Envy and Paranoia 嫉妒和偏执症 Something similar can be identified in the paranoid patients we have been discussing. The envy is often difficult to get at and along with the associated shame is often long in coming to the surface. However, since the envy is so closely related to these patients' tendencies to blame and to project, the most superficial levels of enviousness are relatively more available than the levels of shame. The problem often is that envy quickly activates the patient's underlying shame and stimulates the defensive retreat and guarded suspiciousness and secretiveness that one so often sees in such patients. 在我们讨论过的偏执患者中也可以发现类似的情况。嫉妒往往是难以理解的，与之相关的羞耻往往是很长时间才浮出水面。然而，由于嫉妒与这些患者的责备倾向和投射倾向密切相关，所以最表层的嫉妒比羞耻更容易浮现。通常的问题是，嫉妒很快就会激活患者潜在的羞耻感，刺激出他们防御性的撤退，让他们产生谨慎的怀疑和隐秘，这种情况在此类患者身上很常见。 Enviousness of this sort can often be an impediment to treatment. This element has been recently suggested by Modell (1971). He points out that, while Freud had originally assumed the content of unconscious guilt feelings was responsible for the negative therapeutic reaction, specifically the incestuous and rivalrous impulses, his own experience indicates that the guilt associated with negative therapeutic reaction is related to the conviction that one does not have a right to the better life that might follow as a consequence of the success of the analytic process. The essential element here is that of envy. Such individuals seem to suffer from a conviction that they do not have a right to such improvement and therapeutic success. Modell points out a common fantasy shared by these patients, namely, that if they were to possess something good, this would mean that they were depriving someone else of this same improvement. Modell comments, "These individuals seemed to suffer from a particularly intense form of envy and greed, i.e., they wished to take away all that others possessed. So that in an additional sense the negative therapeutic reaction could be understood as a wish to deprive the analyst of the 'good' that he possessed by virtue of his therapeutic skill"(1971, p. 340). A similar point, based on somewhat different theoretical presumptions, was made by Melanie Klein (1957), who interpreted envy as one of the primary contributing factors to negative therapeutic reactions. 这种嫉妒常常会成为治疗的障碍。Modell(1971)最近提出了这个要素。他指出,尽管弗洛伊德原本认为无意识内疚情绪的内容需要对负面治疗反应负责,特别是乱伦和敌对性的冲动,他自己的亲身经历表明,内疚与负面治疗反应与这样一种信念相关,即一个人没有权力过上更好的生活，这种更好的生活是成功的分析过程的结果。这里的基本要素是嫉妒。这些人似乎有一种信念，即他们没有权利获得这种改善和治疗的成功。Modell指出，这些病人有一个共同的幻想，即如果他们拥有某种好的东西，这就意味着他们剥夺了别人同样的改善。Modell评论道:“这些人似乎遭受着一种特别强烈的嫉妒和贪婪。他们想要夺走别人所拥有的一切。因此，在另一种意义上，消极的治疗反应可以被理解为一种剥夺分析师凭借其治疗技能所拥有的‘好’的愿望”(1971年，第340页)。梅勒妮·克莱因(1957)基于不同的理论假设提出了类似的观点，她将嫉妒解释为负面治疗反应的主要促成因素之一。