Hospitalization 住院治疗 My first contact with Henry came in the context of his most recent hospitalization. The circumstances surrounding the admission to the hospital were rather bizarre. He had arrived in the community quite recently and had contacted an old friend who was working as a resident in one of the local hospitals. This doctor had welcomed him, given him money, arranged for a room for Henry to sleep in at the hospital, and introduced him to several young nurses. Henry was coming off a recent hospitalization and was taking phenothiazines. The doctor friend took Henry to the psychiatric clinic so that his medications could be managed and treatment obtained if necessary. 我与亨利的第一次接触发生在他最近一次住院期间。他入院的情况相当离奇。他刚来到这个社区不久，就联系上了一位老朋友，这位朋友是当地一家医院的住院医生。这位医生朋友热情地接待了他，给了他钱，在医院为他安排了一间房间住下，并把他介绍给了几位年轻护士。亨利之前刚出院不久，正在服用吩噻嗪类药物。这位医生朋友带亨利去了精神科门诊，以便对他的药物进行管理，并在必要时进行治疗。 Henry quickly became rather intensely involved with one of the nurses he had met. He dated this girl frequently for several weeks，and then decided that he was falling in love with her. He decided to ask her to marry him and determined that he would pour out his tale of misery and woe to her. It is not clear whether at this time he was in the incipient stages of decompensation，but certainly the subsequent events had a bizarre quality. Henry began by drinking heavily；the effect was very likely potentiated by the medication he was taking. He then went to the girl's apartment. He began to pour out his protestations of love and his desperate need to be close to her. The girl had no particularly strong romantic interest in him，however，and his wild appearance and manner frightened her. She tried to get him out of the apartment，but he wouldn't leave. Finally she ran out of the apartment to get away from him，but he ran out after her. By this time the excitement and screaming had aroused the neighbors and the police arrived. When the police came Henry ran back up to the apartment and locked himself in. The police had to batter the door down to get him out. 亨利很快就与他遇到的一位护士陷入了热烈的交往。他连续几周频繁地约这个女孩出去，然后确定自己爱上了她。他决定向她求婚，并打定主意要向她倾诉自己悲惨的遭遇。目前尚不清楚他当时是否已处于失代偿的初期阶段，但随后发生的事件无疑充满了离奇色彩。亨利开始酗酒；很可能他服用的药物加剧了酒精的作用。然后他去了女孩的公寓。他开始向她倾诉自己的爱意，以及自己渴望与她亲密相处的迫切需求。然而，女孩对他并没有特别强烈的浪漫兴趣，而且他狂野的外表和举止吓到了她。她试图把他赶出公寓，但他就是不走。最后，她跑出公寓想摆脱他，但他也跟着追了出去。这时，喧闹声和尖叫声引起了邻居的注意，警察赶到了现场。警察来时，亨利跑回公寓把自己锁在了里面。警察不得不破门而入把他带了出来。 Psychiatric examination showed Henry to be quite excited and agitated. The psychiatrist could not determine whether his behavior had been due to decompensation or to inebriation. When he spoke about his doctor friend who had introduced him to the nurse, Henry was quite vociferous in expressing his disappointment, his anger at the friend for not helping him more, for betraying him, for luring him to this city and treating him so poorly, introducing him to women who would lead him on and get him into such trouble, etc. The content was full of distortions and delusional material. The ideation was quite paranoid, and Henry could not recognize anything extraordinary or strange about his behavior. Because of the bizarre behavior, paranoid ideation, and the depressive content of his thinking it was felt that further evaluation was advisable. 精神检查发现，亨利表现得非常兴奋和激动。精神科医生无法确定他的行为是由于失代偿还是醉酒引起的。当亨利谈到那位把他介绍给护士的医生朋友时，他大声地表达了自己的失望，以及对朋友没有给予他更多帮助、背叛他、诱骗他来到这个城市并如此糟糕地对待他、把他介绍给那些会引诱他并让他陷入麻烦的女人等行为的愤怒。他的言辞充满了歪曲和妄想的内容。他的思维相当偏执，亨利并不认为自己的行为有任何异常或奇怪之处。鉴于他行为怪异、偏执思维以及想法中带有抑郁情绪，医生认为有必要对他进行进一步评估。 When I first met him and began his evaluation, there was little that was remarkable about him. He was thirty-one years old, husky in build, somewhat balding, a moderately good-looking man. His mental functions were quite intact. The diagnostic points that stuck out, however, were his tremendous tension and anxiety. He sat with clenched fists, almost rigid, and with large drops of sweat standing on his forehead. Along with his obvious anxiety there was a strong degree of denial. Despite his tenseness and agitation he denied that he felt tense or anxious in any way. He tended to minimize or deny any significant difficulties in the past and resorted to elaborate intellectualized rationalizations to explain his behavior. He was able to express his feelings of bewilderment and disillusionment over the fact that the people he had counted on so much had all let him down. 当我第一次见到他并开始对他进行评估时，他并没有什么特别之处。他三十一岁，体格健壮，有些秃顶，算得上相貌端正。他的精神功能完全正常。然而，最突出的诊断要点是他的极度紧张和焦虑。他坐着的时候双拳紧握，身体几乎僵硬，额头上布满了大颗汗珠。除了明显的焦虑之外，他还表现出强烈的否认情绪。尽管他紧张不安，但他否认自己有任何紧张或焦虑的感觉。他倾向于轻描淡写或否认过去遇到的任何重大困难，并用精心构思的理性化解释来为自己的行为辩解。他能够表达出自己对于曾经非常依赖的人都让他失望这一事实的困惑和幻灭感。