Paranoid Psychosis 偏执性精神病 During the course of her many admissions, observers noted the intense feelings of insecurity, the intense dependency needs, and the threatening depressive feelings that lay beneath the surface—and against which Ellen defended herself by her belligerent attitude and hostile assaultiveness. Her attitude was always one of guarded suspiciousness. The content of her delusions were highly sexualized and often assaultive. At one point she had to be transferred from a state hospital to a private hospital because of her repeated escapes. She claimed that the state hospital was full of blacks and lesbians. She claimed that she had to continually fight them off, and was afraid that she would become a black or a lesbian herself. She believed that the doctors in the hospital were crawling into bed with her at night and having intercourse with her while she was asleep. She also thought that she had been forced to have intercourse with one of the blacks in the hospital. 在她多次收治的过程中，观察者注意到她强烈的不安全感，强烈的依赖性需求，以及潜藏在表面之下的威胁的压抑感——埃伦用她好斗的态度和敌对的攻击性为自己防御这些。她的态度总是小心翼翼，满腹狐疑。她幻想的内容是高度性别化的，往往具有攻击性。有一段时间，她不得不从公立医院转到私立医院，因为她多次逃脱。她声称州立医院里全是黑人和女同性恋。她声称自己必须不断地与他们抗争，并担心自己会成为黑人或女同性恋。她相信医院的医生晚上会爬上她的床，趁她睡着的时候和她性交。她还认为她被迫和医院里的一个黑人发生了性关系。 Ellen's delusional state was fairly constant. On one of her recent admissions, she was walking past a monument in a square near her home. She thought the people present were talking about her and laughing at her. It seemed that for more than a year she had felt that certain people whom she identified only as "the witches" had been talking about her and laughing at her in the same way. On this day, however, she heard them calling her a "dirty pig"and a"nigger." She became enraged and attacked the people sitting around the monument. The police were called and she was thus brought to the hospital. Her victims included a couple of young adolescents, an older woman, and an elderly man. Even in the hospital her voices continued to laugh at her, criticize her, call her a "nigger," accuse her of sleeping with blacks, or of being queer. It was not difficult to hear in these delusional accusations the echoes of her mother's voice. 埃伦的妄想状态相当稳定。在她最近的一次住院中，她走过她家附近广场上的一座纪念碑。她以为在场的人都在谈论她，嘲笑她。似乎一年多以来，她一直觉得，某些她只知道是“女巫”的人，也在用同样的方式谈论她，嘲笑她。然而，就在这一天，她听到他们叫她“肮脏的猪”和“黑鬼”。她勃然大怒，袭击了坐在纪念碑周围的人们。警察来了，她就这样被送到了医院。她的受害者包括两名青少年，一名老年妇女和一名老年男子。甚至在医院里，她的声音还在嘲笑她，批评她，称她为“黑鬼”，指责她和黑人上床，或者是同性恋。在这些痴心妄想的指责中，不难听到她母亲的回音。 Ellen's behavior in the hospital was extremely agitated and chaotic. Despite attempts to control her behavior and high doses of tranquilizing medications, she would burst out in angry tirades, shouting obscenities at nurses or patients. At times she would physically attack people and would have to be forcibly restrained. Escape attempts were frequent. Between her angry outbursts and attacking behavior, she would quiet down for a time and then suddenly dash for the ward door and try to run out of the hospital. This became a regular feature of her hospital routine. Frequently her attackson other patients or the nursing staff were precipitated by her feeling that they were talking about her or accusing her of something. On a number of occasions her outbursts were related to her seeing elderly and demented female patients on the ward. Seeing these patients was very upsetting to her and she would "lose control." 埃伦在医院里的行为非常激动和混乱。尽管她试图控制自己的行为，并服用高剂量的镇静剂，但她还是会大发雷霆，对护士或病人大喊脏话。有时她会对人进行人身攻击，而且必须被强制约束。经常试图逃跑。在她愤怒的爆发和攻击行为之间，她会安静一段时间，然后突然冲向病房门，试图跑出医院。这成了她在医院的例行公事。她经常攻击其他病人或护理人员，因为她觉得他们在谈论她或指责她。在许多情况下，她的情绪爆发与她在病房里看到老年和精神错乱的女性病人有关。看到这些病人让她很沮丧，她会“失去控制”。