Levels of Anxiety 焦虑水平 We can remind ourselves at this point of Little Hans' anxiety dream which preceded the outbreak of his phobic state by just a few days. He had dreamt that his mother had gone away, and Freud interprets this as a punishment dream expressing Hans' fear of retaliation for his forbidden Oedipal wishes. But the Oedipal fear clearly expresses a more primitive anxiety, namely, the loss of the mother. We can also recall that the Wolf-Man's famous dream of the wolves in the walnut tree was a fairly typical nightmare for the four-year-old child. While Freud again appealed to castration fears, he also pointed to the anal-homosexual preoccupations it expressed, as well as the primitive oral-sadistic fears of being eaten or bitten. The Wolf-Man's experience in dreaming seems to have been the more primitive and the more terrifying. 我们可以在这时提醒自己，小汉斯的焦虑梦，正好在他的恐惧状态爆发之前几天。他梦见母亲走了，弗洛伊德把这解释为一个惩罚梦，表达了汉斯害怕自己被禁止的俄狄浦斯愿望遭到报复。但俄狄浦斯恐惧显然表达了一种更原始的焦虑，即失去母亲。我们还可以回想一下，狼人著名的核桃树上狼群的梦，对于四岁的孩子来说是一个相当典型的噩梦。弗洛伊德在再次求助阉割恐惧的同时，也指出了它所表达的肛-同性恋先占观念，以及被吃或被咬的原始口-虐待恐惧。狼人在梦中的经历似乎是越原始越可怕的。 One of the fascinating questions concerning nightmares is the variation in levels and intensity of the anxiety. Some valuable information has been added by the researches of Charles Fisher and his co-workers (Fisher, 1965). Fisher has distinguished on a number of grounds severe anxiety dreams, which occur during the REM phase of the sleep cycle, from nightmares, which are found to occur in the non-REM phase of the sleep cycle. The severe anxiety dream contains threats of violence which are more elaborate and often disguised. The anxiety experienced is intense, but the subjects are relatively lucid and dream activity can generally be recalled (Broughton, 1968). 有关噩梦的一个引人入胜的问题是焦虑程度和强度的变化。查尔斯费希尔和他的同事的研究提供了一些有价值的信息（费希尔，1965年）。费舍尔在一些理由上将发生在睡眠周期REM阶段的严重焦虑梦 与 发生在睡眠周期非REM阶段的噩梦区分开来。严重焦虑梦中包含有暴力威胁，这种威胁比较复杂，而且往往是伪装的。经历的焦虑是强烈的，但受试者相对清醒，梦境活动一般可以回忆起来（Broughton，1968）。 The nightmare occurring in a non-REM phase, however, is usually accompanied with considerable motility, even to the point of violent body movement. The subject may sit up or stand up and move about and often is found screaming. The content is violent and persecutory, usually with intense sadistic oral-aggressive and destructive features. The anxiety is severe to the point of panic, and the subject is disoriented, confused and often hallucinating immediately after arousal. Frequently, there is a general amnesia for the whole nightmare experience. Similarly, differences have been described between the nightmare attacks of children and night terror attacks of pavor nocturnus (Mack, 1970). 然而，发生在非REM阶段的噩梦通常伴随着相当大的运动[REM即快速眼动期]，甚至到了身体剧烈运动的地步。受试者可能会坐起来或站起来活动，并经常被发现尖叫。内容是暴力的、迫害性的，通常具有强烈的虐待 口-攻击性 和 破坏性 特征。焦虑严重到惊恐的程度，受试者在唤醒后立即迷失方向，神志不清，常出现幻觉。常常对整个噩梦经历有普遍的遗忘。同样，有人也描述了儿童的噩梦发作和帕夫夜行症夜惊发作之间的差异（Mack，1970）。 Thus there are identifiable neurophysiological states which may parallel the degrees of experienced anxiety and terror in the nightmare. Obviously a theory of the nightmare must also take into account this diversity of patterns of neurophysiological activation, which distinguish anxiety dreams from the more disruptive and terrifying nightmare experience. We can note in this connection that there seems to be a qualitative difference in the dream experience of our patients. The anxiety dreams experienced by Jimmy J., for example, certainly have a persecutory aspect, but the organization is more complex: there is usually an evolved plot element in the dream sequence, and the attack takes a modified and less violent form of being chased by police or even a fear of being attacked. Nowhere in his dream content was there a direct violent and destructive attack—at most, there was only the apprehension over the possibility of attack. However, in the dreams reported by Bob B. or Fred F., there was a marked destructive and murderous aspect to the persecutory content. These latter patients were certainly much less healthy, and the quality of their nightmare experience was much more primitive and much more in the line of the typical nightmare experience, with an extreme degree of panic and terror, a sense of helplessness and vulnerability, often as a sense of paralysis, and inability to breath or move, which the patients found to be quite terrifying. 因此，有一些可识别的神经生理状态，它们可能与噩梦中体验到的焦虑和恐怖程度平行。显然，关于噩梦的理论也必须考虑到这种神经生理激活模式的多样性，它将焦虑梦与更具破坏性和恐怖性的噩梦体验区分开来。在这方面我们可以注意到，我们的患者的梦境体验似乎有质的区别。比如吉姆所经历的焦虑梦当然有被迫害的一面，但其组织结构更为复杂：梦境序列中通常有一个演化的情节元素，攻击的形式经过修改，不那么暴力，比如被警察追赶，甚至害怕被攻击。在他的梦境内容中，没有一处是直接的暴力和破坏性攻击——最多只有对攻击可能性的忧虑。然而，在鲍勃或弗雷德所报告的梦中，迫害的内容有明显的破坏性和谋杀性。后面这些病人的健康状况肯定要差得多，他们的噩梦体验的质量也要原始得多，更符合典型的噩梦体验，有极度的惊恐和恐怖，有一种无助感和脆弱感，常常表现为一种麻痹感，无法呼吸和移动，病人觉得相当可怕。 The primitive quality of the fears expressed in the nightmare has been frequently noted. In the nightmares of children, the anxieties and conflicts expressed in the content of the nightmares were related to anxieties relating to earlier levels of development which were elicited by the regressive conditions of sleep. Under the sleep conditions, various ego functions undergo regression with a resulting impairment of reality testing and a failure of defensive configurations. There is a return to more concrete and symbolic forms of thoughts. 人们经常注意到噩梦中所表达的恐惧的原始性。在儿童的噩梦中，噩梦内容中所表达的焦虑和冲突与与早期发展水平有关的焦虑有关，这种焦虑是由睡眠的退行条件引起的。在睡眠条件下，各种自我功能发生退行，并由此产生现实检验的障碍 和 防御性配置的失效。思想又回到了更具体和象征性的形式。 Under the force of this regression and the relative helplessness that is associated with it, earlier conflicts and anxieties are aroused, typically the fears of devouring and being devoured, or even a primitive terror concerning the loss of the mother or a fear of abandonment and loss of love. This regressive content is frequently quite oral in character. The quality of children's nightmares is frequently highly aggressive, with a devouring oral element. The child fears being eaten up or devoured by huge monsters or machines. Or the dream content will express impulses of oral-sadism or aggression by biting or devouring someone else. Often, even in older children, these same regressive oral conflicts over devouring and being devoured are reactivated (Mack, 1965). 在这种退行力量和与之相关的相对无助下，先前的冲突和焦虑被激发出来，典型的是对吞噬和被吞噬的恐惧，甚至是对失去母亲的原始恐惧，或对被抛弃和失去爱的恐惧。这种退行内容往往具有相当的口的特征。儿童噩梦的质量常常具有高度的攻击性，具有吞噬性的口元素。孩子害怕被巨大的怪物或机器吃掉或吞噬。或者梦境内容会通过咬伤或吞噬他人来表达口-虐待性 或 攻击性的冲动。通常情况下，即使在大一点的孩子身上，这些同样的因吞噬和被吞噬而产生的退行口冲突也会被重新激活（Mack，1965）。