Turning Point 转折点 Ann graduated from high school at eighteen. This marked a turning point in her life, the conjunction of several significant events which led to the precipitation of her illness. Within a short space of the time she graduated from high school, her family moved to a new neighborhood some distance from the old one, and Bobby broke off his relationship with her. There was thus a series of losses. She lost her school environment in which she had been able to maintain a fairly adequate level of adjustment, and thus had to surrender her more or less superficial relationships with schoolmates. She lost her ties to the old neighborhood and moved to a new one in which she knew no one and in which she felt that she was being watched and evaluated by the strangers who were her neighbors. There is a pathetic quality to this loss that seems remarkable. In later years, Ann would drive back to the old neighborhood and visit the places she knew as a child. There was a nostalgic longing in her voice when she talked about this old neighborhood. It seemed to have represented a part of her life when she was less troubled, more in touch with life and people around her, and more superficially adjusted. And finally, and perhaps most significantly, she lost Bobby. 安娜十八岁高中毕业。这标志着她生命中的一个转折点——几件导致她病情加重的重大事件的结合。在她高中毕业后的很短时间内，她的家人搬到了一个离旧社区有些距离的新社区，罗伯特和她断绝了关系。因此出现了一系列的损失。她失去了能够保持相当充分适应的学校环境，因此不得不放弃与同学们多少有些肤浅的关系。她失去了与旧社区的联系，搬到了一个新的社区，在那里她一个人也不认识，她感到自己被邻居中的陌生人监视和评价。这场损失有一种可悲的特质，这似乎很不寻常。在后来的几年里，安娜会开车回到老社区，参观她小时候熟悉的地方。当她谈到这个古老的街区时，她的声音里有一种怀旧的渴望。这似乎代表了她生活的一部分，那时她的烦恼较少，更多地与生活和周围的人接触，而且更容易适应环境。最后，也许也是最重要的，她失去了罗伯特。 It was as though Ann never really recovered from these losses—particularly the breakdown of her relationship with Bobby. She could never accept that loss and seemed to cling to that relationship and her fantasies about it in a desperate and forlorn way. Subsequent to that loss, in any case, she became increasingly isolated and withdrawn, and increasingly disturbed. She tried working, usually in a clerical or secretarial position, but was unable to keep any of her jobs for any extended period of time. In several of these jobs, she developed a crush on older men-usually men who were single or divorced. She would daydream about these men constantly and imagine herself going out with them, talking to them, etc. 安娜似乎从未真正从这些损失中恢复过来——尤其是她与罗伯特关系的破裂。她永远无法接受这种失去，似乎以一种铤而走险和孤立无助的方式紧紧抓住这段感情和她对它的幻想。无论如何，在那次失败之后，她变得越来越孤立，孤僻，越来越不安。她试着工作，通常是文员或秘书的职位，但无法在任何一份工作上保持很长一段时间。在其中几份工作中，她爱上了年长的男性——通常是单身或离异的男性。她经常幻想着这些男人，想象着自己和他们一起出去，和他们聊天，等等。 In the meantime, the mother was putting more pressure on her to get a boyfriend and start dating. Mother found a boy who she thought would be good for Ann, and put pressure on her to go out with him and to marry him. Ann did not particularly like this boy and finally broke up with him. Mother, of course, was furious. She saw Ann's action as an attack on herself, as undermining her wishes, and as an attempt on Ann's part to undercut mother herself by not getting married. Mother saw the whole situa-tion in highly narcissistic terms of what people might think of her as a mother if she had an unmarried daughter. She seemed incapable of thinking in terms of Ann's wishes or happiness. 与此同时，母亲给她施加了更大的压力，要她找个男朋友，开始约会。母亲找到了一个她认为对安娜很好的男孩，并对她施加压力，要她和他出去，并嫁给他。安娜并不特别喜欢这个男孩，最后和他分手了。母亲当然很生气。她认为安娜的行为是对她自己的攻击，是对她愿望的破坏，是安娜试图通过不结婚来削弱母亲的地位。母亲从一个高度自恋的角度来看待整个情况:如果她有一个未婚女儿，人们会怎么看待她作为一个母亲。她似乎无法考虑安娜的愿望或幸福。 The sexual area of Ann's life—while it had always been an area of confusion and uncertainty for her—became a central preoccupation and an area of conflict. Her sexual contacts had been generally quite limited. Even though she dated steadily with Bobby over several years, sexual activity waslimited to kissing and occasional petting. She would not permit intercourse, although she acknowledged that she had wishes for it. She felt terribly conflicted over these wishes. She felt that the only way she could hold Bobby was by responding to his sexual interest—but her wishes and fantasies made her feel guilty and vile. Even a moderate degree of sexual activity made her feel cheap and dirty and worthless—the "whore" that her mother so frequently accused her of being. After the loss of Bobby, these feelings became increasingly intense. She felt more and more guilty about sexual feelings orthoughts. For several years she had bleached her hair, but even this began to make her feel cheap and dirty. Even when she walked past a group of boys and they made suggestive comments to her, she felt shamed, cheapened, and vile, as though their comments turned her into a prostitute or whore. 安娜生活中的性领域——对她来说，这一直是一个混乱和不确定的领域——成了她关注的焦点和冲突的领域。她的性接触通常相当有限。尽管她和罗伯特稳定地约会了好几年，但性行为仅限于亲吻和偶尔的爱抚。她不允许性交，虽然她承认她希望这样做。她对这些愿望感到非常矛盾。她觉得她能抓住罗伯特的唯一办法就是回应他的性兴趣——但是她的愿望和幻想让她感到内疚和卑鄙。即使是适度的性行为也会让她感到廉价、肮脏和毫无价值——她的母亲经常指责她是“妓女”。失去罗伯特后，这种感觉变得越来越强烈。她对性的感觉和想法感到越来越内疚。几年来，她一直在漂白头发，但即使这样，她也开始觉得自己既廉价又肮脏。即使当她走过一群男孩，他们对她说一些挑逗的话时，她也会感到羞愧、被贬低和邪恶，仿佛他们的话把她变成了妓女或婊子。 Over the course of several months following these losses and changes in her life. Ann became more and more withdrawn, isolated, and increasingly disturbed. Her behavior became more and more automatic and robotlike. She gradually lost interest in things around her, became more apathetic and depressed. She kept to herself more and more. She stopped dating and avoided any contacts with boys. If she was approached in any way or if a boy talked to her, she felt ashamed and guilty. She became more and more suspicious, feeling that people were insincere and deceitful. She felt that people at work or on the street or bus were talking about her, criticizing her, saying that she was a cheap whore and prostitute. The feelings of loss, abandonment, confusion, doubt, suspicion, and helpless vulnerability had crystallized into a frank paranoid psychosis. 在经历了这些损失和生活的变化后的几个月里。安娜变得越来越退缩，越来越孤立，越来越不安。她的行为变得越来越自动，越来越像机器人。她逐渐对周围的事物失去了兴趣，变得更加冷漠和沮丧。她越来越孤僻了。她停止约会，避免与男孩接触。如果有人以任何方式接近她，或者有个男孩跟她说话，她就会感到羞愧和内疚。她变得越来越多疑，觉得人们不真诚，不诚实。她觉得单位里、街上或公共汽车上的人都在谈论她，批评她，说她是一个廉价的妓女。失落感、被遗弃感、困惑感、疑惑感、怀疑感和无助的脆弱感，这些感觉已经结晶成了一种直白的偏执型精神病。