Projective Aspects 投射方面 The phobic aspects of Fred's personality functioning are also of importance and interest. His early childhood experience—apparently from the earliest strata of his memory—was highly phobic, and the phobic elements of his personality persisted into his pathology in later years. The early animal phobia—his morbid fear and anxiety particularly of rabid foxes—was an exquisite expression of his intense oral aggression and oral sadism. These same elements are reflected in his projective test material from the time of his decompensation. Phobic anxiety likewise remained a significant portion of his clinical picture through most of the time he was under treatment. We can note that phobic elements have been a frequent manifestation in these paranoid and paranoid-disposed patients. This raises the interesting question of the relation between phobic anxiety and the later development of paranoia. 弗雷德人格功能中的恐惧症方面也很重要和有趣。他的童年早期经历——显然从他最早的记忆层面开始——就具有高度恐惧症特征，他人格中的恐惧症元素一直持续到他后来的病理学中。早期的动物恐惧症——他特别对疯狂狐狸的病态恐惧和焦虑——是他强烈的口欲攻击和口欲施虐的精致表达。这些相同的元素反映在他失代偿时的投射测试材料中。恐惧症焦虑在他接受治疗的大部分时间里仍然是他临床表现的一个重要部分。我们可以注意到，恐惧症元素在这些偏执和偏执倾向的患者中经常出现。这就提出了一个有趣的问题，即恐惧症焦虑与后来偏执症的发展之间的关系。 Another important aspect of Fred's pathology was his recurrent nightmares. Recent research on the phenomenon of nightmares has suggested that this form of dream activity takes place in the stage of deep sleep (stage 4). The occurrence in this stage is somewhat paradoxical since dreaming activity has been thought to occur more typically in stages of REM activity (Broughton, R.J., 1968; Fisher et al., 1970). The stage 4 arousal nightmare is the most severe form observed and includes the night terrors of children ("pavor nocturnus") and the nightmares of adults. It also seems to include the nightmares that are associated with traumatic neuroses in adult life. These NREM forms of nightmare are distinguished from relatively severe REM anxiety dreams which are often described by subjects as "nightmares" (Fisher, C., et al., 1970 a,b; Hartman, 1970). 弗雷德病理学的另一个重要方面是他经常做噩梦。最近关于噩梦现象的研究表明，这种形式的梦境活动发生在深度睡眠阶段（第4阶段）。在这个阶段出现这种现象有点自相矛盾，因为人们通常认为梦境活动更典型地发生在快速眼动活动阶段（Broughton，R.J.，1968；Fisher等人，1970）。第4阶段吓醒人的噩梦是观察到的最严重的形式，包括儿童的夜惊（“pavor nocturnus”）和成人的噩梦。它似乎还包括与成人生活中的创伤性神经症相关的噩梦。这些NREM[非快速眼动]形式的噩梦与相对严重的REM[快速眼动]焦虑梦相区别，后者通常被受试者描述为“噩梦”（Fisher，C.等人，1970a，b；Hartman，1970）。 It seems likely that the nightmares that Fred describes as a frequent aspect of his childhood were of the "pavor nocturnus" variety. Moreover, nightmares remained a relatively constant feature of his adult experience. He would have nightmares often even before his decompensation, and they resumed again later in his treatment. The typical attack that he describes is that of the classic "incubus attack." He experienced the intense anxiety, the feeling of respiratory oppression and choking, the sense of paralysis and impending doom, and specifically the feeling of a great weight pressing down on his chest and crushing the life out of him. He would often awaken from these attacks screaming and feeling terrified and panicked. Fisher (1970) and others (Mack, 1969) have observed that in the nightmare the ego capacity for reality testing is lost. The nightmare, in fact, seems to represent a failure of defenses and a breakthrough of the psychosis which overwhelms and terrifies the fragmented ego. 弗雷德描述的童年时期经常出现的噩梦似乎属于“夜惊”的范畴。此外，噩梦仍然是他成年后经历的一个相对不变的特征。他甚至在失代偿之前就经常做噩梦，在治疗后期又再次发作。他描述的典型发作是经典的“梦魇发作”。他经历了强烈的焦虑、呼吸压迫和窒息的感觉、瘫痪和即将来临的厄运的感觉，尤其是感觉到巨大的重量压在他的胸口，把他的生命压碎。他经常会从这些发作中惊醒，感到害怕和恐慌。费舍尔（1970）和其他人（麦克，1969）观察到，在噩梦中，自我进行现实测试的能力会丧失。事实上，噩梦似乎代表了防御的失败和精神病的突破性进展，这压倒了分裂的自我并使其感到恐惧。 We have discussed the projective aspects of Fred's pathology, but there remain the broader implications and complications of his projective pattern. Fred's view of the world was organized almost universally in terms of dichotomies of the strong vs. the weak, the victimizers vs. the victimized, the dominant vs. the submissive, the exploiters vs. the exploited, the manipulaters vs. the manipulated, the controllers vs. the controlled. He saw these patterns of relationship and interaction in almost every area of his interaction and in every aspect of social life and organization around him. He saw it in the lowest level of human exchange with the same intensity that he found it in the highest levels of social or political structure. In all of these contexts he viewed himself as the helpless victim of malevolent forces which were inhuman and uncaring. These inexorable and uncontrollable forces exercised their remorseless influence on his life, made decisions over which he had no control and nothing to say, exploited him for their selfish interests—all without any concern or interest in his needs and wishes and hopes. He saw himself—along with the countless other victims of society, the poor, the underprivileged, racial minorities, women, and any other underprivileged or deprived groups as the helpless victims of powerful and evil forces. He identified these forces as the government, the military-industrial complex, big corporations, the "system," the "establishment," the armed forces, the university and its administrators—any institution or individual who exercised authority or in any way made decisions that could conceivably affect him. 我们已经讨论了弗雷德病理学的投射方面，但他的投射模式还有更广泛的含义和复杂性。弗雷德对世界的看法几乎普遍是以二分法组织的，即强者与弱者、加害者与受害者、支配者与顺从者、剥削者与被剥削者、操纵者与被操纵者、控制者与被控制者。他在 自己几乎每一个互动领域 和 周围社会生活与组织的每一个方面 都看到了这些关系和互动的模式。他在人类交流的最低层次上以同样的强度看到了这一点，就像他在最高层次的社会或政治结构中所发现的那样。在所有这些背景下，他都将自己视为无情、冷漠的邪恶力量的无助受害者。这些不可阻挡和无法控制的力量对他的生活施加了无情的影响，做出了他无法控制和无权发言的决定，为了他们的自私利益而剥削他——所有这一切都没有对他的需求、愿望和希望给予任何关心或兴趣。他把自己——以及社会上无数其他受害者、穷人、弱势群体、少数民族、妇女以及其他任何弱势或被剥夺的群体——视为强大而邪恶力量的无助受害者。他认为这些力量是政府、军工复合体、大公司、“系统”、“当局”、武装部队、大学及其管理者——任何行使权力或以任何方式做出可能影响他的决定的机构或个人。 The projective aspects of this elaborate view of social reality were clear and obvious. It was also clear that he directed the same rage and sense of bitter frustration and disappointment against these agencies that he had felt and continued to feel toward his parents. His response on all these fronts amounted to an extensive projection of elements derived from the parental introjects. Just as he had seen the parents as powerful and unreachable and uninfluenceable figures, he also responded to the social forces and structures around him in the same manner. It was often clear to him and to me that the intensity of his rage was far out of proportion to the external situation that gave rise to it. The rage that was generated in these contemporary contexts of social interaction was a cumulation of the deeper and more intense rage that he had felt so often toward his parents. 这种精心构建的社会现实观的投射性方面是清晰明了的。同样清楚的是，他将这些机构视为与父母相似的存在，对他们怀有同样的愤怒、痛苦的挫折感和失望感。他在所有这些方面的反应都是对父母内摄物的广泛投射。正如他曾经把父母视为强大、遥不可及、不可影响的人物一样，他也以同样的方式看待和回应周围的社会力量和结构。对他和我来说，很明显，他的愤怒强度远远超出了引起这种愤怒的外部环境所能解释的范畴。他在当代社会互动中所表现出的愤怒，实际上是他长期以来对父母所怀有的更深层次、更强烈的愤怒的累积和体现。 These projective elements were elaborated into a paranoid construction that provided a complete context for his interaction with individuals and social groupings and structures that formed the fabric of his life. He saw himself as engaged in mortal struggle with these inexorable forces. He evolved a revolutionary rationale rooted in this overriding paranoid construction which dictated his attitudes and the patterning of his life and activity. There were self-defeating and self-destructive aspects to this attitude. He could not tolerate or adjust to army discipline or training. He had considerable difficulty in his educational endeavors simply because of his intolerance of discipline or requirements. Similarly, he refused to accept certain jobs that were available to him because they were with certain corporations that he hated for their exploitation of the workers or for their involvement in defense production, with the result that he had available to him only the most menial unskilled jobs. He could not therefore make very much money, and he was again bitter about the fact that a college graduate was reduced by society to such a state. He could not accept any responsibility of his own for the situation he found himself in. 这些投射元素被精心构建成一个偏执建构，为他与个人和社会群体的互动提供了一个完整的背景，为构成他生活的基本框架提供了结构。他将自己视为与这些不可阻挡的力量进行殊死搏斗的战士。他发展出一种革命性的基本原理，这种原理根植于他那种支配性的偏执建构，决定了他的态度和生活和活动的模式。这种态度具有自我挫败和自我毁灭的方面。他无法容忍或适应军队的纪律或训练。他在教育努力中遇到了相当大的困难，仅仅是因为他无法容忍纪律或要求。同样，他拒绝接受某些可供他选择的工作，因为它们是与他所痛恨的某些公司相关的，他憎恶这些公司剥削工人或参与国防生产，结果是他只能从事最低微的不需要技能的工作。因此，他赚不到多少钱，他再次对社会将一个大学毕业生沦落到如此境地感到愤怒。他无法为自己所处的境况承担任何责任。