Decompensation and Delusion 失代偿与妄想 The immediate setting for the acute decompensation was provided by a conference on hypnosis that was being conducted by an internationally renowned medical hypnotist. The conference was being held in a rather intensive fashion over a weekend. It should be explained that Bob had been interested in hypnotism for some time, and had trained himself to become quite skilled in the use of hypnosis in his clinical work. He had been using it with selected clinical patients in performing procedures, and had even once demonstrated it to his surgical colleagues as a technique in inducing deep anesthesia for an abdominal surgical procedure. It was apparent that Bob's interest in hypnosis was motivated by strong inner needs. He felt himself to be a very suggestible person, who could be easily swayed to accept any point of view. He felt himself to be thus vulnerable and weak. His interest and involvement in hypnosis thus had a decided counterphobic element—it provided a way in which Bob could suggest rather than be suggested to, influence rather than be influenced, and control rather than be controlled. It enabled him to deny his inner feelings of weakness and inadequacy, and provided a realizable channel for his wishes to be powerful and skillful, as well as a way of controlling and influencing others. 急性失代偿的直接环境是由一个国际著名的医学催眠师主持的催眠会议提供的。会议在一个周末密集地举行。需要解释的是，鲍勃对催眠术感兴趣已经有一段时间了，他已经把自己训练得相当熟练，可以在临床工作中使用催眠术。他曾在一些临床病人的手术中使用过它，甚至有一次向他的外科同事演示了它是一种用于腹部外科手术诱导深度麻醉的技术。很明显，鲍勃对催眠的兴趣是由强烈的内在需求所激发的。他觉得自己是一个很容易受影响的人，很容易受影响而接受任何观点。他觉得自己就是这样的脆弱和软弱。因此，他对催眠的兴趣和参与有一个明确的反恐惧元素——它提供了一种方式，让鲍勃可以建议而不是被建议，影响而不是被影响，控制而不是被控制。它使他能够否认自己内心中软弱和不足的感觉，为他想要强大和熟练的愿望提供了一个可实现的渠道，也是一种控制和影响他人的方式。 It was in the context of this intensive weekend conference that Bob began to decompensate. He began attending the conference, but after about a day he began to feel confused. He did not really know who or what he was. He felt himself perplexed, confused, befuddled. He described himself at this stage as phasing in and out of reality—at this point the delusional system began to assert itself. Bob began to think that he was in fact the famous Dr. X who was conducting the conference. He then began to think that he was having a homosexual affair with Dr. X. and that he was the special and favorite colleague and confidant of Dr. X. He was at first puzzled and perplexed by this belief, which seemed to come and go in brief delusional waves that became gradually established. He would return to reality between these delusional periods and wonder why he was having these thoughts and why he was believing them. Gradually his delusional beliefs became more and more elaborate and more stable. He began to think that he was a member of an extraterrestrial race of creatures who were gifted with godlike powers. They were immortal and would never die. They were the possessors of extraordinary powers. They could transpose themselves to any part of the universe and could enter or leave the solar system at will. They could also assume any identity just by willing it. Thus simply by willing it Bob could become the chief resident, or he could become the famous psychiatrist, Dr. X. He wondered to himself whether he should become a psychiatrist or not—whether he should follow the regular course of training of a psychiatrist or whether he should simply will it and become one in an instant. He might follow the regular course of training so no one would suspect his real powers and ability. 正是在这个密集的周末会议的背景下，鲍勃开始失代偿。他开始参加会议，但大约一天后，他开始感到困惑。他并不真正知道自己是谁，是什么。他感到自己不知所措，困惑不解，晕头转向。他把自己描述为在这个阶段逐渐进入和脱离现实——在这个时候，妄想系统开始显现出来。鲍勃开始认为他实际上就是那个主持会议的著名的X博士。然后他开始认为自己和x医生有同性恋关系，认为自己是X医生特别的、最喜欢的同事和知己。他起初对这种想法感到困惑和困惑，这种想法似乎在短暂的妄想浪潮中来了又去，并逐渐建立起来。在这些妄想期之间，他会回到现实，想知道自己为什么会有这些想法，为什么会相信这些想法。渐渐地，他的妄想变得越来越复杂，越来越稳定。他开始认为自己是外星生物的一员，被赋予了神一般的力量。他们是不朽的，永远不会死。他们拥有非凡的力量。他们可以把自己转移到宇宙的任何地方，可以随意进入或离开太阳系。他们也可以通过自己的意愿来获得任何身份。因此，只要鲍勃愿意，他就可以成为住院总医师，或者成为著名的精神病医生X。他心里在想，他是否应该成为一名精神病医生——是应该按照精神病医生的常规训练程序去做呢，还是只要他自己愿意，就能立刻成为一名精神病医生。他可能会遵循常规的训练课程，这样就不会有人怀疑他真正的力量和能力。 It was important for the members of this race to keep their real identity unknown. They had the special power to influence men's minds and to change the course of events. These powerful creatures entered the world to do good and help men straighten themselves out—just the sort of thing psychiatrists do. They were known only by other members of the same race, and if ordinary men knew who and what they were, they would be frightened and want to try to destroy them. Bob worried about dying during this period, but felt secure because in fact members of this race did not die. They didn't have to worry about sex, or about having to get married—since they were immortal. They didn't have to worry about God either, or about God punishing them for sins, since they were like gods themselves and very powerful. 对这个种族的成员来说，保持自己的真实身份不为人知是很重要的。它们具有影响人们思想和改变事件进程的特殊力量。这些强大的生物来到这个世界上是为了行善，帮助人类摆正自己的心态——就像精神病医生做的那样。只有同种族的其他成员知道他们，如果普通人知道他们是谁和什么，他们会感到害怕，并想要试图消灭他们。在这段时间里，鲍勃担心自己会死，但他感到很安全，因为实际上这个种族的成员并没有死。他们不必担心性，也不必担心结婚——因为他们是永生的。他们也不用担心上帝，也不用担心上帝会因为他们的罪惩罚他们，因为他们自己就像神一样，非常强大。 In the midst of these delusional thoughts, Bob came to the conference that Sunday morning and walked up on the stage and presented himself as Dr. X. His bizarre behavior and disorganization were apparent, and he was brought directly to the hospital. 就在这些妄想中，那个星期天早上，鲍勃来到了会议现场，走到讲台上，自称是X医生。他的古怪行为和混乱很明显，他被直接送到了医院。