Presenting Complaint 病人主诉 The present case is that of a young woman in her mid-twenties who came seeking psychoanalysis primarily because of the difficulty she was having in heterosexual relationships. She was unmarried, and although she could claim other areas in her life in which there had been significant achievement, the area of heterosexual adjustment had been a most chaotic and unhappy one for her. As a result she found herself quite unhappy and depressed. 现在的这个案例是一个25岁左右的年轻女性，她来寻求精神分析主要是因为她在异性关系中遇到了困难。她没有结婚，尽管她可以声称自己在生活的其他领域取得了重大成就，但对她来说，异性适应领域是最混乱、最不快乐的。结果，她发现自己非常不快乐和沮丧。 She had, it turned out, become quickly and rather intensely involved in relationships with men which turned out to be short-lived and most unsatisfactory. Her involvement in these relationships was always very competitive and basically sadomasochistic. The men in these relationships were almost exclusively unavailable, that is, they were either married or sufficiently immature to preclude even a remote possibility for a meaningful and perduring heterosexual involvement, let alone marriage. 事实证明，她很快就和男人们建立起了相当紧密的关系，但这种关系最终被证明是短暂的，而且最令人不满意的。她在这些关系中总是充满竞争，基本上是施虐受虐狂。这些关系中的男人几乎都是不可得的，也就是说，他们要么结婚了，要么还不够成熟，以至不可能有任何有意义的、持续的异性交往，更不用说结婚了。 Karen's decision to seek therapeutic help came as a result of a particularly intense, unusually disappointing, and extraordinarily sadomasochistic relationship, in which she and her boyfriend would alternate in attempts to undercut and devalue each other, even to the point of physical beatings and abuse. She found herself acutely depressed and confused after the breakup of this unhappy relationship. She was intelligent and resourceful enough, however, to recognize that there was a recurrent pattern in these relationships and that she had better think about doing something about it. She sought psychiatric consultation, and psychoanalysis was recommended. 卡伦决定寻求心理治疗的原因是一段特别紧张、异常失望、异常施虐受虐狂的关系。在这段关系中，她和男友会轮流试图削弱和贬低对方，甚至达到殴打和虐待的地步。在这段不愉快的关系破裂后，她发现自己极度沮丧和困惑。然而，她足够聪明和足智多谋，能够认识到在这些关系中有一个反复出现的模式，她最好考虑做些什么。她寻求精神咨询，并被推荐进行精神分析。 When Karen first came to my office I found her to be a very impressive person. She was a tall, statuesque, platinum blonde, who was very attractive and obviously very bright. She handled herself with considerable poise and composure, even though it was detectable that she was covering a considerable degree of insecurity and anxiety. Over the course of several interviews, she told me something of the problems she faced and some of the general outlines of what her life had been like. There was little doubt in my mind that she was clinically depressed, but what impressed me perhaps more strongly than anything else was her remarkable resourcefulness and her capacity for mobilizing her energy and generally effective defenses in the service of dealing with her disappointments and anxieties. 当卡伦第一次来到我的办公室时，我发现她是一个令人印象深刻的人。她个子高高的，身材匀称，金发碧眼，非常迷人，显然非常聪明。她以相当镇定的态度处理自己，尽管可以看出她在掩饰相当程度的不安和焦虑。在几次会谈的过程中，她告诉了我一些她所面临的问题，以及她生活的一些大致轮廓。毫无疑问在我的脑海里,她是临床抑郁,但最让我印象深刻的是她非凡的智慧，和她动用能量和有效防御来来处理失望和焦虑的能力。 In fact, she had been able to accomplish a considerable amount in her score or more of years. Despite considerable adversity, as we shall see, her academic career had been remarkably successful. She had always been at the top of her class through grade school and high school. She had graduated with high honors from a prominent eastern university and was elected a member of Phi Beta Kappa. She had continued on to postgraduate work, and at the time was just beginning the work on her doctoral dissertation. 事实上，多年来，她在她的成绩和其他事情上取得了很多成功。正如我们将看到的，尽管经历了相当多的逆境，她的学术生涯还是非常成功。从小学到高中，她一直是班上的尖子生。她以优异的成绩从东部一所著名大学毕业，并被选入美国大学优等生荣誉学会。她继续攻读研究生，那时她刚刚开始写博士论文。