The Therapeutic Experience 治疗经历 We have cast a backward look over the pattern of Clare's life which brought her to the hospital and into treatment. We can now turn to a more detailed look at the process of therapy itself. The course of Clare's improvement over several years of treatment offers us an opportunity to gain some understanding of the elements which constituted her basic pathology. Our objective will be to link these elements and their understanding to what we already know of her experience within the structure of her family and in relation to the experience she endured in relationship to her two rather disturbed parents. 我们回顾了克莱尔的生活模式，正是这种生活模式让她来到医院接受治疗。现在我们可以更详细地看看治疗过程本身。经过几年的治疗，克莱尔的病情有所好转，这为我们提供了一个机会，让我们对构成她基本病理的因素有了一些了解。我们的目标是将这些因素及对这些因素的理解与我们已知的她的经历联系起来。这些经历发生在她的家庭结构之中，与她在跟两位相当不正常的家长的关系中所承受的经历有关。 When Clare came to our hospital and I first met her, she was a rather frightened and confused young woman. In my early contacts with her, she seemed moderately anxious but tried to present herself with a bland, almost casual, facade. It was almost as though in relating the events that brought her to the hospital, she was telling me about something interesting that had happened to someone else. Her manner was simplistic, even childlike, but she gave an unavoidable, if vague, impression of a deep underlying depression. She was obviously a bright and verbal person, and had a basic willingness to be involved and to communicate about herself. She had a unique ability to describe her feelings and inner processes—and a remarkable introspective bent. These qualities were to stand her in good stead in the years ahead. 当克莱尔来到我们医院，我第一次见到她的时候，她是一个非常害怕和困惑的年轻女人。在我与她的早期接触中，她似乎有些焦虑，但试图以一种平淡无奇、几乎漫不经心的样子出现。在讲述把她带到医院的那些事情时，就好像她在告诉我一些发生在别人身上的有趣的事情。她的举止过于单纯，甚至孩子气，但她给人一种不可避免的、即使是模糊的、深层抑郁的印象。她显然是一个聪明伶俐、善于言辞的人，有一种基本的意愿去参与其中，并与人交流自己。她有一种独特的能力来描述自己的感受和内心的过程——以及一种引人注目的内省倾向。这些品质将使她在今后的岁月中处于有利地位。[要知道，偏执者往往是没有自省能力的] She talked easily and readily about her early experiences and about her family. When she told me about her father's angry tirades and beatings, she smiled. I asked her why she smiled like that. She replied that she smiled when she felt angry and really felt like crying inside. She could allow herself to cry when she was alone, but not in front of anyone else. Her fear was that if she were to cry in front of me she would simply fall apart. She was able to talk about her feelings of loneliness and sadness and hurt. She felt this particularly in regard to her former therapist, whose loss she was still grieving. She wanted desperately to be loved by everyone. She was crying inside but couldn't let me see the tears. If she started to cry she felt that she would never be able to stop. She couldn't trust me, and didn't know if she ever could. She feared that if she started to cry it would hurt me in some way and would hurt the other patients in the hospital as well. She would feel guilty for doing such a thing. 她轻松愉快地谈起她早年的经历和她的家庭。当她告诉我她父亲愤怒的长篇大论和殴打时，她笑了。我问她为什么那样笑。她回答说，当她生气的时候，她就会笑，但实际她的心里在哭。当她一个人的时候，她可以让自己哭，但不能当着任何人的面哭。她害怕的是，如果她在我面前哭，她就会崩溃。她能够谈论她的孤独、悲伤和受伤的感觉。她对她的前心理医生尤其如此，她仍在为失去他而悲痛。她拼命地想被每个人爱。她在内心哭泣，却不能让我看到她的眼泪。如果她开始哭，她觉得她永远无法停止。她不相信我，也不知道她以后是否能相信我。她担心如果她开始哭，会在某种程度上伤害我，也会伤害医院里的其他病人。她做这样的事会感到内疚。[是不是很奇怪的想法？为什么会伤害到治疗师跟其他病人？] After about three weeks in the hospital, there was an episode in which she broke a glass container and cut her wrist with the glass. The episode had been precipitated by one of the attendants leaving the hospital. Clare expressed her feelings of loneliness and anger—her feelings of unreality, anxiety, and depression. When she cut herself she could feel the pain and see the subcutaneous tissue below the skin. That made her feel that she must be real and that she was really in that tissue someplace. She referred to herself repeatedly as "an extension of the process C." She translated that into the unreal and dehumanized perception of herself as a machinelike extension of the impersonal and efficiently functioning "process" that she saw her father to be. The "process" functioned as a smoothly operating system that left no room for feelings. The "process" was not human—and Clare was the extension of that process. 在医院住了大约三周后，有一次她打破了一个玻璃容器，用玻璃割破了手腕。这件事是由一个离开医院的服务员促成的。克莱尔表达了她的孤独和愤怒的感觉——她的不真实、焦虑和抑郁的感觉。当她割伤自己时，她能感觉到疼痛并看到皮下组织。这让她觉得她必须是真实的，她真的在那个组织的某个地方。她反复称自己是“进程C的延伸”[为什么是C，而不是A或B？回忆下本章标题：CLARE C.小姐。C是她的姓氏的首字母]。她把这种想法转化为一种不真实的、非人性化的自我认知，认为自己是一种机器，是她眼中父亲那种冷淡的、有效运作的“进程”的延伸。这个“进程”就像一个流畅的操作系统，没有给情感留下任何空间。这个“进程”不是人类，克莱尔是这个进程的延伸。[进程process是操作系统中的一个概念，一个程序执行起来后就是一个进程，进程可跟人生类比] Her perception of herself as hateful, destructive, loathsome, and evil was overwhelming. Her concern was to try to protect me from this powerful and magically destructive evil within her. Her attraction to me and her feelings for me were a danger because they raised the possibility that I might begin to care about her and thus be sucked in and destroyed by her evil poison. She labored to keep me at an emotional distance. She vacillated between anger at me and her fear of trusting me. She wanted to make our relationship nothing more than a strictly professional one—no personal interest or caring involved. She tried to maintain an image of me as simply doing my job—as she did as a nurse with her patients——no emotional involvement, just performing a professional function. I was someone she paid to perform that function. The payment of the fee became a sort of magical talisman which protected her from deeper feelings about me and insured that our relationship was a strictly contractual one. She talked about the anger and disgust she felt when her own patients became so dependent on her. 她认为自己是可恨的、破坏性的、令人厌恶的和邪恶的。她关心的是试图保护我不受她内心强大而神奇的破坏性邪恶的伤害。她对我的吸引力和对我的感情是一种危险，因为它们使我有可能开始关心她，从而被她邪恶的毒性所吸引和毁灭[是不是很奇怪的想法？]。她竭力与我保持情感上的距离。她在对我的愤怒和对信任我的恐惧之间摇摆不定。她想让我们的关系仅仅是一种严格的职业关系——没有个人兴趣或关心。她试图保持我的形象，就像她作为护士对待病人一样，只是简单地做我的工作——没有情感上的介入，只是履行一种专业的功能。我是她花钱雇来扮演这个角色的人。这笔费用的支付成了一种神奇的护身符，使她对我没有更深的感情，也确保了我们的关系是严格的契约关系。她谈到当她的病人变得如此依赖她时，她感到愤怒和厌恶。 Clare's dreams served as an important element in the course of her treatment and reflected in a particularly impressive way the progress she was making. In the present instance, she was able in the context of the dream to being talking about her grandmother, how important and special that relationship had been for her, and was able to recount the painful events that surrounded her grandmother's death. In the course of this retelling, Clare was able to break down in tears. Her willingness to cry and weep in my presence was an index of the developing trust and understanding she felt with me. She was able to share with me her feelings of loneliness and despair, the feeling that she had lost the only person in the world who really loved and cared about her. I felt that something important was achieved at this stage of Clare's treatment. It seemed to establish a bond between us that had not been there before. Moreover, it was a situation in which she had showed me her hurt, and loneliness, and weakness, and vulnerability, and had come away without rejection, or loss, or destruction. I had not been overwhelmed or destroyed by the intensity of her feelings, and I had not run from them or withdrawn from her in any way. 克莱尔的梦是她治疗过程中的一个重要因素，并以一种特别令人印象深刻的方式反映了她正在取得的进步。在目前的情况下，她能够在梦的上下文中谈论她的外婆，以及这种关系对她来说是多么重要和特殊，并且能够讲述围绕着她祖母的死亡所发生的痛苦的事情。在复述这个故事的过程中，克莱尔忍不住哭了起来。她愿意在我面前哭，这表明她对我越来越信任，越来越理解。她能够和我分享她的孤独和绝望的感觉，那种她失去了世界上唯一真正爱她和关心她的人的感觉。我觉得在克莱尔接受治疗的这个阶段，取得了一些重要的胜利。它似乎在我们之间建立了一种前所未有的纽带。此外，在这种情况下，她向我展示了她的伤、孤独、软弱和脆弱，并在没有遭到拒绝，失去，毁灭的情况下离开。我没有被她强烈的感情压垮或摧毁，我也没有逃走或以任何方式退却。[偏执者为什么会觉得自己的感受有伤害到他人的能力？]