea which then was allowed to return in a modified form. Freud adds that the mechanism of projection is very commonly employed in normal life. It arises, he says, as a result of a normal tendency to presume that internal changes are due to external causes. The process is normal as long as we remain aware of the internal changes, but it becomes abnormal when we lose sight of the internal change. Paranoid projection, therefore, is really an abuse of a mechanism of projection for the purposes of defense(Freud,1950,[1892-99],p.209). Later, in Draft K, he describes paranoia as a pathological aberration of the relatively normal affective state of mortification. The painful affect is handled by projection onto the patient's fellowmen. The primary symptom is distrust or an excessive sensitiveness to other people. The determining element is thought to be the mechanism of projection which involves the refusal of belief in self-reproach. The partial failure of the defense and the return of the repressed in its distorted form produces secondary alterations of the ego which can take the form of either melancholia, that is,a sense of the ego's littleness or worthlessness, or can take the form of the more serious protective delusions of megalomania in which the ego is completely remodeled(Freud,1950[1892-99]). 偏执症被想象成是对自我责备的一种防御，弗洛伊德所使用的模型是他从对歇斯底里症的研究中发展出来的，也就是对痛苦的想法进行压抑，然后再以一种修改的形式返回。弗洛伊德补充说，投射机制在日常生活中经常被使用。他说，这是一种正常倾向的结果，这种倾向认为内部变化是由外部原因造成的。只要我们注意到内部的变化，这个过程就是正常的，但是当我们忽略了内部的变化时，这个过程就不正常了。因此，偏执投射实际上是一种为了防御而滥用投射机制的行为(弗洛伊德，1950，[1892-99]，第209页)。后来，在草稿K中，他把偏执描述为一种相对正常的禁欲情感状态的病态失常。这种痛苦的感情是通过投射到病人的同伴身上来处理的。主要症状是不信任或对他人过于敏感。决定因素被认为是投射的机制，包括拒绝相信自责。防御的部分失败和被压抑部分以扭曲形式的返回，产生自我的二次改变，以精神忧郁症的形式,也就是说,一种自我的渺小或无价值感,或者可以采取狂妄自大这种更严重形式的妄想，在其中自我被完全改造(弗洛伊德,1950 [1892 - 99])。 In the section on paranoia in the paper "The Neuropsychoses of Defense"(1896), Freud discusses the case of a young mother who developed paranoid symptoms about six months postpartum. He emphasized the defensive nature of the symptoms and related them to the repression of distressing memories. The burden of an intolerable idea is relieved by means of projection. The patient guarded herself against the self-reproach and guilt related to infantile sexual experiences which returned in the form of accusations from hallucinated voices. In obsessional neurosis the initial self-reproach is represed by the formation of a primary defense of self-distrust; but in paranoia the self-reproach is repressed in a projective manner by the defensive symptom of distrust of other people. The return of the repressed, however, in the form of delusional ideas, demands acceptance without contradiction from the ego. The preservation of defense demands that the ego adapt itself to them, so that interpretive delusions end in an alteration of the ego which provides a secondary stage of defense(Freud,1896,p.185). 在论文《防御的神经精神疾病》(1896)中关于偏执症的章节中，弗洛伊德讨论了一个年轻母亲的案例，她在产后六个月左右出现偏执症状。他强调症状的防御性，并将其与压抑痛苦的记忆联系起来。一种无法忍受的思想负担通过投射来减轻。病人保护自己不受与婴儿时期的性经历有关的自责和内疚的影响，这些自责和内疚以来自幻觉的声音中指责的形式出现。在强迫性神经官能症中，最初的自我责备被自我不信任的主要防御所压抑;但在偏执症中，自我责备被一种投射性的方式所压抑，其定义性症状是对他人的不信任。然而，被压抑想法以以妄想的形式返回，要求自我不带矛盾地接受。防御的保存要求自我去适应它们，因此解释性的妄想以自我的改变而结束，这提供了防卫的第二阶段(弗洛伊德，1896，第185页)。 In the years between the early papers and the publication of the Schreber case, Freud added several important observations. He noted the characteristic transformation of affectionate impulses into hostile impulses or the transformation of love into hate that is so characteristic of the paranoid mechanism(Freud,1905b,p.167). He also noted that the delusions of the paranoid represent fantasies which are basically sadomasochistic in composition(Freud,1908,p.162). These early papers bring us to the threshold of Freud's treatment of the Schreber case, except for the essential element, namely, the relationship to homosexuality. Beside some cryptic suggestions in a letter to Fliess in 1899, in which he suggested that paranoia involved a return to early levels of autoeroticism(Freud,1887-1902, letter 125), there is hardly any mention of paranoia in Freud's writings. According to Jones he presented a paper on female paranoia to the Vienna Society in1906, still without mention of the connection to homosexuality(Jones,1955, p.281). A little over a year later he proposed the hypothesis to Jung and Ferenzi(Freud,1911, pp.4-5). In these letters Freud hints that the suggestion had come originally from Fliess. There is also an unpublished memorandum sent by Freud to Jung, presumably early in 1907, on the subject of paranoia which has no hint of its connection to homosexuality(Freud,1950[1892-99], pp.206-207). With these additional straws in the wind, then, Freud was ready to provide a more extensive analysis of paranoia and to express his more complete views on the subject. Thus the elements were at hand which Freud assembled into his analysis of the famous Schreber case. 在早期论文和史瑞伯案例发表之间的这些年里，佛洛伊德增加了几个重要的观察结果。他注意到由深情冲动转变为敌对冲动或由爱转变为恨是偏执机制的典型特征(弗洛伊德，1905b，第167页)。他还指出，偏执狂的妄想表现出本质上是施虐受虐的幻想(弗洛伊德，1908年，第162页)。这些早期的论文把我们带到了弗洛伊德对待史瑞伯案例的门前，除了基本的元素，即同性恋的关系。1899年，弗洛伊德在给弗里斯的信中提出了一些隐晦的建议，他在信中表示，偏执症涉及回归到自体性欲行为的早期水平(弗洛伊德，1887-1902，第125封信)，除此之外，弗洛伊德的著作中几乎没有提到偏执症。根据琼斯的说法，弗洛伊德在1906年向维也纳协会提交了一篇关于女性偏执症的论文，但仍然没有提及与同性恋的联系(琼斯，1955年，第281页)。一年多以后，他向荣格和费伦齐提出了这一假说(弗洛伊德，1911年，第4-5页)。在这些信件中，佛洛伊德暗示，这个建议最初来自于弗里斯。还有一份由弗洛伊德寄给荣格的未发表的备忘录，大概是在1907年初，内容是关于偏执症，但与同性恋毫无关联(弗洛伊德，1950[1892-99]，页206-207)。随着更多的蛛丝马迹的出现，弗洛伊德准备对偏执症进行更广泛的分析，并在这个问题上表达他更完整的观点。因此，在弗洛伊德分析著名的史瑞伯案例时，他就把手边的这些要素装配了进去。