Diminution of Self-esteem 自尊的减少 The understanding of depressive phenomena and their intimate involvement in narcissistic dynamics was clarified by Edward Bibring(1953). Bibring pointed to the common theme in a variety of depressive states of the undermining or diminution of self-esteem. In depressive states, patients felt helpless in the face of superior forces, or in the grip of organic diseases. Or on a more psychological plane they felt incapable of controlling or directing an inescapable fate—of loneliness, isolation, a lack of love and affection, or other apparent evidences of weakness, inferiority, or failure. They were without hope; they were helpless and powerless. Bibring consequently defined depression as "... the emotional expression (indication) of a state of helplessness and powerlessness of the ego, irrespective of what may have caused the breakdown of the mechanisms which established his self-esteem"(1953, p. 24). Edward Bibring(1953)澄清了对抑郁现象及其与自恋动力学的密切关系的理解。Bibring指出，在各种抑郁状态下，自尊被削弱或减少是一个共同的主题。在抑郁状态下，患者在面对强大的力量或受到器质性疾病的控制时感到无助。或者在一个更心理的层面上，他们觉得无法控制或引导一个不可避免的命运——孤独、孤立、缺乏爱和情感，或其他明显的弱点、自卑感或失败的迹象。他们没有希望;他们无能为力。因此Bibring将抑郁症定义为“……自我的一种无助和无力的情绪表现(指示)，不管是什么原因导致了建立他的自尊的机制的崩溃”(1953年，第24页)。 Paradoxically, in the face of such feelings of helplessness these patients tend to maintain strongly a set of goals and objectives which are highly narcissistically determined and pertinent to the individual's self-esteem. The depressive patient aspires to be worthy, to be strong and powerful, to be loved or appreciated, to be valued and esteemed by those around him, to be thought superior or talented or especially gifted. They wish to be felt good and loving; they wish not to be thought hateful or destructive. It is the disparity between these highly charged narcissistic aspirations and the acute awareness of the ego's helplessness and inability to meet them or attain them that lies at the heart of the depression. There is a haunting fear of failure, and whenever the fear of inferiority or defectiveness comes into play, the patient begins to feel hopeless. He feels that he is doomed to be a victim in the face of overwhelming powers that confront him, or he feels himself to be hateful and evil in the face of his latent aggressive tendencies. We have seen both of these affective states amply demonstrated in our patients. 矛盾的是，面对这种无助的感觉，这些病人倾向于强烈地保持一套目标和目的，这些目标和目的是高度自恋决定的，与个人的自尊相关。抑郁症患者渴望成为有价值的人，渴望变得强壮有力，渴望被爱或欣赏，渴望被周围的人重视和尊重，渴望被认为是卓越的、有才华的或特别有天赋的人。他们希望被感觉良好和充满爱;他们不希望被认为是可恨的或具有破坏性的。正是这些高度自恋的渴望与对自我在达到它们或获得它们的无助和无能的敏锐意识之间的差距，是抑郁的核心所在。对失败有一种挥之不去的恐惧，每当自卑或缺陷的恐惧开始起作用时，病人就开始感到绝望。他觉得自己在面对压倒性的力量时注定是一个受害者，或者他觉得在面对自己潜在的攻击倾向时是自己可恨和邪恶的。我们已经看到这两种情感状态在我们的病人中得到了充分的展现。 Whatever the narcissistic aspiration, whatever shape or direction it takes, the resulting mechanism of the depression seems to follow a final common path. It is, in Bibring's terms, "the emotional correlate of a partial or complete collapse of the self-esteem of the ego, since it feels unable to live up to its aspirations (ego ideal, superego) while they are strongly maintained"(1953, p. 26). As long as the ego maintains its investment in and longing for the narcissistically invested object, and as long as the circumstances persist in which it is confronted with its inability or inadequacy to obtain the object or to undo the loss, the conditions of the depression persist. Thus depression must be regarded as an affective state which is characterized primarily by a diminution of self-esteem, along with a more or less intensely felt state of helplessness and/or hopelessness. 无论自恋的渴望是什么，无论它的形式或方向是什么，作为结果的抑郁机制似乎遵循着一条最终的共同道路。用Bibring的话来说，它是“自我的自尊，部分或完全崩溃的情感关联，因为它感到无法不辜负它的愿望(理想自我、超我)，当这些愿望被强烈地维持时”(1953年，第26页)。只要自我保持对自恋投资的客体的投入和渴望，只要它面临着无法或不充分地获得该客体或弥补损失的情况持续存在，抑郁的情况就会持续存在。因此，抑郁必须被视为一种情感状态，其主要特征是自尊的降低，以及或多或少强烈的无助和/或无望的感觉状态。 In Bibring's view, then, the basic mechanism of depression, namely the ego's awareness of its helplessness in relation to excessive or unattainable aspirations, represented the core of the depressive state whether the depressive response took place in a normal, neurotic, or even psychotic level. Bibring felt that the tendency to depression was thus related to early childhood fixation of the ego to the state of helplessness, and that this original state was regressively reactivated in situations of later frustration of narcissistic wishes. The depressive reaction to narcissistic frustration was thus seen to be independent of the aggressive component, rather than directly a function of internally directed aggression as in Freud's formulation. This does not mean, however, that aggression does not play an important role in not only depressive states but in the paranoid process as well. Bibring summed up and specified the relationship to narcissism in the following words: 因此，在Bibring看来，抑郁的基本机制，即自我意识到其与过度或无法实现的愿望相关的无助，代表了抑郁状态的核心，无论抑郁反应发生在正常、神经质甚至精神病水平。因此，Bibring认为，抑郁的倾向与儿童早期对自我无助状态的固着有关，而这种原始状态在后来的自恋愿望受挫的情况下会退行性地重新激活。因此，对自恋挫折的压抑反应被认为是独立于攻击性成分的，而不是像佛洛伊德的构想那样，是内部导向的攻击性的作用。然而，这并不意味着攻击性不仅没有在抑郁状态中起重要作用，也没有在偏执过程中起重要作用。Bibring总结并指明了与自恋的关系如下: In general, one may say that everything that lowers or paralyzes the ego's self-esteem without changing the narcissistically important aims represents a condition of depression. External or internal, actual or symbolic factors, may consciously or unconsciously refute the denial of weakness or defeat or danger, may dispel systems of self-deception, may destroy hope, may reveal lack of affection or respect or prove the existence to one's self of undesirable impulses or thoughts or attitudes, or offer evidence that dormant or neutralized fears are actually "justified" and so forth; the subsequent results would do the same: the individual will regressively react with the feelings of powerlessness and helplessness with regard to his loneliness, isolation, weakness, inferiority, evilness, or guilt. Whatever the external or internal objects or representations of the narcissistically important strivings may be, the mechanism of depression will be the same. The narcissistic shock may be mild or severe, focal or extensive, partial or complete, depending on whatever peripheral or central narcissistic aspirations are involved. These factors will contribute to the extent and intensity of the depression as well as the possibilities, the means or the tempo of recovery (1953, pp. 42-43). 一般来说，人们可能会说，任何降低或损坏自我的自尊的事情，如果不改变自恋的重要目标，就代表了一种抑郁状态。外部或内部,实际的或象征性的因素,可能有意或无意反驳对软弱、失败、危险的否认,可能消除系统的自我欺骗,可能摧毁希望,可能揭示缺乏感情、尊重，或证明自己不受欢迎的冲动、想法、态度的存在,或提供证据表明休眠或中和的恐惧实际上是“合理的”等等;随后的结果也会是一样的:个体会退行性地对自己的孤独感、孤立感、软弱感、自卑感、邪恶感或负罪感，以无力感和无助感了反应。无论外部或内部客体或自恋重要奋斗的表现形式是什么，抑郁的机制都是相同的。自恋休克可能是轻微的或严重的，病灶的或广泛的，部分的或完全的，这取决于周围或中心的自恋渴望涉及。这些因素将影响抑郁的程度和强度，以及恢复的可能性、手段或速度(1953年，第42-43页)。 Nor must the claims of narcissism on us be restricted to a more or less pathological concept of orally fixated and infantile narcissism. Rather the claims of narcissism are universal, and its demands for satisfaction are inescapable. As Rochlin has recently observed in telling fashion— 对我们自恋的断言也不应局限于一个或多或少有些病态的概念，即口腔固着和婴儿式自恋。相反，对自恋的断言是普适的，它对满足的要求是不可避免的。正如Rochlin最近在讲述风格上所说的那样—— Neither the beloved child nor the fabled heroes of legend, any more than a people chosen by God, are spared outrageous trials. The flaw and the virtue in all is in the peril to self-esteem. Its defense may bring the highest honors and justify the lowest violence. But its loss risks our extinction (1973, p. 216). 无论是心爱的孩子还是传说中的英雄，就像上帝选择的民族一样，都不会免于残暴的审判。一切的缺点和优点都是对自尊的威胁。它的辩护可以带来最高的荣誉，证明最低的暴力是正当的。但是它的损失使我们面临灭绝的危险(1973，第216页)。 He coined the excellent phrase "the tyranny of narcissism." It is a tyranny because the demands of narcissism are unconquerable and inexorable. Narcissistic fixation in the form of the grandiose self, usually as a consequence of pathogenic experiences of enmeshment with a narcissistic mother and a consequent traumatic disappointment, leaves the exhibitionistic and grandiose fantasies isolated and disavowed, or repressed, and consequently inaccessible to the more realistic and adaptively functioning ego. The persistence of the grandiose self carries with it a damming up of primitive narcissistic-exhibitionistic libido which can be symptomatically manifested in an intensification of hypochondriacal concerns, or of self-consciousness to the point of shame and embarrassment. 他创造了一个绝妙的短语“自恋的暴政”。这是一种暴政，因为自恋的要求是不可压制和不可抗拒的。自恋以夸大自体的形式固着(这通常是与一个自恋母亲的致病性体验以及随后的创伤性失望的后果)，留下一个拉风的夸大的幻想，这个幻想被孤立和否认，被压抑，因此对更现实的和适应性运作的自我来说无法访问。夸大自体的持续，伴随着原始的自恋-表现力比多的堰塞，这种力比多的症状表现为疑病症的担忧加剧，或自我意识达到羞愧和尴尬的程度。