Paranoid Aspects 偏执方面 I have not made much mention of the paranoid aspects of Don's clinical picture since they deserve to be seen against the backdrop of the more general picture. But they were a constant feature. In the early months of treatment he reported ideas of reference at almost every session. He felt people on the streets were staring at him. He felt people on streetcars were whispering about him. When I asked him what they were whispering he was vague in his reply, but the content of the whispering was generally hinted to be derogatory or critical. There were certain situations that provoked paranoid fears in him. There was a relatively dark passageway through which he had to pass to get to the entrance to his apartment building. Frequently, when he had to pass through this passage at night he would be overwhelmed by a feeling of panic—a dreadful fear and apprehension that there was someone waiting in the dark for him, ready to pounce on him, and kill and rob him. He entertained this fear even though the neighborhood in which he lived was comparatively safe and no one had ever been accosted or robbed—let alone killed—in that area. 我没有过多提及唐的临床表现中的偏执方面，因为它们值得在更全面的背景下看待。但它们是一个永恒的特征。在治疗的最初几个月里，他几乎在每次治疗中都报告了牵连观念。他觉得街上的人都在盯着他看。他觉得有轨电车上的人都在议论他。当我问他他们在窃窃私语什么时，他的回答含糊其辞，但窃窃私语的内容通常暗示着贬损或批评。有些情况引起了他的偏执恐惧。有一个相对黑暗的通道，他必须通过它才能到达他的公寓大楼的入口。当他不得不在夜里经过这条通道时，他常常会被一种恐慌的感觉所淹没——一种可怕的恐惧和担心，担心有人在黑暗中等待着他，准备扑向他，杀死他，抢劫他。尽管他所居住的社区相对安全，没有人被搭讪或抢劫——更不用说被杀害了，他还是怀着这种恐惧。 There was also several episodes of severe paranoid anxiety that overtook him. On one such occasion, for example, he went into a lunch counter before one of his visits to me. He noticed a man sitting at the counter who seemed suspicious to him. He suddenly was overwhelmed with a terrible fear that the man would attack him and try to kill him. He suddenly had the idea that the man was a mental patient who had escaped from the hospital and who would suddenly go berserk and try to kill him. Don fled in a panic from the lunchroom, and came to my office trembling and frightened. He was able to test out the reality of his fear and the overwhelming anxiety, and able to see them as a projection, a projection of his own inner anger and destructiveness. In discussing this particular episode, he was able to relate it to his own fears of letting go of his aggression and killing and destroying. He referred to his fantasies of Judy's dying, being run over by a car, and of his attending the funeral, etc. He talked about his fantasies of the end of the world, of an atomic holocaust, and other destructive and overwhelming fantasies of death and destruction. He saw that the fantasies were his own creation, and that they were ways in which he frightened and scared the wits out of himself. 还有几次严重的偏执焦虑困扰着他。例如，有一次，在拜访我之前，他走进了一家午餐柜台。他注意到一个坐在柜台旁的人似乎很可疑。他突然被一种可怕的恐惧所笼罩，害怕那个人会攻击他并试图杀死他。他突然想到，这个人是一个从医院逃出来的精神病人，会突然发疯并试图杀死他。唐惊慌失措地从餐厅跑了出来，来到我的办公室，浑身发抖，惊恐万分。他能够识别出自己的恐惧和压倒性的焦虑的真实情况，并能够将它们视为一种投射，一种他自己内心愤怒和破坏性的投射。在讨论这一特殊事件时，他能够将其与他自己对释放攻击、杀戮和破坏的恐惧联系起来。他提到他幻想朱迪死去，被车碾过，以及他参加葬礼等等。他谈到了他对世界末日、原子弹大屠杀的幻想，以及对死亡和毁灭的其他毁灭性的、压倒性的幻想。他明白这些幻想是他自己创造出来的，是他把自己吓得魂飞魄散的方式。