Prior Psychiatric History 既往精神病史 It turned out that the present hospitalization was neither the first nor the last that Fred was to experience. I would like at this point in discussing his case to go back to the point of his first hospitalization and review the experiences which brought him to this second one. In the light of that more recent part of his history, we can then go back to his earlier life experience and family background to try to determine the influences which might have lain behind this illness and determined the pattern of its emergence. 事实证明，弗雷德此次住院既不是第一次，也不是最后一次。在讨论弗雷德案例的这一点上，我想回到他第一次住院的时候，回顾一下导致他这第二次住院的经历。根据他最近病史，我们可以回顾他早年的生活经历和家庭背景，试图确定可能导致这种疾病并决定其出现模式的影响因素。 Fred's first psychiatric hospitalization took place while he was serving in the armed services. We can pick up the story at the beginning of his college career. Fred's first year in college was not altogether a successful or encouraging one. At the university he quickly became involved in the drug scene and made friends mostly with other students who were also actively involved in taking drugs. He became a regular user of marijuana and also indulged in an occasional LSD trip. This routine became rather depressing for him. His grades were poor and he became rather distressed at his inability to perform well academically. He also wished to break away from the drug routine, which he felt was hurtful to himself. He felt that he was liable to be drafted anyway because of his poor marks, so he decided that he would enlist in the army. 弗雷德第一次精神病住院是在他服兵役期间。我们可以从他大学生涯的开始说起。弗雷德大学一年级的生活并不成功，也不令人鼓舞。在大学里，他很快就沾染上了毒品，结交的朋友也大多是其他积极吸毒的学生。他成了大麻的常客，偶尔还会沉迷于迷幻药之旅。这种生活对他来说相当压抑。他的成绩很差，他对自己学业上的不佳表现感到相当苦恼。他也希望摆脱日常吸毒，因为他觉得这对自己是有害的。他觉得自己反正成绩不好，很可能会被征兵，所以他决定参军。 His experience in the army was also an unhappy one. He was unable to develop any close friendships. He looked down on his fellow trainees as being less educated or less intelligent than himself. But most intensely of all he bitterly resented and hated the army discipline that was inflicted on him and to which he felt that he had to submit himself. He felt such discipline was a humiliation and an infringement on his rights. At the end of his basic training period, he was sent by the army to be trained as an electronics technician. By this time, of course, he had contacted some of his friends back in school and had received a shipment of LSD. By this time also his thinking was becoming increasingly disorganized and confused, and his capacity to control his anger and resentment increasingly impaired. He was becoming progressively suspicious and guarded and felt that the service was persecuting him. He felt that they were keeping him under surveillance. 他在军队的经历也很不愉快。他无法发展任何亲密的友谊。他瞧不起自己的同伴，认为他们比自己受教育程度低，也不如自己聪明。但最让他痛心疾首、痛恨不已的是强加给他的军纪，他觉得自己不得不屈服于军纪。他觉得这样的纪律是一种羞辱，侵犯了他的权利。在基础训练结束后，他被军队送去接受电子技师的培训。当然，这时他已经联系上了学校里的一些朋友，并收到了一批迷幻剂。这时，他的思维也变得越来越混乱，控制愤怒和怨恨的能力也越来越差。他变得越来越多疑和戒备，觉得军队在迫害他。他觉得他们一直在监视他。 He became confused, delusional, and frankly paranoid. He thought that his thought processes were being blocked by an electronic device, so that he couldn't remember things and could not think straight. He felt that the army was doing this to him and using this machine on him so that they could keep control over him and make him do what they wanted. 他变得困惑、妄想，明确地偏执了。他认为自己的思维过程被一种电子设备阻断了，以至于他记不住事情，也无法正常思考。他觉得军队这样对他，用这台机器控制他，让他按照他们的意愿行事。 Fred's decompensation was, however, short-lived. He was hospitalized for a brief period and was then discharged from the hospital. He was given a medical discharge from the army and was mustered out. He decided to return to school and complete his studies. His performance academically continued to be rather mediocre. This was a severe blow to his narcissism. But his difficulties were more than merely academic. He tended to be shy and awkward, found it difficult to talk to people or to communicate with other students. He had constant ideas of reference. He felt that people were talking about him behind his back or that they were laughing at him. He recalled incidents when he would go to the school library to study, but was distinctly uncomfortable because he felt the other students were whispering about him or watching him. He desperately wanted to be able to reach people and gain their respect and admiration. 然而，弗雷德的失代偿是短暂的。他住院了一小段时间，然后就出院了。他获得了军队的出院，并被遣散。他决定回到学校继续学业。他的学业成绩仍然很平庸。这对他的自恋是一个沉重的打击。但他的困难不仅仅是学业上的。他往往害羞笨拙，发现很难与人交谈或与其他学生交流。他总有牵连观念。他觉得人们在背后议论他，或者在嘲笑他。他回忆起去学校图书馆学习时的情形，但明显感到不舒服，因为他觉得其他学生在窃窃私语或在注视他。他迫切地希望能够与人接触，获得他们的尊重和钦佩。