Clinical Paranoia 临床偏执症 The clinically paranoid patient is from this point of view precisely the individual for whom the embedding of paranoid mechanisms in this social matrix proves inadequate to satisfy the intensity of the inner needs and drives. Where the level of ambivalence is too intense, or the sensitivity to narcissistic loss and compromise too powerful for the individual to be able to sustain an adequate sense of self in interaction with such a social matrix, the powerful pressures continue to operate in such a way that the individual must resolve the defensive needs by resorting to a more idiosyncratic and divergent paranoid system. 从这个角度来看，临床上的偏执患者正是这样的个体，对他们来说，偏执机制在这个社会环境中的嵌入被证明不足以满足内心需求和驱力的强度。如果矛盾心理的程度太过强烈，或者对自恋损失和妥协的敏感度太过强大，个体无法在与这种社会环境的互动中维持足够的自体意识，那么强大的压力就会继续以这样的方式运作，即个体必须借助于更加特异和分歧的偏执系统来解决防御性需求。 Where the sense of self is more profoundly threatened by unresolved ambivalences, the need for an enemy becomes a predominant influence in the shaping and sustaining of a sense of self. We can recognize in this aspect of the process the workings of unresolved narcissistic needs. Primitive and unresolved narcissism, with its tendency to unremitting and exclusive demands, leaves little room for sharing or alliance, and sees external objects as generally threatening to its need for omnipotence and omnivorous possessiveness. Such pathogenic narcissism carries within itself the potentiality and the need for enemies. 在自体意识受到未解决的矛盾心理更深刻的威胁时，对敌人的需要就成为塑造和维持自体意识的主要影响。我们可以在过程的这个方面中认识到未解决的自恋需求的运作。原始的、未解决的自恋，具有不懈和排他性要求的倾向，几乎没有分享和结盟的余地，并认为外在的客体一般都会威胁到它对全能性和全食性占有欲的需要。这种致病性的自恋本身就有建立敌人的潜力和需要。 As long as the individual sense of self remains congruent and adaptive in the functioning social matrix, we do not tend to regard the sense of self as pathological. Where the individual's relationships to the group are pervaded by a sense of conformity, we may recognize a certain impairment of the individuality of that identity and may be able to recognize the lineaments of what is essentially a false self, but we nonetheless regard this as falling within the relatively normal range of socially acceptable adaptation. Where the individual cannot join himself to these forms of group-related paranoia and where the internal pressures override the resources of these processes to absorb the intensity of destructive and ambivalent impulses, the individual must resort to a delusional system within which the false sense of self overwhelms the intrapsychic configuration and in which that false sense of self seeks its pathological relatedness to a persecutory environment. 只要个体的自体感在运作中的社会环境中保持一致性和适应性，我们就不会倾向于将自体感视为病态。当个体与群体的关系中弥漫着顺从感时，我们可能会认识到这种身份的个性受到一定的损害，可能会认识到本质上是虚假自体的特征，但我们还是认为这属于社会可接受的相对正常的适应范围。如果个体不能把自己加入这些形式的与群体有关的偏执症，如果内部压力超过了这些过程的资源，无法吸收破坏性和矛盾心理冲动的强度，那么，个体就必须求助于一个妄想系统，在这个系统中，虚假自体感压倒了心理内构型，而且在这个系统中，虚假自体感寻求其与迫害性环境的病态关系。