Mother 母亲 The trouble with Clare's mother was that she adopted a submissive and nonchallenging role in relation to her husband. She never confronted her husband; she never intervened when he would go on his angry tirades or when he would beat the children so viciously. Clare's resentment at her mother for not protecting her against her father was deep and intense. The mother was in many ways a capable woman. She worked for many years as a psychiatric nurse, and for most of the time that Clare lived at home was the head nurse in a large psychiatric ward. At home, however, she kept her light under a bushel. She was apparently chronically depressed. Clare remembered her as never very warm or affectionate. She would often withdraw from the family and stay in her room for days on end, not eating, talking to no one. This would apparently happen particularly at times when she was enraged at her husband. She was a very conflicted women in regard to her own angry or hostile impulses, and would withdraw into a deep and sullen depression at such times. 克莱尔的母亲的问题在于，她在与丈夫的关系中扮演了一个顺从的、没有挑战性的角色。她从来没有和丈夫对质过;他大发雷霆的时候，恶狠狠地打孩子的时候，她从不干预。克莱尔对母亲没有保护她不受父亲伤害的怨恨是深沉而强烈的。这位母亲在许多方面都是个能干的女人。她做了很多年的精神科护士，克莱尔住在家里的大部分时间里，她是一个大型精神科病房的护士长。然而在家里，她却很低调。她显然长期患有抑郁症。克莱尔记得她从来没有非常热情或深情。她常常离开家庭，一连几天呆在自己的房间里，不吃饭，不跟任何人说话。这显然会发生，尤其是在她对丈夫生气的时候。对于自己的愤怒或敌对冲动，她是一个非常矛盾的女人，在这种时候，她会陷入深深的、阴郁的抑郁。 These episodes of silent and sullen withdrawal were particularly difficult and perplexing to Clare. She could remember them as far back as her memory served her. She felt hurt and angered by them. She would wonder whether she was responsible for what was happening. At such times her mother was unavailable to her—in a sense, lost for a time. Clare felt hurt and abandoned, unable to understand why her mother would no longer talk to her, why she was so withdrawn and sad. These were times of real anguish and doubt for her, making her feel guilty for her hostile feelings toward her mother and her father, making her feel that she was somehow bad and evil and the cause of all the unhappiness in the family. It made her feel particularly that she was the evil power that drove her mother away from her. 克莱尔对这些沉默和阴郁的退缩感到特别困难和困惑。她的记忆可以追溯到她所记得的最久远的时候。她对他们感到伤害和愤怒。她会怀疑自己是否对所发生的一切负责。在这种时候，她在某种意义上失去了她的母亲，失去了一段时间。克莱尔感到受了伤害，被遗弃了，无法理解为什么她的母亲不再和她说话，为什么她那么孤僻和悲伤。这段时间对她来说是真正的痛苦和怀疑，让她为自己对父母怀有敌意而感到内疚，让她觉得自己在某种程度上是邪恶的，是家庭中所有不幸的根源。这使她特别感到她是把母亲从她身边赶走的邪恶力量。 The mother's illness became exacerbated on two occasions. The firsttook place when Clare was about eleven years old. The mother became severely depressed and suicidal. She had to be hospitalized and was given shock treatments. Clare remembered only that this time was full of severe disruptions and anxiety in the family. She recalled that her father was very worried, upset, and irritable. She could not understand what was happening, and remembered feeling responsible for her mother's plight and for her having to go to the hospital. Before she went to the hospital mother had been through a period of severe withdrawal, spending whole days in bed and communicating with no one. It was like one of mother's typical withdrawal episodes, except that it was on a larger and more intense scale. 母亲的病情有两次加重。第一次发生在克莱尔大约11岁的时候。母亲变得严重抑郁并有自杀倾向。她不得不住院接受休克治疗。克莱尔只记得这一次家里充满了严重的混乱和焦虑。她回忆说，她父亲非常担心、不安和易怒。她不明白发生了什么事，还记得自己对母亲的困境和她不得不去医院感到有责任。在她去医院之前，母亲经历了一段严重的退缩，整天躺在床上，没有和任何人交流。这就像母亲典型的退缩发作，只是规模更大、强度更大。 The second occasion took place about five years prior to Clare's last hospitalization. The setting was the death of her mother's own mother. We shall have occasion to come back to this event because it proved to be acritical one for Clare as well. The grandmother had died of cancer of the breast. Her terminal course was long and drawn out. She became increasingly weak and emaciated and, in the final months of her life, required constant nursing care. Clare's mother undertook this responsibility. The difficulties surrounding this set of circumstances and the strain of caring for her mother in the face of an inevitable but slow death took its toll on Clare's mother. She began having increasing difficulties sleeping, and began taking Doriden. She took increasing doses, and just a few months after the grandmother died, the mother had to be hospitalized. She was suffering from what was thought to be chronic Doriden intoxication. Her behavior became bizarre and psychotic, with frank hallucinations. The exact nature of the decompensation remains obscure. Whether the psychotic symptoms were simply toxicin etiology, or whether there may have been any underlying schizophrenic process remains an open question. In any case she was hospitalized and treated for a rather long period on phenothiazines. 第二次是在克莱尔最后一次住院的五年前。故事的背景是她母亲的亲生母亲去世。我们以后还会有机会谈到这件事的，因为这件事对克莱尔来说也是一件很不愉快的事。外婆死于乳腺癌。她最后的旅程又长又拖。她变得越来越虚弱和消瘦，在她生命的最后几个月，需要不断的护理。克莱尔的母亲承担了这个责任。克莱尔的母亲在面对一场不可避免但缓慢的死亡时，围绕着这种情况的种种困难，以及照顾母亲的压力，使她付出了代价。她开始越来越难入睡，开始服用道力顿[一种用作镇静、催眠药及麻醉前给药的神经系统药物。]。她服用的剂量越来越大，外婆去世后几个月，母亲就不得不住院治疗。她被认为患有慢性力顿中毒。她的行为变得奇怪和精神病，带有明显的幻觉。失代偿的确切性质仍不清楚。这些精神症状在病因学上是否仅仅是中毒，或者是否可能有任何潜在的精神分裂过程，仍然是一个悬而未决的问题。无论如何，她住院并接受了相当长时间的吩噻嗪[抗精神病药物]治疗。 As the basic picture of the structure and pattern of interaction within this family emerges, we begin to see a pattern that we have already identified in our previous cases—and which we will meet again in subsequent cases. There is a basic imbalance in the parental relationship, one parent being relatively dominant and aggressive, while the other is relatively submissive and usually presents a more or less chronically depressed picture. We have also seen in our previous cases that one of the parents—usually the dominating, aggressive, and sadistic one—carries on an undercutting, devaluing, and critically disparaging attack on the patient. Clare was subject to this manner of treatment from her father, who would both criticize and devalue her for not meeting his high and exacting standards of performance, and yet would simultaneously work to impress on her that she was not able to measure up in any number of ways and for any number of reasons. The reasons were never specified but included the assumption that she couldn't live up to any standards of attainment or intellectual capacity simply because she was a girl; additional reasons could not be focused any more than in the impression left with Clare that she was worthless and inadequate in herself. The pattern of paranoid-depressive interaction which characterized the relationship between her parents set the terms for the introjective configuration within Clare herself. 随着这个家庭内部互动结构和模式的基本图景出现，我们开始看到一个我们在之前的案例中已经确定的模式——我们将在接下来的案例中再次见到它。在父母关系中有一个基本的不平衡，父母中的一方相对强势和好斗，而另一方相对顺从，通常表现出或多或少的慢性抑郁。在以前的案例中，我们也看到过，父母中的一方——通常是专横、好斗和虐待狂——对病人进行贬损、贬低和批判性的攻击。克莱尔受到了来自他父亲的这种对待方式的影响，他会批评和贬低她没有满足他高和严格的表现标准,但同时会努力用各种方式各种原因让她觉得她没有能力达到他的标准。原因从未具体说明，但包括她无法达到任何标准的成就或智力，仅仅因为她是一个女孩;克莱尔给她留下的印象是，她没有价值，她是不胜任的，除此之外，再也找不到其他的理由了。偏执-抑郁相互作用的模式是她父母之间关系的特征，这种模式为克莱尔自己的内摄构造设定了条件。