The Kleinian Contribution:Paranoid and Depressive Positions 克莱因的贡献：偏执和抑郁心位 One of the most significant developments in the post-Freudian considerations of paranoia was the contribution of Melanie Klein(Klein,1932,1964). Following Abraham's formulation of paranoia as a regression to the earlier phase of anal sadism and as involving a partial introjection of the love object(Abraham,1954,p.490), Klein studied paranoid manifestations in young children. On the basis of her extensive clinical experience, Klein agreed with Abraham's basic position and felt that the period of maximal sadism in infantile development took its origin in the oral sadistic phase of libidinal development and extended through the period of early anal sadism. She felt that fixation at this point of maximal sadism provided the fixation point for the later development of paranoia. 后弗洛伊德时代对偏执症的思考中最重要的发展之一是梅勒妮·克莱因的贡献(克莱因，1932年，1964年)。在亚伯拉罕提出偏执作为肛门施虐的早期阶段的退行，并涉及到爱的客体的部分内摄(亚伯拉罕，1954年，第490页)之后，克莱因研究了幼儿的偏执表现。基于她丰富的临床经验，克莱因同意亚伯拉罕的基本立场，认为婴儿期最大施虐期起源于力比多发展的口腔施虐期，并延伸至早期肛门施虐期。她觉得在固着在最大的施虐点上，为后来偏执症的发展提供了一个固定点。 The child's sadism is translated into fears of attacks upon itself from the part of both introjected and external objects. To the excreta are attributed, in fantasy,a poisonous and dangerous quality and a power of destruction, which arouses tremendous anxiety in the child and is defended against by delusions of reference and persecution. Klein felt that behind the homosexual love, which is regarded as transformed into hatred of the parent of the same sex, there was a deeper hatred and destructive wish. The child fantasies attacking the mother's breast and body and destroying them by means of his own dangerous and destructive feces. Klein regarded the homosexuality as a defense in the service of neutralizing the intense sadistic wishes to destroy the feared and hated parent. 孩子的施虐倾向会转化为对自身攻击的恐惧，无论这攻击是来自内摄的客体，还是外部的客体。在幻想中，人们把一种有毒的、危险的性质和一种毁灭的力量归罪于排泄物，这种性质和力量在儿童中引起极大的焦虑，并以牵连观念和迫害的妄想来防御。克莱因认为，同性恋之爱(被认为是对同性父母的憎恨)的背后，有一种更深层次的憎恨和破坏性的愿望。孩子的幻想攻击母亲的乳房和身体，并通过自己的危险和破坏性的粪便来摧毁它们。克莱因认为，同性恋是一种防御，是为了消除强烈的虐待欲，摧毁令人恐惧和憎恨的父母。 Freud had hinted at the child's hostility to the mother and the fear of being devoured by the mother. Klein makes it clear in her formulation that this fear itself is due to the projection of sadistic impulses on the part of the child. Klein emphasizes that the sadistic fantasies of the omnipotent destructiveness of both bladder and bowels is closely connected with paranoid mechanisms. As Klein sees the process, the child projects its aggressive impulses onto the frustrating breast of the mother. The mother's breast thus becomes a persecuting object which is incorporated and thus becomes an internal persecutor. The ego struggles to defend itself against these internalized persecutors by processes of expulsion and projection. The resultant anxiety and the defense mechanisms associated with it form the basis of paranoia. 弗洛伊德曾暗示过孩子对母亲的敌意和对被母亲吞噬的恐惧。克莱因在她的提法中明确指出，这种恐惧本身是由于儿童的施虐冲动的投射。克莱因强调，有关膀胱和肠道具有全能破坏性的施虐幻想与偏执机制密切相关。克莱恩如此看这个过程，孩子将自己的攻击冲动投射到母亲令人沮丧的乳房上。因此，母亲的乳房成为一个迫害性客体，被合并进来并成了一个内部迫害者。自我通过驱逐和投射的过程，努力防御这些内化的迫害者，保护自己。由此产生的焦虑和与之相关的防御机制构成了偏执症的基础。 Abraham had commented on the close association between depression and obsessional states. Klein also notes the close association between paranoia and the more severe forms of obsessional neurosis. Paranoia derives from the earlier anal sadistic phase through which the individual must pass. These rudimentary paranoid states are normally overcome in the subsequent secondary stage of anal sadism from which obsessional mechanisms derive. The severity of the obsessional illness will depend on the severity of the preceding paranoid disturbance, so that later on, if obsessional mechanisms cannot adequately overcome the paranoid fixation, the obsessional traits may give way to a frank paranoia. More significant, however, is Klein's view of the relationship between the paranoid and depressive states. They are closely associated but can be distinguished in terms of the direction of the persecution anxiety. In the paranoid the anxiety is primarily related to the preservation of the ego, but in the depressive it is primarily related to the preservation of the good internalized objects with which the ego is identified as a whole. The anxiety lest the good objects, and with them the ego, should be destroyed is associated with continuous efforts to save the good objects both internal and external. 亚伯拉罕曾评论过抑郁和强迫状态之间的密切联系。克莱因还注意到偏执和更严重的强迫性神经症之间的密切联系。偏执起源于早期的肛门施虐阶段，个人必须通过这个阶段。这些基本的偏执状态通常会在随后的段肛门施虐的第二阶段中被克服，而这种第二阶段是强迫机制的起源。强迫症的严重程度将取决于之前的偏执困扰的严重程度，因此，如果以后的强迫机制不能充分克服偏执固定，强迫特征可能会让位于明确的偏执。然而，更重要的是克莱因对偏执和抑郁状态之间关系的看法。它们是密切相关的，但在迫害焦虑的方向上是可以区分的。在偏执者中，焦虑主要与自我的保存有关，而在抑郁者中，焦虑主要与好的内化客体的保存有关，有了这个客体，自我才是一个整体。这焦虑(唯恐好客体跟自我，被毁灭)与拯救内外好客体的不断努力有关。 In the earliest phase of the child's development, the persecuting object and the good objects are kept widely separated. However, when the child moves from the phase of the introjection of partial objects to the introjection of whole and real objects, these aspects must be brought closer together. This is a major developmental step to bring the bad and good objects into conjunction, and the child's ego must resort over and over again to the splitting of its objects into loved and hated, good and dangerous ones. If the child is able to gain more trust and confidence in its real objects and consequently in its introjected objects, the capacity for the tolerance of ambivalence, the capacity to relate to real objects develops. Klein writes as follows: 在儿童发展的最初阶段，迫害性客体和好客体被截然地分开。然而，当孩子从部分客体的内摄发展到整体和真实客体的内摄时，这些方面必须更紧密地结合在一起。这是一个主要的发展步骤，把坏的和好的客体结合起来，孩子的自我必须一次又一次地求助于把它的客体分裂成爱的和恨的，好的和危险的。如果孩子能够在他的真实客体中(从而在他的内摄客体中)获得更多的信任和信心，包容矛盾心理的能力，与真实客体建立联系的能力就会发展。克莱因写道: It seems that at this stage of development the unification of external and internal, the loved and hated, real and imaginary objects is carried out in a way that each step in the unification leads again to a renewed splitting of the imagos. But as the adaptation to the external world increases, this splitting is carried out on planes that gradually come increasingly nearer and nearer to reality. This goes on until love for the real and the internalized objects and trust in them are well established. Then ambivalence, which is partly a safeguard against one's own hate and against the hated and terrifying objects, will in normal development again diminish in varying degrees(1964,p.317). 似乎在这一发展阶段，外在与内在、爱与恨、真实与想象的客体的统一是这样进行的:统一的每一步都导致意象的重新分裂。但是，当对外部世界的适应增加时，这种分裂在逐渐越来越接近现实的层面上进行。这一直持续到对真实和内化的客体的爱和对它们的信任建立起来。然后，矛盾心理(这部分上是对自己的恨，和所恨的可怕客体的防护措施)将在正常发展过程中再次不同程度地减少(1964年，第317页)。 The capacity for the child to move developmentally from the paranoid to the depressive position implies, therefore, the capacity to tolerate ambivalence and also the capacity to achieve full identification with the good objects. Along with the capacity for love of and identification with a good object—at first the breast and then the whole person, particularly of the mother—there goes hand in hand an anxiety for its destruction and disintegration, as well as feelings of guilt and remorse and a sense of responsibility for preserving it against persecutors. Associated with this there is the sadness related to expectation of impending loss of the good object. It is the unconscious knowledge of the hate resident in ambivalence that exists alongside the love and may at any point gain the upper hand and so destroy the loved object, which brings about the feelings of sorrow, guilt, and despair which underlie the depression. 因此，儿童从偏执发展到抑郁心位的能力，意味着容忍矛盾心理的能力，以及完全认同好客体的能力。 伴随着对好客体(首先是乳房,然后是整个人,尤其是母亲)热爱和认同的能力，随之而来的是对美其的毁灭和瓦解的焦虑，以及内疚和自责的感觉，以及保护美好事物不受迫害的责任感。与此相关的是与即将失去好客体的预期相关的悲伤。正是这种(对与爱并存的矛盾心理中存在的恨，以及这恨在任何时候都可能占上风，从而摧毁所爱的对象的)无意识认知，导致构成抑郁的悲伤、内疚和绝望。 The paranoid, according to Klein, cannot allow himself this fullness of identification. The reasons are multiple. The persecution anxiety is too great; the way to a full and stable introjection of a good object is blocked by multiple suspicions and fantastic anxieties, which quickly turn the loved object once again into a persecutor. The paranoid cannot get beyond his early relationship to internalized part objects and their sadistic accompaniments. Klein comments: 克莱因认为，偏执者无法允许自己达到这种完全的认同。原因是多方面的。迫害的焦虑太大了;一个好客体完全而稳定地被内摄的路子被多重的怀疑和荒诞的焦虑所阻挡，这很快就把所爱的客体再次变成了迫害者。偏执者无法超越他与内化的部分客体及其施虐伴随物的早期关系。克莱因评论道: Where the persecution anxiety for the ego is in the ascendant, a full and stable identification with another object, in the sense of looking at it and understanding it as it really is, and a full capacity for love, are not possible(1964,p.291). 当对自我的迫害焦虑上升时，你就不可能完全而稳定地认同另一个客体，因为你不可能以她本来的面目看到她、理解她，也不可能有完全的爱的能力(1964年，第291页)。 The paranoid is unable to tolerate the guilt and remorse which are implicit in the depressive position. Moreover, to move into the depressive position is threatening because it limits his capacity to use projection. Projection carries with it the fear of expelling the good objects and thus carries with it the threat of losing them. But, at the same time, if he expels what is evil from within himself he runs the risk of injuring and destroying the good external objects. Thus Klein proposes, as a basic component of her position and as a fundamental insight, that paranoid fears and suspicions operate as a defense against the intolerable anxiety and ambivalence of the depressive state. 偏执者无法忍受隐含在抑郁心位中的内疚和自责。此外，进入抑郁心位是有威胁的，因为它限制了他使用投射的能力。投射带走对驱逐好客体的恐惧，因此也带走失去好客体的威胁[投射可以带走恐惧与威胁]。但是，与此同时，如果他从自己的内心驱除邪恶，他就有伤害和摧毁好的外部客体的风险[他必须把好坏客体分开]。因此，克莱因提出(作为她的立场的一个基本组成部分和一个基本的洞察力)偏执的恐惧和怀疑是作为抑郁状态无法忍受的焦虑和矛盾心理的一种防御手段。 Mrs. Klein's views have been controversial and have raised a number of basic problems from both methodological and conceptual points of view(Zetzel,1956; Kernberg,1969). Without accepting her theoretical suppositions, her descriptions of paranoia and depression have considerable clinical relevance and form important contributions to the study of these conditions. Her views have been of the greatest utility in refocusing our concerns toward the issues of aggression and hostility in the genesis of paranoia, and have also redirected our attention to the child's early life experiences as having considerable impact on the development of later pathological states. Whether her descriptions of paranoid and depressive concerns are capable of being validated in one-and two-year-old infants remains a moot question, but there can be little doubt that paranoid and depressive concerns can be identified in older children, and that in adult patients these same factors are of considerable significance in the elaboration of their ilness. 克莱因夫人的观点一直是有争议的，并从方法和概念的观点提出了一些基本问题(Zetzel,1956; Kernberg,1969)。不用接受她的理论假设，她对偏执症和抑郁症的描述也具有相当大的临床意义，并对这些疾病的研究做出了重要贡献。在使我们重新关注偏执者产生时的攻击和敌意问题时，她的观点是最有用的，她的观点也使我们重新关注儿童早期的生活经历，因为这些经历对后来的病理状态的发展有相当大的影响。她对偏执和抑郁问题的描述是否能够在—两岁的婴儿身上得到验证，仍然是一个悬而未决的问题,但毫无疑问,偏执和抑郁关注可以在年龄较大的儿童身上识别出来，对于成人患者,这些因素对于详述他们的疾病具有重大意义。