Narcissistic Mortification 自恋屈辱 The point of view that is emerging in the course of this study, takes the affect of shame to lie close to the dynamic heart of the paranoid process. Shame is, in this view, the direct affective expression of the underlying narcissistic deprivation or mortification. In all of the patients we have discussed, we have found significant elements of shame. Often this aspect of their inner state has remained relatively concealed through significant periods of the therapy. It is an area which carries the burden of sensitivity and guardedness, as though it were a sensitive pain center which the patient needed to keep hidden and concealed at all costs. While the affective shame could be frequently attached to certain past actions or characteristics or behaviors, more frequently the focus of the feeling of shame was directed toward the self. These patients are by-and-large ashamed of what they have come to be. 在这个研究过程中出现的观点，把羞耻感的影响，放在靠近偏执过程的动力学核心的位置处。在这种观点看来，羞耻是潜在的自恋剥夺或屈辱的直接情感表达。在我们讨论过的所有患者中，我们都发现了明显的羞耻感。通常这方面的内在状态在治疗的关键时期一直保持相对隐藏。这是一个承载着敏感和警惕的区域，就好像它是一个敏感的疼痛中心，病人需要不惜一切代价来隐藏它。情感上的羞耻感往往与过去的某些行动、特征或行为有关，而更多的羞耻感则指向自体。这些病人对自己的所作所为大体上感到羞愧。 The extent to which this whole area of shameful feeling can be preserved over long periods of time is sometimes astounding. Perhaps the best example of this was Gloria. Through all the nearly five years of psychotherapy which she and I carried out together, the pattern of her response was one of constant blocking and obfuscation. Whenever we would get close to any area of significant emotional involvement for her, her mental processes would seem to fragment and become disorganized before my eyes. She would forget statements she had made minutes before. Her memory would become a blank. She would literally be unable to put together two consecutive sentences. The blocking was massive and sometimes almost total. On rare occasions—very rare occasions—by dint of some effortful digging on my part, we were able to get at some of what she was feeling. Inevitably it came out to be a feeling of confusion and shame, a general state of feeling that she described as "embarrassment." At such points in the therapy it seemed that we had come close to, if not touched upon, areas of self-concern and self-contempt which generated a feeling of deep and pervasive shame in Gloria. It should be added that I was never able to break through this stubborn barrier. It inevitably stalled and frustrated any progress in her therapy. 在很长一段时间内，这种羞耻的感觉所能保持的程度有时是令人震惊的。也许这方面最好的例子是格洛丽亚。在我和她一起进行的近5年的心理治疗中，她的反应模式是不断的阻塞和混淆。每当我们接近她的任何一个重要的情感关系区域时，她的心理过程似乎会支离破碎，变得杂乱无章，就在我的眼前。她会忘记几分钟前说过的话。她的记忆会变成一片空白。她简直无法把两个连续的句子连在一起。阻塞是大规模的，有时几乎是全面的。在罕见的情况下——非常罕见的情况下——通过我努力的挖掘，我们能够了解到她的一些感受。结果不可避免地是一种困惑和羞愧的感觉，一种她称之为“尴尬”的感觉。在治疗过程中的这种时刻，我们似乎已经接近，如果没有触及，自我关心和自我轻视的领域，这些东西在格洛丽亚身上产生了一种深刻和普遍的耻辱感。应该补充的是，我从来没有能够突破这个顽固的障碍。这不可避免地阻碍并挫败了她治疗的进展。 But similar attitudes and feelings, in varying degrees of intensity and dimension, were recognizable in all our patients. In Jimmy, for example, there was no question that he felt an abiding sense of inferiority and shamefulness about himself. It expressed itself in his profound and utter conviction of failure. For him it was very precisely and specifically a defense against his underlying narcissistic and exhibitionistic wishes. Any occasions on which we were able to break through this feeling of shameful inferiority, were labeled by him as "showing off." It was only by dint of long and laborious and repeated clarifications that it became clear to him that he was unable to see the difference between showing himself with whatever talents and capacities he might realistically possess, and exhibitionistically "showing off." 但是相似的态度和感受，在不同程度的强度和维度上，在我们所有的病人中都可以辨认出来。例如，在吉姆身上，毫无疑问，他始终感到一种自卑感和耻辱感。这表现在他对失败的深刻而彻底的信念中。对他来说，这恰恰是对他潜在的自恋和自我表现欲的一种防御。任何我们能够打破这种羞耻的自卑感的场合，都被他贴上了“炫耀”的标签。只有通过长时间的、艰苦的、反复的澄清，他才清楚地认识到，他无法看出用他可能实际拥有的任何才能和能力来展示自己与以表现性的方式“炫耀”之间的区别。 Often the patient's resistance, which seems so intense and belabored, finally yields up a relatively trivial fantasy to which the feeling of shame is attached. Often this terrible secret is shared with the analyst as a privileged communication. It becomes a communication which is enshrined with special importance and significance within the patient's inner world. The analyst or therapist may experience a sense of disappointment, a letdown which does not measure up to the echoes of power and importance that the experience has in the patient's perspective. As Kohut(1971) has pointed out, the patient's shame is related to the discharge of relatively crude and unneutralized narcissistic exhibitionistic libido. His concern is inevitably associated with his fear of ridicule and humiliation. 病人的阻抗似乎是如此强烈和反复无常，但往往最终会产生一种相对琐碎的幻想，并带有羞耻感。通常，这个可怕的秘密作为一种保密的交流方式被分析人员分享。它成为一种交流，在病人的内心世界中有着特殊的重要性。分析师或治疗师可能会体验到一种失望感，这种失望的程度无法与这种体验在患者看来所具有的力量和重要性相匹配。正如Kohut(1971)所指出的，患者的羞耻感与相对粗糙和未中和的自恋表现性力比多的释放有关。他的担忧不可避免地与他对嘲笑和羞辱的恐惧联系在一起。