Clinical Implications 临床意义 But its implications nonetheless do have important ramifications that affect even the more clinical level of understanding with which we have been dealing. What it enunciates is the realization that even the most extreme psychopathological expressions of the paranoid process do not take place in a vacuum. Rather they emerge out of an extremely rich and complex social, cultural, and familial matrix which can have powerful determining influences on the emergence and expression of the paranoid process. Thus, for example, in considering the vicissitudes of an individual case of paranoid pathology, we are faced with the possibility that the identifiable levels of distortion in terms of the patient's developmental experience may be strongly influenced by paranoid attitudes, which permeate the family system in which the child grows up. 但是，它的意义确实有重要的影响，甚至影响到我们一直在处理的更为临床的理解水平。它所阐明的是，即使是偏执过程中最极端的精神病理表现，也不是在真空中发生的。相反，它们是从一个极其丰富和复杂的社会、文化和家庭环境中产生的，这个环境对偏执过程的出现和表达有强大的决定性影响。因此，举例来说，在考虑一个个别的偏执病理个案的变迁时，我们面临的可能性是，在病人的发展经验方面，可辨认的扭曲程度可能受到偏执态度的强烈影响，而偏执态度渗透了儿童成长的家庭系统。 However, such attitudes do not always reach the level of acknowledgeable psychopathology in other family members, particularly the parents. In several of our own case studies, this pattern seems to be quite clear. In the case of Clare, it seems quite likely that her father carried a certain paranoid disposition, but its manifestations were by no means clinical and he was able to integrate this basically paranoid disposition into a pattern of life and work that enabled him to maintain himself without any significant dysfunction. Similarly in the case of Gloria, her father's attitudes were quite explicitly paranoid, but the expression of his paranoia seems to have been limited more or less to the family context and seems not to have affected significantly other areas of his life and work. However, such attitudes may not even be identifiable as pathological at all. 然而，这种态度在其他家庭成员(特别是父母)身上并不总是达到可认出的精神病理学程度。在我们自己的几个案例研究中，这种模式似乎相当明显。在克莱尔的案例中，她的父亲似乎很有可能带着某种偏执的倾向，但其表现绝不是临床上的，他能够将这种基本偏执倾向融入到生活和工作的模式中，使他能够维持自己的生活，而不出现任何明显的功能障碍。同样在格洛丽亚的案例中，她父亲的态度也是相当明确的偏执，但他的偏执症的表现似乎或多或少地局限在家庭环境中，似乎并没有对他的生活和工作的其他领域产生重大影响。然而，这种态度甚至可能根本不能被认定为病态。