Delusional Fixity 妄想的不变性 The element of delusional fixity and conviction of the reality of the delusion has long been recognized as part of the paranoid syndrome. Freud (1940[1938]) saw the basis for this in the persistence of a kernel of historical truth within the content of the delusion. The delusion, he felt, formed itself around fragments of experience derived from childhood. Thus a repressed fragment derived from preverbal levels of experience forces its way into consciousness in a distorted and displaced way. The belief attached to such delusions was thus derived from infantile sources, but was based upon an historical kernel of truth. 长期以来，妄想的不变性和对妄想的真实性的确信一直被认为是偏执综合症的一部分。弗洛伊德(1940年[1938年])认为，这种妄想的实质是历史真相的核心。他觉得，这种错觉是在童年经历的碎片周围形成的。因此，从前语言的经验层面衍生出来的一个被压抑的片段以一种扭曲和移位的方式强行进入意识。附属于这种妄想的信念因此从幼年源头派生而来，但基于历史真相的核心。[即偏执者在婴儿期确实被不合格的养育者“迫害”过，至少在婴儿看来是迫害] Moreover, the paranoid's projection does not ocur in a vacuum. He is highly percepive of, and sensitive to, the hostility that exists in the persecutor and reflects his own inner impulses. Thus the delusional system is not often without its reality elements (Freud,1922). In his reconsideration of paranoid ideas, Waelder (1951) takes his point of departure in Kraepelin's definition of delusions as erroneous judgments not subject to correction by experience."Thus the paranoid is unable to modify his beliefs under the impact of experience. Waelder, however, explains the paranoid inaccessibility to influence by appeal to Freud's hypothesis that adherence to delusional ideas reflects an intrinsic, although distorted, content of truth. 此外，偏执者的投射并非凭空而来。他对迫害者身上存在的敌意有高度的觉察和敏感，这些敌意也反映了他自己内心的冲动。因此，妄想系统并不是经常没有它的现实因素(弗洛伊德，1922)。Waelder(1951)在重新考虑偏执的想法时，将自己的观点与Kraepelin对妄想的定义进行了比较，后者将妄想定义为不受经验纠正的错误判断。因此偏执者无法在经验的影响下改变自己的信念。然而，韦尔德通过求助于弗洛伊德的假设，解释了偏执者无法获得影响力的原因。弗洛伊德的假设是，坚持妄想反映了一种内在的、尽管扭曲了的真理内容。 Frosch (1967) has contributed several important elements to the understanding of this sense of conviction and fixity. He points out the fixity and the compelling quality of neurotic symptoms. The neurotic may still be able to question the reality of his fear; that is to say, he has not lost his capacity to test reality, but he maintains a feeling of conviction about impending danger which provokes his anxiety. In addition to the kernel of historical truth, which can lend support and conviction to a delusional belief, Frosch points out that there are other pressures at work which operate in the direction of maintaining and reinforcing the delusional conviction. His patient, who maintained the delusional belief that the day was Friday rather than Saturday, finally was able to say that for her to admit the wrongness of her belief would have raised severe questions in her own mind about her sanity and mental intactness. Not to maintain her conviction would have meant that she was crazy, and for her to be crazy would have meant the loss of control, disintegration, and a complete negation of herself. Frosch(1967)为理解这种信念和坚定感贡献了几个重要的因素。他指出了神经症症状的不变性和令人信服的特质。神经症水平偏执者可能仍然能够质疑自己恐惧的真实性;也就是说，他并没有丧失检验现实的能力，但他对迫在眉睫的危险保持着一种信念，这种信念激起了他的焦虑。Frosch指出，除了历史真相的核心——它可以为妄想信念提供支持和确信——还有其他压力在起作用，这些压力的作用方向是维持和加强妄想信念。他的病人一直持有一个妄想信念，认为那天是星期五而不是星期六，但她终于能够说，如果她承认自己的错误，就会在她自己的头脑中对自己的理智和精神完整性提出严重的质疑。不坚持自己的信念就意味着她疯了，对她来说，疯就意味着失去控制、瓦解和对自己的彻底否定[宁可变成百分百的疯子，也不愿承认自己已经疯了一半。所以不去治疗，最终全疯]。 Frosch concludes that the problem of danger must be viewed hierarchically. The most basic and primitive fears operate at a biological level and involve the problem of survival. These fears are represented psychically by fears of disintegration and dissolution of self. Other fears and dangers are phase-related in terms of levels of psychic development, and assume forms relevant to the level of development of object-relations of ego structure and reality contact. The regression of psychotic states is associated with de-differentiation and the consequent fusion of self and object brings along with it the possibility of unconditional omnipotence. However, it may also bring the possibility of engulfment and absorption by the object with the consequent disappearance of the self. Frosch comments: Frosch的结论是，必须分层次地看待危险问题。最基本和最原始的恐惧在生物层面上运作，涉及生存问题。这些恐惧在心理上表现为对自我瓦解和解体的恐惧。其他恐惧和危险就心理发展水平而言是阶段相关联的，并呈现出与自我结构和现实联系中客体关系发展水平相关的形式。精神病状态的回归与去分化有关，随之而来的自我与客体的融合带来了无条件全能的可能性。然而，它也带来被客体吞没和吸收随后自体消失的可能性。Frosch评论到: It is the possibility that de-differentiation might eventuate in ultimate loss and dissolution of self that makes this phenomenon so frightening to the psychotic or borderline psychotic. Furthermore, the threat of de-differentiation with the ultimate eventuality of dissolution of self may be especially frightening to the psychotic because the possibility of reversal is minimal. in the normal and in the neurotic, blurring of ego boundaries and de-differentiation may be tolerated in the belief that ultimately the ego boundaries can be reestablished intact.... In the psychotic, since the chance of reversal is less, the process of de-differentiation may really eventuate in dissolution of self. It is for this reason that in the psychotic de-differentiation is an ever-present and real danger(Frosch,1967,p.487). 正是去分化可能最终导致自体的最终丧失和解体，使得这种现象对精神病水平患者或边缘水平患者如此可怕。此外，去分化的威胁与最终自体解体的可能性可能对精神病水平患者特别可怕，因为逆转的可能性是最小的。在正常水平和神经症水平中，自我边界的模糊和去分化可能是可以容忍的，因为相信最终自我边界可以完整地重建……在精神病水平患者中，由于逆转的机会更小，去分化的过程可能最终导致自我的解体。正因为如此，在精神病患者中，去分化是一种时时刻刻存在的、真实的危险(Frosch,1967,p.487)。 Laing (1965) has discussed this same psychotic fear of dissolution and loss of self in terms of the fear of engulfment. 莱因(1965)从对吞没的恐惧的角度讨论了对自我解体和丧失的精神病性恐惧。 Thus the paranoid sense of conviction can be related to an historical kernel of truth on the one hand, and on the other hand to a set of psychological pressures which make the admission of error in the delusion threatening or painful. To admit error or inadequacy in one's theoretical formulation means that one must also in some sense admit personal defect. The threat to the self may extend all the way from relatively innocuous self-accusations, such as ignorance, stupidity, lack of intellectual capacity and understanding, or they may extend to psychotic levels of intensity in which dissolution and utter loss of self are implied and in which the individual faces engulfment or psychic death. The paranoid conviction of rightness, therefore, can be seen in terms of its function in maintaining self-esteem at one level, or in the maintaining of psychic integrity at another. 因此，偏执的信念感一方面与历史真相的核心有关，另一方面又与一系列心理压力有关，这些压力使得承认错误的妄想具有威胁性或痛苦性。承认理论构想中的错误或不足，在某种意义上也意味着承认个人的缺陷。对自体的威胁可能以各种方式扩展，从相对无害的自责,如无知,愚蠢,缺乏知识和理解能力,到精神病水平的强度，这意味着自体瓦解和彻底丧失，个体面临吞没或精神死亡。因此，偏执者对自己正确的确信，可以从它在维持自尊，或维持精神上的完整性上的作用来看待。[站长想对偏执者说的：没有人是完美的，如果害怕承认自己的错误就会变得不完美，然后就拒绝承认错误，拒绝改错，人才会真的变得不完美] In these terms, then, paranoia can be fitted into a continuum of cognitive states in which available experiential data are integrated and interpreted in terms of a theoretical system of some sort. This applies to the formation of scientific theories and to the development of systems of religious belief. In this connection, we need only remind ourselves that the history of science is replete with examples of the conviction of theoretical rightness being unwilling to yield in the face of newly acquired evidences. Similarly, systems of religious belief are often maintained, if not in the face of contradictory evidence, at least in the face of lack of evidence. We shall return to this point below. But it seems safe to observe at this point that the need for conviction of rightness and the denial of uncertainty is a quality of human thinking that has broader application than merely to paranoia or related pathological conditions. Rather it spans a wide spectrum of adaptive and socially valuable human cognitive processes. 在这些术语中，偏执可以被纳入一个连续的认知状态，在这个状态中，可用的经验数据被整合起来，并按照某种理论体系进行解释。这适用于科学理论的形成和宗教信仰体系的发展。在这方面，我们只需要提醒我们自己，科学史上充满了这样的例子，即在面对新获得的证据时，不愿屈服于理论正确性的信念。同样，宗教信仰制度即使没有面对相互矛盾的证据，至少在缺乏证据的情况下，也经常得到维护。我们后边将回到这一点上来。但在此刻，我们似乎可以有把握地观察到，对自己是对的的信念和对不确定性的否认的需要，是人类思维的一种品质，它不仅适用于偏执或相关的病理状况。相反，它涵盖了广泛的适应性和具有社会价值的人类认知过程。[偏执者其实就跟烧死布鲁诺的天主教会一样。他们无法接受自己的信仰被新的观察所否定，这意味着自我的坍塌。]