Therapy 治疗 Attempts to conduct therapy with Ellen were difficult and chaotic. Her general attitude was one of hostile suspiciousness. Her moods were extremely labile. She would shift with startling quickness from angry accusations to tearful remorse. In moments of great distress, she would frequently begin talking with great feeling and remorse about her father and his death. At times she was able to weep bitterly about this event, but often her tears would turn to angry outbursts. It seemed clear that her paranoid outbursts were serving important defensive needs against the severe loss and intense feelings of depression that she could not tolerate. At such times her thinking would become quite obviously disorganized and loose, and she would become tremendously anxious. She would often feel that she was having a heart attack—feeling pain over her heart—having difficulty breathing, and feeling a tingling sense in her extremities. 和埃伦一起进行治疗的尝试既困难又混乱。她总的态度是充满敌意的猜疑。她的情绪极不稳定。她会以惊人的速度从愤怒的指责转变成含泪的悔恨。在极度痛苦的时刻，她常常带着极大的感情和悔恨谈起她的父亲和他的死。有时她会为这件事痛哭流涕，但她的眼泪往往会变成愤怒的爆发。显然，她偏执的情绪爆发是为了满足重要的防御需求，以应对她无法忍受的严重损失和强烈的抑郁情绪。在这种时候，她的思维显然会变得紊乱和松散，她会变得非常焦虑。她常常觉得自己心脏病发作了——感到心脏疼痛——呼吸困难，四肢发麻。 Even in the best therapeutic relationship she was able to establish, it was plain that she could not tolerate any closeness and could not bring herself to trust her therapist. She was constantly testing, both in treatment sessions and in her behavior on the ward. When she succeeded in provoking a restrictive or repressive response from the staff, she took it as proof that they did not really care about her but were only out to do her in. Many of her escape attempts and provocative attacks also had this manipulative flavor. Unfortunately—but also almost unavoidably—she would succeed in making the staff angry at her, particularly by her frustration of their therapeutic intents and purposes. She was intent on recreating in the therapeutic setting the pattern of interaction that she maintained at home with her mother. 即使在她能够建立的最好的治疗关系中，她也不能容忍任何亲密，也不能让自己相信她的治疗师。无论是在治疗过程中，还是在病房里，她都在不断地进行测试。当她成功地激起工作人员的限制性或压制性反应时，她把这看作是他们并不真正关心她，而只是想陷害她的证据。她的许多逃跑企图和挑衅性攻击也有这种操纵的味道。不幸的是——也是几乎不可避免的——她会成功地让工作人员生她的气，尤其是因为她让他们的治疗意图和目的受挫。她打算在治疗环境中重新创造她在家与母亲保持的互动模式。