PERSPECTIVE ON PARANOID MECHANISMS 偏执机制的各个方面 The mechanisms of projection/introjection, denial, and paranoid construction, which we have been discussing, are seen in their most extreme form in psychotic states in which the distortion and loss of reality are most apparent. These mechanisms are driven to their most extreme form by the intensity of underlying subjective needs, and in the extremities of psychosis the dominant subjective need is as intense as the radical need to preserve the self from engulfment and annihilation. The same mechanisms, however, operate in less intense and less extreme ways in response to more neurotic inner needs related to issues of castration and self-esteem. Thus individuals can function with basically neurotic styles which are fundamentally paranoid in character but not psychotic. The paranoid characteristics span a spectrum of psychopathologies from the minimally neurotic to the intensely psychotic. 我们已经讨论过的投射/内摄、否认和偏执建构的机制，在精神病状态中以最极端的形式出现，在这种状态中，现实的扭曲和丧失最为明显。这些机制被底层的主观需要的强烈程度驱动到其最极端的形式，而在精神病的极端情况下，主要的主观需要与保护自我不被吞没和湮灭的极端需要一样强烈。然而，同样的机制以不那么强烈和不那么极端的方式运作，以回应与阉割和自尊问题相关的更神经症水平的内在需求。因此，个体可以具有基本的神经症类型，也就是性格上的偏执[DSM-5偏执型人格障碍对应神经症水平和边缘水平的偏执人格；妄想障碍被迫害型对应精神病水平的偏执人格]，但不是精神病。偏执的特点跨越了精神病理学的光谱，从轻微的神经症到强烈的精神病。 The same mechanisms demonstrate, even in their most distorted forms, an adaptive function which serve to preserve object-relations and defend the self from narcissistic injury. This adaptive aspect of the paranoid mechanisms extends beyond the reach of psychopathology to the level of normal and culturally induced adaptive patterns of action and interaction. The same mechanisms can be socially and culturally reinforcing and supportive in one context, or can be distortive and maladaptive in another. Any theory of the genesis of paranoia must keep both aspects in perspective, and must bring those forces into focus which determine when the identical mechanisms are either adaptive or pathological. 同样的机制表明，即使是在它们最扭曲的形式下，也有一种自适应功能，用于维护客体关系和保护自我免受自恋损伤。偏执机制的这种适应性超出了精神病理学的范围，达到了正常和文化诱导的行为和互动的适应性模式的水平。同样的机制可能在一种环境中具有社会和文化上的强化和支持作用，也可能在另一种环境中具有扭曲和不适应作用。任何关于偏执起源的理论都必须正确看待这两个方面，并且必须聚焦于那些决定相同机制是适应机制还是病态机制的力量。