Introduction We want to turn at this point to the clinical material upon which the present study is essentially based. In turning to this material, it may be well to pause for a moment of methodological reflection. 此刻，我们想转向临床材料，目前的研究在本质上就是基于它们的。在转向这一材料时，不妨暂停一下，对方法论进行一下反思。 The psychoanalytic and clinical methodology is essentially one of naturalistic observation. It is based on the close observation and analysis of single case histories and the experience of the therapeutic encounter with individual patients, often extending over long periods of time. It is essentially this methodolgy which is employed in the present study. 精神分析和临床方法论本质上是一种自然主义的观察方法。它是基于对单个病例历史的密切观察和分析，以及与单个患者的治疗接触的经验，这种接触通常会持续很长一段时间。本研究基本上就是采用这种方法论。 Such an approach has its inherent limitations, but also carries within it certain specifiable advantages. The limitations are quite apparent, and Freud himself was quite aware of them. In commenting on the case of Dora, he wrote: 这种方法有其固有的局限性，但也有其特定的优点。局限性是很明显的，弗洛伊德本人也很清楚。在评论朵拉的案例时，他写道: It is, on the contrary, obvious that a single case history, even if it were complete and open to no doubt, cannot provide an answer to all the questions arising out of hysteria. It cannot give an insight into all the types of this disorder, into all the forms of internal structure of the neurosis, into all the possible kinds of relation between the mental and the somatic which are to be found in hysteria. It is not fair to expect from a single case more than it can offer. And anyone who has hitherto been unwilling to believe that a psychosexual aetiology holds good generally and without exception for hysteria is scarcely likely to be convinced of the fact by taking stock of a single case history. He would do better to suspend his judgment until his own work has earned him the right to a conviction(1905a, p.13). 相反，很明显，一个个案史，即使是完整和毫无疑问的，也不能对歇斯底里所产生的所有问题提供一个答案。它不能让我们深入了解这种疾病的所有类型，了解神经官能症的所有内部结构形式，了解歇斯底里症中精神和肉体之间所有可能的关系。期望从一个案例中得到比它所能提供的更多是不公平的。迄今为止，任何一个不愿相信性心理成因普遍成立，歇斯底里症也不例外的人，都不太可能通过回顾单一的案例历史来确信这一事实。他最好暂停他的判断，直到他自己的工作为他赢得了定罪的权利(1905a，第13页)。 To this there can be added a methodological comment which Freud made a few years later regarding the way in which the analytic theorist uses case material. He commented: 除此之外，还可以加上一条方法论上的评论，这是弗洛伊德在几年后对分析理论家使用案例材料的方式所做的评论。他评论道: The cases of illness which come under a psycho-analyst's observation are of course of unequal value in adding to his knowledge. There are some in which he has to bring to bear all that he knows and from which he learns nothing; and there are others which show him what he already knows in a particularly clearly marked manner and in exceptionally revealing isolation, so that he is indebted to them not only for a confirmation but for an extension of his knowledge. We are justified in supposing that the psychical processes which we wish to study are no different in the first class of cases from what they are in the second, but we shall choose to describe them as they occur in the favorable and clear examples afforded by the latter. Similarly the theory of evolution assumes that in the animal kingdom, the segmentation of the egg proceeds in the same manner in those cases where a high degree of pigmentation is present and which are unfavorable for observation, as it does in those cases where the object of study is transparent and poorly pigmented and which are on that account selected for observation (1913a,p.193). 精神分析学家所观察到的病例，在增加他的知识方面，其价值当然是不相等的。有些东西，他必须把他所知道的全部运用到实践中去，而他却什么也学不到;还有一些以一种特别明显的方式，以一种异常具有揭示性的隔离，向他展示了他已经知道的东西，因此，他不仅感激这些书的证实，而且感激它们扩展了他的知识。我们有理由假设，我们希望研究的心理过程在第一类案例中与在第二类案例中并无不同，但我们将选择用后者所提供的有利而明确的例子来描述它们。类似地，进化论假设在动物王国里,卵的分节[与体节生成有关]是以相同的方式进行的，无论卵是高色素的，还是透明低色素的。高色素对于观察是不利的，低色素被挑选出来，因为有利于观察。(1913 a, p.193)。 Consequently our approach in the present study does not depend on the material or the analysis of any single case. Rather by a careful analysis of a series of cases and a comparative analysis of the patterns of development and defensive organization, we hope to elicit from each case in a differentiated manner certain aspects and dimensions of the paranoid process which are idiosyncratically expressed in the material of the respective case. To a certain extent the meaningful configuration within certain limits of variance can be identified in each of these cases, and consequently form a common core of paranoid dynamics which can be related specifically to the paranoid process. So there is differentiation and variation from case to case, which serves to flesh out and amplify our understanding of the paranoid process rather than reducing it simplistically to a core set of dynamics or inferences. 因此，我们在本研究中的方法不依赖于任何单一案例的材料或分析。而通过仔细分析的一系列病例和发展模式与防御组织的比较分析,我们希望以差异化的方式从每个案例引出偏执过程的某些方面和维度，它们在各个案例的材料中是独特表达的。在一定程度上，在一定方差范围内的有意义的配置可以在每一个案例下被识别出来，从而形成一个偏执动力学的共同核心，它可以具体地与偏执过程相关联。因此，每个案例之间都有区别和变化，这有助于具体化和扩大我们对偏执过程的理解，而不是简单地将其简化为一组核心的动力学或推理。 Consideration of a series of cases of varying degrees of psychological involvement, and from various strata of maturity of functioning and psychic organization, provides us with considerable enrichment of our understanding of the workings and functionings of the paranoid process rather than a reductively simplified and sterile appreciation. We are not seeking, therefore, a central core concept which reductively and simplistically provides an explanation for the identifiable patterns of paranoid pathology, but our concern is rather with the richness and variety of forms of expression of the paranoid process which reach a span that extends from the most disturbed levels of psychopathology to the limits of productive and creative human potentiality. 考虑到一系列不同程度的心理介入的案例，以及不同层次的功能和心理组织的成熟程度，使我们对偏执过程的运作和功能有了相当丰富的理解，而不是一种简单化的、枯燥无味的欣赏。因此,我们不寻求一个核心概念,其还原性地和简单地提供了一个偏执病理学的可识别的行为模式的解释,但我们关注的是,偏执过程表达形式的丰富性和多样性，从精神病理学的最干扰水平,到生产性和创造性的人类潜力的极限。 Moreover, as Freud has indicated in his comparison of the study of segmentation, we can expect to find that different aspects and different segments of the range of paranoid manifestations will be reflected in different ways in each of the different cases. This is a matter not merely of variation in the cases themselves, but also reflects the vicissitudes of obtaining clinical information which can vary so considerably from case to case. For some of these patients fairly extensive records were available, either from previous hospital admissions or from previous therapists who were able to provide more detailed impressions of the patient's history and pathology. Some of these patients have been involved in a therapeutic contact which has been considerably more extensive and deeper than others. Consequently like the egg of the sea urchin, our investigation cannot expect to learn the same things from all of them. It is only in their comparative study, with a sensitivity to the idiosyncratic variations that play themselves out from case to case, that we begin to grasp the manner in which the paranoid process has played itself out within the life experience of each of these individuals. 此外，正如弗洛伊德在对分节研究的比较中所指出的，我们可以预期，偏执表现范围的不同方面和不同片段会在每一个不同的案例中以不同的方式反映出来。这不仅是病例本身的变化，而且还反映了获取临床信息的变迁，而临床信息在不同的病例之间可能有很大的差异。对于这些病人中的一些人，有相当广泛的记录，要么来自以前的住院治疗，要么来自以前的治疗师，他们能够提供病人的病史和病理学的更详细的印象。这些病人中有一些已经参与了比其他病人更为广泛和深入的治疗接触。因此，就像海胆的卵一样，我们的研究不能指望从所有的海胆身上都能学到同样的东西。只有在他们的比较研究中(带着对特殊变化的敏感，这些变化从一个案例到另一个案例显现着自己)，我们才开始理解偏执的过程是如何在每个人的生活经历中发挥作用的。 I would like also to offer a justification for presenting as detailed an analysis of these cases as I have made available here. From an analytic perspective there is no substitute for detailed case analysis. If one wishes to illustrate a point of theory or to explain a particular clinical finding or low-level clinical generalization, fragments of case histories are useful and often illustrative. But it is my conviction that in an attempt to study and formulate the workings of a process which is as extensive and central to human experience as the paranoid process, one cannot remain satisfied with bits and pieces. One must see the workings of the process in as great an extent as is feasible, not only in the current material which a patient brings to the therapeutic hour, but throughout the course of the patient's developmental history. A similar point has been made by Anna Freud in her foreword to Muriel Gardiner's volume on the Wolf-Man. Commenting on the dearth of adequately documented case histories, she observes: 我还要提出一个像我在这里所作的那样，详细地分析这些案例的理由。从分析的角度来看，详细的案例分析是无可替代的。如果一个人想要阐明一个理论观点或解释一个特定的临床发现或低水平的临床概括，病例历史片段是有用的，而且经常是说明性的。但我坚信，在试图研究和阐明类似偏执过程这样对于人类经验来说是广泛的和中心的过程的工作原理时，一个人不能满足于零零碎碎的东西。一个人必须在尽可能大的范围内看到这个过程的工作，不仅是病人在治疗时带来的当前材料，而是包括病人整个发展历史。安娜•弗洛伊德在她为穆丽尔•加德纳的《狼人》一书撰写的前言中也提出了类似的观点。在评论缺乏充分记录的病例历史时，她指出: This failure in output where the practicing analyst's main preoccupation is concerned is not attributable to the fact that analysts know too little of their patients but to the opposite—that they know too much. The technical tools of analytic therapy such as free association, dream interpretation, resistance and transference interpretations produce a mass of data about the patient's life history, the healthy and the pathological sides of his nature, which, due to its bulk, is unwieldy and, if written up in undigested form, unreadable. To handle this raw material in a manner which produces, on the one hand, a vivid image of the individual person and, on the other hand, a detailed picture of a specific psychological disorder is no mean task and, as a literary achievement, far beyond the powers of most scientific authors. What is produced accordingly in our day are either snippets of clinical material used to illustrate some theoretical conception or, at best, one-sided clinical accounts which fail to acquaint the reader with the patient as a living personality(Freud, A., 1971, p.ix). 执业分析师主要关注的输出失败不是因为分析师对病人了解太少，而是相反——他们知道的太多。分析治疗的技术工具如自由联想、梦的解析、阻抗和移情的解释，产生了关于病人生活历史的大量数据,他的健康和病态本性,,由于它的数量,是笨拙的,如果以未消化的形式写出来,不是可读。处理这些原始资料的方法，一方面能产生一个生动的个人形象，另一方面又能详细描述一种特定的心理障碍，这绝非易事，而且作为一项文学成就，远远超出大多数科学作家的能力。因此，我们今天所产生的要么是一些临床材料的片段，用来阐明一些理论概念，要么充其量是片面的临床描述，无法让读者把病人作为一个活生生的人来了解(Freud, A., 1971, p.ix)。 We can only hope, then, that in the case histories that follow we have been able to catch some of the living reality of the patient's experience as it reflects and expresses the underlying dimensions of the paranoid process. 因此，我们只能希望，在接下来的病例历史中，我们能够捕捉到病人经历的一些活生生的现实，因为它反映和表达了偏执过程的潜在维度。