The Patient's Profile 病人简介 The case of Dr. Robert B. represents an example of a patient who led a premorbid life pattern that was not without its pathological indicators, but which seemed to fall within a relatively normal range of developmental and adjustment vicissitudes. It was not until he was beyond his thirtieth year that his pathology broke through in a most virulent form. One of the most difficult things for psychiatrists to understand is why certain patients seem to demonstrate a relatively adaptive life-style, but then seem to decompensate acutely in the face of often identifiable—but often, too, apparently unidentifiable—precipitants. As the present case suggests, often the precipitants are imposed on an underlying pathological process that can successfully conceal itself—or perhaps, can successfully be ignored or denied-until an acute and dramatic break with reality makes its presence undeniable. 罗伯特博士的案例代表了一个病人在发病前生活模式的例子，这种生活模式并非没有病理指标，但似乎属于相对正常的发展和调整变化范围。直到他过了三十岁，他的病理学才以一种最致命的形式取得突破。对精神科医师来说，最难理解的一件事是，为什么某些病人似乎表现出相对适应性的生活方式，但在面对通常可辨认的——但往往也是显然无法辨认的——诱因时，却似乎急剧失代偿。正如本案例所表明的那样，这些诱发因素往往是强加在潜在的病理过程上的，这种病理过程可以成功地掩盖自己——或者也许可以成功地被忽视或否认——直到与现实发生剧烈而戏剧性的断裂，使其存在不可否认。