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陀思妥耶夫斯基的癫痫症。

The epilepsy of Dostoevsky.

作者信息

Kiloh L G

出版信息

Psychiatr Dev. 1986 Spring;4(1):31-44.

PMID:3085083
Abstract

The evidence in favour of a diagnosis of limbic epilepsy in the case of Dostoevsky is reviewed. Independent records from numerous biographical sources support the widely held view that Dostoevsky had frequent convulsive episodes, that the episodes began in childhood and continued throughout his life and that Dostoevsky himself was able accurately to record the premonitory aura and sequelae of such episodes. In addition the increasing memory impairment he suffered both for recent and remote events from the age of 40 supports the presence of progressive brain damage. This information renders implausible the analytic interpretations of Freud and his followers, that Dostoevsky's epilepsy was hysterical in origin, where epileptiform somatization was presumed to dispose of excessive psychic excitation, and that this process had its roots in Dostoevsky's unconscious hatred of his father and latent homosexuality. Nevertheless, Dostoevsky's neuroticism is clearly supported by his life-long hypochondriasis, obsessionality, paranoid traits, tendency to reactive depressions, and experience of quasi-hallucinatory episodes which were probably not epileptic in origin. Neither his epilepsy nor his neuroticism can explain or detract from the profundity and wisdom of the literary monuments which clearly attest Dostoevsky's ample genius.

摘要

本文回顾了支持将陀思妥耶夫斯基的病症诊断为边缘性癫痫的证据。众多传记资料的独立记载支持了一种广泛的观点,即陀思妥耶夫斯基频繁发作惊厥,这些发作始于童年并持续终生,而且陀思妥耶夫斯基本人能够准确记录此类发作的先兆和后遗症。此外,他从40岁起对近期和远期事件的记忆损害不断加重,这支持了进行性脑损伤的存在。这些信息使得弗洛伊德及其追随者的分析性解释变得不可信,他们认为陀思妥耶夫斯基的癫痫源于癔症,其中癫痫样躯体化被假定为处理过度的精神兴奋,且这一过程源于陀思妥耶夫斯基对其父亲无意识的仇恨和潜在的同性恋倾向。然而,陀思妥耶夫斯基的神经质显然有其终生的疑病症、强迫观念、偏执特质、反应性抑郁倾向以及可能并非源于癫痫的类幻觉发作经历作为支撑。无论是他的癫痫还是神经质,都无法解释或减损那些文学巨著所彰显的深刻性和智慧,这些巨著清楚地证明了陀思妥耶夫斯基的卓越才华。

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