Social Isolation 社会隔离 In such cases, one is dealing with a combination of social isolation and physical impairments of sight and hearing. Social isolation itself, however, can be a significant precipitant. For example, the onset of paranoid symptoms were studied in a group of married women. To begin with, their husbands were older and rather socially isolated men who were reliable providers and were committed to maintaining the conventional appearances of marital role performance, but were virtually unable to express angry or sexual feelings directly. The marriages were stable but quite isolated from contacts with outsiders. The wife's psychosis emerged in the setting of the husband's withdrawal, along with cessation of intercourse. This deterioration continued until someone outside the family was involved; the wife was then hospitalized, and they then were able to reunite themselves and acted to once again exclude outsiders, including the hospital (DuPont and Grunebaum,1968). The comparative isolation induced by the husband's withdrawal—especially in their already isolated situation—was sufficient to precipitate the frank psychosis. 在这种情况下，一个人要同时面对社会孤立和视觉与听觉的生理缺陷。然而，社会孤立本身可能是一个重要的诱因。例如，对一组已婚妇女的偏执症状的发作进行了研究。首先，她们的丈夫年龄较大，在社会上比较孤立，他们是可靠的提供者，致力于维持婚姻角色表现的传统表象，但实际上无法直接表达愤怒或性感受。他们的婚姻很稳定，但与外界隔绝。妻子的精神病是在丈夫退出的背景下，伴随着性交的停止而出现的。这种恶化一直持续到家庭以外的人介入;妻子随后被送进了医院，他们得以重新团聚，并再次采取行动排斥外人，包括医院(杜邦和格鲁内鲍姆，1968年)。丈夫的退出所引起的相对孤立——尤其是在他们已经孤立的情况下——足以促成明确的精神病。 The significance of social isolation should not be underestimated. The personality cannot maintain its normal functioning except in a matrix of social interaction. When disruptive events occur which isolate the individual from such interaction, normally adaptive patterns of response can no longer function adequately. Social isolation can frequently be found among the precipitants of paranoid reactions. But the concept of isolation has significance beyond the level of social contacts. Each individual shapes for himself a context of personal meaning and relevance which is embedded in a social matrix. The pattern of personal meaning is shaped by the multiple contexts of meaningful relatedness, and the overall meaning is continuous with, and in part derived from, the more general patterns of meaning which constitute the larger cultural matrix. There is a basic need for interaction with other individuals which is emotionally significant and meaningful to the subject. The terms in which such interpersonal contacts are felt to be meaningful are in part dictated by expectations which are culturally derived and internalized. The cultural matrix has considerable significance as a determining influence on what kinds of interactions are felt to be personally relevant and meaningful. When the susceptible individual is deprived of such a cultural matrix, his capacity to satisfy the expectations of others as well as to feel that his own expectations of others are in some sense fulfilled and reinforced is often severely impaired(Melon,J.1970; Melon and Timsit,1971). One can also think in terms of linguistic isolation as having parallel effects—"language shock" as well as "culture shock"(Steyn,1972). The inability to respond meaningfully to others and the failure to receive meaningful responses from them throws the individual's sense of belonging out of kilter, with the result that self-esteem and the sense of personal worth are under attack. In individuals who lack a sense of security and identity and who thus must rely to a greater degree on the external supports for their sense of worth, cultural isolation can have a devastating effect. Prange (1959) has reported a dramatic case of an immigrant Chinese girl who developed acute features of delusional persecution and paranoia under these circumstances. 社会孤立的重要性不应被低估。人格无法维持它的正常功能，除非在一个社会互动的环境中。当破坏性事件发生时，将个体从这种相互作用中隔离出来，通常情况下适应性的反应模式就不能充分发挥作用。在偏执反应的促发因素中，常常可以发现社会孤立。但是，孤立概念的意义超出了社会接触的层面。每个人都为自己塑造了一个嵌入在社会母体中的个人意义和相关性的环境。个人意义模式是由有意义关联的多重环境所塑造的，整体意义是与构成更大文化母体的更普遍的意义模式相连续，并在一定程度上由其派生出来的。有一个基本的需求是与其他个体的互动，这对主体是情感上重要和有意义的。这种人际接触被认为是有意义的，部分是由文化衍生和内化的期望所决定的。文化母体具有相当重要的意义，它决定了什么样的互动被认为是与个人相关和有意义的。当易受影响的个体被剥夺了这种文化母体时，他满足他人期望的能力，以及感到自己对他人的期望在某种意义上得到满足和加强的能力，往往会严重受损(Melon,J.1970; Melon and Timsit,1971)。人们也可以认为语言隔离具有类似的影响——“语言冲击”和“文化冲击”(Steyn,1972)。无法对他人做出有意义的回应，也无法从他人那里得到有意义的回应，会让个人的归属感失去平衡，导致自尊和个人价值感受到打击。对于缺乏安全感和认同感的人来说，他们的价值观在很大程度上依赖于外界的支持，文化隔离可能会产生毁灭性的影响。Prange(1959)报告了一个戏剧性的案例，一个中国移民女孩在这种情况下发展出严重的妄想性迫害和偏执。 But even within the same culture—without the influence of cultural isolation—the effects of social isolation can be detected. In a sense, then, the effects of cultural isolation are mediated by social isolation, and the significant aspect is meaningful relatedness to other human beings. There is an interesting report of the development of paranoid pyschosis in a small group of Norwegian patients who had been Nazi collaborators during the war. After the war they were ostracized by their fellow countrymen. Even family and friends disowned them. The time lapse from liberation until the onset of symptoms ranged from 0 to 24 months, averaging 13 months. Apparently during the occupation they found a certain shared community among a small group of like collaborators, but with liberation this group was dispersed. They thus began to feel the full brunt of social isolation(Retterstol, 1968). 但即使在同一种文化中——不受文化隔离的影响——社会隔离的影响也是可以察觉到的。从某种意义上说，文化隔离的影响是由社会隔离来调节的，而重要的方面是与他人的有意义的联系。有一个关于一小群在战争期间曾是纳粹合作者的挪威病人的偏执型精神分裂发展的有趣报告。战后他们受到同胞的排斥。甚至家人和朋友也和他们脱离关系。从解放到症状出现的时间跨度为0到24个月，平均13个月。显然，在占领期间，他们在一小群类似的合作者中找到了一个共同的社区，但随着解放，这群人分散了。因此，他们开始感受到社会隔离的全面冲击(Retterstol, 1968)。