Ann's Development 安娜的发展 It is within this unhappy, conflicted, difficult and hostile environment that we must situate our patient. Her early development was relatively unremarkable. Our knowledge of this early stage is limited by the fact that we are dependent on parental recollections. Parental recollections are noteworthy for their propensity to distortion, but even taking this into consideration we must recognize an extraordinary degree of masking and denial on the part of Ann's parents. They were both eager to put the blame on each other, but both were also strikingly oblivious to any difficulties that Ann may have had in her early childhood years. 我们必须把我们的病人放在这种不幸、冲突、困难和敌对的环境中来考虑。她的早期发育相对平淡无奇。我们对这一早期阶段的认识受到一个事实的限制，即我们依赖于父母的回忆。值得注意的是父母的回忆容易扭曲，但即使考虑到这一点，我们也必须认识到，安娜的父母在很大程度上掩盖和否认。他们都急于把责任推到对方身上，但都对安娜在童年早期可能遇到的困难毫无察觉。 Two significant facts jump out and provide a striking contrast to this uniformly pseudo-benign background. First, Ann was an habitual thumb-sucker all through her childhood and did not give it up until she was almost twelve years old. Second, Ann had a persistent problem with enuresis until nearly the same age. Bed-wetting was a regular phenomenon and occurredalmost nightly. This was a source of special concern to the mother, who picked on Ann for this and constantly ridiculed and shamed her for it. The patient, herself, in recalling this symptom felt that it usually happened when she was feeling anxious or frightened. One would have to conclude that anxiety and fright were a regular occurrence for little Ann. 两个重要的事实跳了出来，与这种一致的伪良性背景形成了鲜明的对比。首先，安娜在她的整个童年时期都习惯性吮吸指头，直到她快12岁时才停止。其次，安娜一直有遗尿的问题，直到几乎相同的年龄。尿床是一种常见现象，几乎每晚都会发生。这是这位母亲特别关心的一个问题，她为此挑安娜的毛病，不断地嘲笑和羞辱她。病人自己在回忆这种症状时，觉得这种症状通常发生在她感到焦虑或害怕的时候。人们不得不得出这样的结论:对小安娜来说，焦虑和恐惧是经常发生的事情。 The other striking aspect of this symptomatic material is that it was not volunteered by either parent. It came to light only under direct questioning and then was acknowledged only reluctantly. There was first an offhand admission that there had been some problems, but then only gradually and begrudgingly did the full extent of these problems become apparent. It was striking, the extent to which these parents were unwilling or unable to acknowledge deviance or difficulty in this child. This is particularly striking since these symptoms were so apparent and continued through so many years up through latency to the adolescent years. This in fact was a general pattern for these parents—an unwillingness to acknowledge difficulties and a tendency to denial. With Ann, the problem seemed to be more that the mother was so furious at Ann for not living up to her expectations and demands that she was totally unable to see it in terms of a problem for her daughter. She could only see it in terms of an attack on herself and an undercutting of her position as the good mother who raises her children properly. Any admission of a problem in her daughter, therefore, was equivalently an admission of defectiveness or failure on her own part—and she was strongly motivated to avoid this. 这种症状性材料的另一个引人注目的方面是，它不是父母双方自愿提供的。这件事只有在直接询问下才被发现，后来才勉强承认。一开始，他们信口开溜地说有一些问题，但后来，这些问题的全貌才逐渐显露出来，而且是不情愿的。令人惊讶的是这对父母不愿意或不能承认这个孩子的异常或困难的程度。这是特别引人注目的，因为这些症状是如此明显，并持续了这么多年，从潜伏期直到青春期。事实上，这是这对父母的普遍模式——不愿意承认困难，并倾向于否认。对于安娜来说，问题似乎更多的是母亲对安娜没有达到她的期望和要求感到愤怒，以至于她完全无法从女儿的困难的角度来看待这个问题。她只能看到这是对她自己的一种攻击，是对她作为一个把孩子抚养得很好的好母亲地位的削弱。因此，任何承认她女儿有问题的行为，都等同于承认她自己有缺陷或失败——而她强烈地想要避免这一点。 One can also suggest that the degree of denial suggests the extent to which these parents were unable to respond to Ann as a separate individual. They could see her only in terms of their own(primarily narcissistic) needs. Thus the pattern of projection and introjection was set in operation. The least tolerated and most hated aspects of the parents, particularly the mother, were projected onto little Ann, there to be rejected and denied. 我们也可以认为，否认的程度表明，这些父母无法把安娜当作独立的人来对待。他们只能从自己(主要是自恋)的需求来看待她。这样，投射和内摄的模式就形成了。父母们(尤其是母亲的)最不宽容、最讨厌的一面，都投射到小安娜身上，在那里她会被拒绝和否定。