THE PATIENT'S PROFILE 病人简介 My first contact with Miss Ann A. came at a time when she was an inpatient in a large state mental hospital. She was living in a large ward which was primarily custodial in function. She was a plain, rather average and not terribly attractive girl. She was twenty-five years old and had been in the hospital for several months. As we shall see, it was only one of a number of hospitalizations. She was quiet and withdrawn on the ward. She initiated little or no contact with any of the ward personnel or with the other patients. She kept to herself, minded her own business and generally showed little interest or involvement with anything that was happening on the ward or in any of the hospital activities. Occasionally she would burst out in tears, but would resist any attempts to help her or to find out what was bothering her. 我与安娜小姐的第一次接触发生在她在一家大型州立精神病院住院的时候。她住在一个很大的病房里，这个病房的主要功能是监管[已经给控制起来了，说明病得很重]。她是一个普通，相貌平平，并不十分迷人的姑娘。她25岁，在医院住了几个月。我们将看到，这只是众多住院治疗中的一次[因为偏执发作，住了好多次院]。她在病房里沉默寡言，性格孤僻。她很少或不主动与病房工作人员或其他病人接触。她总是一个人呆着，只关心自己的事，对病房里发生的任何事情或医院里的任何活动都不怎么感兴趣或参与。偶尔她也会放声大哭，但她拒绝任何帮助她或找出困扰她的原因的努力。 We began a course of psychotherapy that was to last over two years, and for most of that period she was seen at least once a week and sometimes more. She carried a diagnosis of chronic paranoid schizophrenia—the ward was one for patients who had been judged chronic and unresponsive to treatment. At that point in her career the paranoia was not very remarkable. She kept it quite hidden behind a facade of quiet passivity and compliance. It was only when she was stressed or when demands were put on her that she responded in terms of her feelings of persecution. At such times she would burst into tears and try to run away. When her anger and anxiety were really stirred, the paranoia became flagrant. Usually this expressed itself in delusions of a Communist plot against her. 我们开始了一个为期两年多的心理治疗过程，在这期间的大部分时间里，她每周至少看一次，有时更多。她被诊断为慢性偏执型精神分裂症——病房是为那些被诊断为慢性且对治疗反应迟钝的病人设立的。在她职业生涯的那个阶段，这种偏执并不是很明显。她把它完全隐藏在一种安静、被动和顺从的外表之下。只有当她感到有压力或有人向她提出要求时，她才会以受迫害的感觉来回应。在这种时候，她会大哭起来，试图逃跑。当她的愤怒和焦虑真正被激起时，偏执就变得肆无忌惮了。这通常表现为妄想共产主义者针对她的阴谋。