FROM SYMPTOM TO STYLE 从症状到风格 We have been dealing with paranoid phenomena, both in their pathological deviations and in their more adaptive functions. Implicit in this consideration has been a shift from a focus on paranoid phenomena as symptoms to a focus on these same phenomena as a style of cognitive and affective functioning. Refocusing the consideration of paranoid ideation in this manner makes it possible to see that such phenomena can be elaborated across a broad spectrum of levels of personality functioning. It also sharpens the apperception that the same mechanisms can operate under conditions of severe pathological deviation and in mental states which are not merely socially acceptable, but are important aspects of developmental processes. 我们一直在处理偏执现象，无论是在他们的病理性偏差，还是在他们更适应性的功能。在这种考虑中，隐含着一种转变，即从把偏执现象作为症状，转向把这些现象作为认知和情感功能的一种形式。以这种方式重新聚焦对偏执思维的考虑使我们有可能看到，这种现象可以在人格功能的广泛层次上加以阐述。它还强化了一种统觉，即相同的机制可以在严重的病理偏差和心理状态下发挥作用，而这种心理状态不仅是社会可接受的，而且是发展过程的重要方面。 The shift of focus from a symptom-oriented view of paranoid phenomena to a stylistic view likewise shifts the orientation of an approach to the genesis of paranoid conditions. We can no longer merely concern ourselves with those factors which contribute to the formation of paranoid symptoms. The symptom is by definition a component of an illness and represents a form of deviation from accepted standards of normality. If the question regarding the genesis of paranoid states and ideas is cast in terms of a conceptual framework based on the approach to symptoms, then the answers must similarly be cast in terms of those factors which underlie the deviation of certain forms of thought and behavior from normal patterns. The symptom approach concerns itself, then, with a stratified segment of the factors which are involved in the genesis of the paranoid patterns of behavior. The approach must focus on those factors which bring the individual's patterns of functioning to a point of deviance. That approach leaves out of consideration those factors which underlie those patterns of thought and experience which serve adaptive functions, before they are turned into less adaptive and more deviant channels. 从偏执现象的以症状为导向的观点转向风格观点，同样也改变了偏执症状形成的研究方向。我们不能再只关心那些导致偏执症状形成的因素。从定义上讲，症状是疾病的一个组成部分，代表了对公认的正常标准的偏离。如果关于偏执状态和思想的起源的问题是根据基于症状方法的概念框架来表达的，那么答案必须同样地根据那些构成某些形式的从正常模式的思想和行为偏离的因素来表达。因此，症状研究方法关注的是与偏执行为模式的形成有关的因素的分层部分。这种方法必须把重点放在那些使个体的功能模式达到异常程度的因素上。这种方法忽略了那些构成思维模式和经验模式基础的因素，而在这些因素转变为适应能力较差和更偏离常规的渠道之前，这些思维模式和经验模式具有适应功能。 The approach to paranoid phenomena in terms of style, therefore, serves to broaden the base of questioning about genetic factors. The realization that paranoid delusions of persecution, jealousy, envy, prejudice, authoritarian attitudes, and beliefs and values share certain mechanisms which link them in a continuum of more or less adaptive states, forces us to broaden our consideration so as to include the significant factors that contribute to the formation of those mechanisms and processes which are common to these various states of mind. It raises the reflection that similar genetic conditions can serve in one context for the development of adaptive and developmentally healthy religious beliefs, but may also serve in another context for the formation of severely pathological and developmentally constricting paranoid ideas. Those factors are no less significant in the understanding of the genesis of the paranoid ideas than the other factors which are more immediately related to their deviation from normal. 因此，从风格的角度来研究偏执现象，有助于拓宽对起源因素的质疑基础。意识到对迫害的偏执妄想,嫉妒,羡慕,偏见,专制的态度,和信仰和价值观共享某些机制，这些机制把它们联系在一个或多或少地适应状态的连续统里，迫使我们扩大我们的考虑,以包含那些重要因素，这些因素对于这些机制和过程的形成有贡献，这些机制和过程对于这些不同的心理状态是公共的。它提出了这样一种思考:类似的发生条件可以在一种环境中促进适应性发展和发展性健康宗教信仰，也可以在另一种环境中促进严重病态和发展受限的偏执观念的形成。这些因素在理解偏执思维的成因时，并不比其他与偏执思想偏离正常更直接相关的因素更不重要。 Consequently, in turning at this point to consider the genesis of paranoid conditions, we are focusing on paranoia as a style of life and experience whose manifestations may or may not be pathological. Our view of paranoia is considerably broadened so that we can begin to recognize the presence of paranoidlike states of mind in attenuated and adaptive forms as having much greater distribution in the human environment out of which more pathological forms of paranoid thinking arise. Any genetic formulations pertaining to paranoia as such must take in the broader perspective that is implied in these much more widely occurring and general conditions. 因此，在考虑偏执症状的成因时，我们把偏执作为一种生活方式和体验，其表现可能是病态的，也可能不是病态的。我们对偏执的看法大大拓宽了，这样我们就可以开始认识到，以减弱和适应的形式存在的偏执样的心理状态，在人类环境中有更大的分布，由此产生了更多病态的偏执思维形式。任何与偏执有关的起源形成都必须从更广泛的角度来考虑，这在这些更广泛发生和更普遍的情况中有所暗示。 The shift from symptoms to styles also carries with it a change in perspective from a concern with content and unconscious symbolic meaning to a concern with more formal characteristics in the organization and patterning of thought processes, affective responsivity, subjective experience and objective behaviors. The psychoanalytic approach took its origin from the startling revelation that symptoms have meaning, and the approach that Freud elaborated in his Interpretation of Dreams (1900) has served as the basis for nearly all of the subsequent analytic investigation of mental processes. The focus has been on the mental content, and psychoanalytic investigation has been a matter of unveiling by the combined techniques of free association and transference the inner unconscious meaning which ties the symptom to levels of infantile functioning and permits some understanding of the symptom in the patient's life and experience. The value of this approach is unquestioned and its importance is undiminished. 从症状到风格的转变也带来了视角的变化，从关注内容和无意识的象征意义，到关注思维过程的组织和模式、情感反应、主观经验和客观行为的更形式化特征。精神分析方法起源于一个惊人的发现，即症状是有意义的，弗洛伊德在他的《梦的解析》(1900)中阐述的方法是后来几乎所有精神过程分析研究的基础。重点是精神内容，精神分析调查一直是自由联想和转移相结合的技术，用来揭示内在无意识的意义，这些无意识意义将症状与婴儿功能水平联系起来，并允许在生活和经历对患者症状的某些理解。这种方法的价值是不容置疑的，其重要性也没有减少。 With the emergence of a more elaborate and sophisticated ego psychology, however, and with an increasing tendency for analysts to treat patients with problems less of a symptomatic nature and more of a characterological nature—or at least to undertake analysis more extensively on a characterological level—there has been a greater concomitant emphasis on process, formal aspects of the organization and patterning of thought processes, affects and experience, and generally on stylistic aspects of ego functioning. It has become apparent that there is more that is unconscious and pathogenic in the organization of personalities than the id-derived symbolic content and meaning. There are also ways in which the individual's thought patterns and patterns of affective response are organized, which are part and parcel of his pathology, which are for the most part inadvertent—and thus in part preconscious and in part unconscious—and which must be recognized as a significant aspect of his ego functioning. Such stylistic aspects of ego organization contribute to the patient's neurotic difficulties and are not less deserving of analytic attention in the therapeutic setting. 然而，随着更加精细和复杂的自我心理的出现，分析师越来越倾向于处理问题不那么具有症状性质且更具性格性的患者——或者至少在性格层面上进行更广泛的分析——同时强调过程，组织的形式方面和思维过程的模式，影响和经验，以及一般的自我运作的风格方面。很明显，在人格的组织中，除了本我派生的符号内容和意义之外，还有更多无意识的和致病的东西。这里还有其他方式，在其中个人的思维模式和情感反应模式被组织起来，这是他的病理学的一部分,在很大程度上是无意的——因此部分是前意识的，部分是无意识的——且必须被认为是他的自我运转的一个重要方面。自我组织的这种风格方面有助于患者的神经症困难，在治疗环境中也同样值得分析注意。 Thus, the shift from a symptomatic to a stylistic orientation carries with it significant implications for an inquiry into the genesis of the elements involved. The stylistic approach broadens the base of the inquiry simply because the stylistic elements that are involved have a wider incidence in the general population than the symptomatic elements that usually form the substance of psychopathology. There are also important shifts in what one looks at in searching out the determining influences in the patient's life history and experience. The relevant influences stem from all levels of human interaction, from the intimacy of the mother-child interface to the broadest levels of cultural and social integration. 因此，从症状导向向风格导向的转变对探究所涉要素的成因具有重要意义。风格方法拓宽了研究的基础，仅仅是因为涉及的风格元素在普通人群中比通常构成精神病理学实质的症状因素有更广泛的发病率。在寻找病人生命历史和经历中决定性影响的过程中，也有一些重要的转变。相关的影响来自于所有层次的人类互动，从亲密的母子关系到最广泛的文化和社会融合。 While our attention in this consideration will be directed primarily toward stylistic concerns, the caution needs to be added that such concerns cannot be isolated and treated in a kind of investigative vacuum. The stylistic aspects of personality organization and fuctioning cannot simply be divorced from considerations of content. The respective approaches are intertwined and interrelated, both in the life and experience of the patient and in the complexities of psychoanalytic theory. One need only think of the problem of the relation between defenses and personality styles to be reminded of the relativity of these approaches. 虽然我们在审议这一问题时的注意力将主要集中在风格上的关切，但需要补充的是，这种关切不能孤立起来，不能在一种调查真空中加以处理。人格组织和功能的风格方面不能简单地脱离内容的考虑。无论是在病人的生活和经验中，还是在精神分析理论的复杂性中，这两种方法都是相互交织和相互关联的。我们只需要思考防御和人格风格之间的关系问题，就能想起这些方法的相关性。