Early Mother-Child Interaction 早期母子互动 One of the first questions that the data in this case urge on us is the question of genetic influence. In most of the other cases we have been forced to surmise a pathogenic relationship between mother and child from later disturbances in the relationship. In Gloria's case, however, there seems to be good and clear-cut evidence that the relationship between Gloria and her mother was disturbed from the very beginning. The mother's postpartum depression and insecurity and inability to nurse and care for her child seem to have distorted the smooth regularity and mutuality that is so necessary for early development. In every case we have had to study, the relationship between a paranoid daughter and her mother was overloaded with ambivalence and hostility. In none of the cases is the evidence for this impairment in the mother-daughter relationship so clear or so early. As is so often the case, the evidence is provided not merely by the historical data but by the contemporary data provided by the patient's ongoing dynamics. Rarely in my experience have the pregenital elements behind the paranoid dynamics been so explicit. Gloria's yearning for love and affection from her mother, her tearful and anguished cry that her mother was lost to her, and that she could not reach out to her and embrace and be embraced by her as she wished, were infantile and regressive, primitive wishes of the infant to be held, cuddled, fed and warmed by the mother's body. In these tearful regressive episodes Gloria became the frustrated and wrathful infant who cannot reach the mother's breast. She seemed overwhelmed with a sense of deep loss and abandonment. 这个案例中的数据向我们提出的第一个问题是遗传影响的问题。在其他大多数情况下，我们不得不从后来关系中的问题推测母亲和孩子之间的致病关系。然而，在格洛丽亚的案例中，似乎有很好的和明确的证据表明格洛丽亚和她母亲的关系从一开始就受到了干扰。母亲的产后抑郁症、缺乏安全感、无法看护和照顾孩子，似乎扭曲了对早期发育非常必要的平稳的规律性和相互关系。在我们不得不研究的每一个案例中，偏执女儿和她母亲之间的关系都充满了矛盾和敌意。在所有的案例中，都没有证据能如此明确或如此早地证明母女关系受损。通常情况下，证据不仅由历史数据提供，而且由病人持续的动力学提供的当代数据提供。在我的经验中，这种偏执动力学背后的前性器因素很少如此明显。格洛里亚渴望来自母亲的爱和情感,她泪流满面痛苦地哭泣,因为她失去了她的母亲,因为她触不到母亲，无法按自己期望的拥抱母亲并被母亲拥抱，这是婴儿般的、退化的、原始的愿望，只有婴儿才渴望被保持，被拥抱，被喂养，被母亲的身体温暖。在这些泪流满面的退步情节中，格洛丽亚变成了一个无法触及母亲乳房的沮丧愤怒的婴儿。她似乎被深深的失落感和遗弃感淹没了。 Freud had commented in his essay on female sexuality(1931)(1961): 弗洛伊德在他的文章《女性的性》(1931)(1961)中评论道: We find the little girl's aggressive oral and sadistic wishes in a form forced on them by early repression, as a fear of being killed by her mother—a fear which, in turn, justifies her death-wish against her mother, if that becomes conscious. It is impossible to say how often this fear of the mother is supported by an unconscious hostility on the mother's part which is sensed by the girl (p.237). 我们发现，这个小女孩咄咄逼人的口欲愿望被察觉到了，这种愿望被早期压抑强加在他们身上，以害怕被母亲杀害的形式出现。而这种恐惧反过来又合理化了她对母亲的死亡愿望[怕被母亲杀害，其实是想让母亲死]。很难说这种对母亲的恐惧有多少是由母亲无意识的敌意所支持的，而这种敌意被这个女孩感知到了(p.237)。 For Gloria these primitive aggressive impulses were derived not merely from the usual run of frustrating and denying responses that are inevitably involved in any maternal ministrations. From the beginning Mrs.G.'s attempts at mothering had been permeated with anxiety and her own sense of insecurity in the performance of her mothering duties. We shall see more of this later, but we can recall at this point that Gloria's earliest experience with her mother was shrouded with a severe depression in the mother. Moreover the mother's difficulties with her mothering position were persistent, extending in fact into the period of Gloria's psychotic decompensation and treatment. 对格洛丽亚来说，这些原始的攻击冲动不仅来自于任何母亲照料中不可避免地涉及到的通常令人沮丧和否认的反应。从一开始，G.夫人做母亲的努力就充满了焦虑和她自己在履行母亲职责时的不安全感。我们稍后会看到更多，但我们可以回忆起，在这一点上，格洛丽亚与她母亲的早期经历是笼罩在母亲的严重抑郁症下的。此外，母亲在母亲的位置上的困难是持续的，事实上延伸到格洛丽亚的精神病失代偿期和治疗期间。 Gloria's desperate longing for closeness and affection from her mother and its continual frustration was one of the significant leitmotivs of her life and experience. We can suggest a number of important consequences of this basic dimension of her life, particularly in regard to her early life experience. The basic uncertainty and instability in the early mother-child interaction undermined the establishment of basic trust. Gloria was faced early in her experience with the equivalent of maternal loss or its threat. She was not provided with a stable, responsive, and constant mothering object. Her mother was conflicted, anxious, and depressed—psychologically withdrawn and unavailable in a variety of ways. Gloria did not have the opportunity for the experience of mutual regulation and responsiveness that lies at the root of basic trust. 格洛丽亚对母亲的亲密和关爱的极度渴望，以及不断的挫折，是她生活和经历的重要动力之一。我们可以提出她生活的这个基本方面的一些重要后果，特别是关于她早年的生活经历。早期母子互动的基本不确定性和不稳定性破坏了基本信任的建立。格洛丽亚在她早期的经历中就面临着相当于失去母亲或失去母亲的威胁。她没有一个稳定的、有反应的、持续不断的母性对象。她的母亲是矛盾的，焦虑的，抑郁的-心理上的退缩和各种各样的不可得。格洛里亚没有机会体验作为基本信任基础的相互调节和反应。