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[一个患有精神病的共生型儿童。临床与精神病理学研究]

[A psychotic symbiotic child. Clinical and psychopathological study].

作者信息

Ledoux M H

机构信息

Centre de jour Michel Ange, Saint-Nazaire.

出版信息

Psychiatr Enfant. 1993;36(1):27-65.

PMID:7689733
Abstract

Through the case study of a psychotic girl, we have tried to outline the psychotic mechanisms involved in this mental functioning. Anxieties of an autistic type have been found, as well as anxieties of a more psychotic type (i.e. symbiotic and schizophrenic). Characteristics of this psychotic functioning were: omnipotence, primitive identification mechanisms, fragmenting separation anxiety, search for sameness and for a low of identical repetition, difficulties in accessing to symbolism. Difficulties in defusion from the symbiotic object and the potential role played by this object in the difficulties are noteworthy. But it is not possible to conceptualize them in terms of direct causal relationship, because the object has also a counterphobic function and compensates for the void of subject as well as for the dissolution of the self. Also present is a schizoparanoïd aspect, with a temptation to cuddle inside the object. The sudden breaking through of informations or requirements from reality provokes surprise, panic reactions and retirement from the objectal world. Otherness triggers psychic pain and vacillation of symbiotic bounds. Thus the avoidance of, and retirement from, reality and the recourse to delusional thinking, especially when attempts to controlling with a rigid system are failing and deceiving. Threats of intrusion and loss of control are experienced as a threat of fragmentation and dissolution of the psyche. Far less threatening to the subject's internal balance is the policy of rigidly maintaining sameness and cuddling inside the object.

摘要

通过对一名患有精神病的女孩的案例研究,我们试图勾勒出这种心理功能中所涉及的精神病机制。我们发现了自闭症类型的焦虑,以及更具精神病性质的焦虑(即共生性和精神分裂性焦虑)。这种精神病功能的特征包括:全能感、原始认同机制、碎片化的分离焦虑、对相同性的寻求以及对重复相同事物的渴望、难以进入象征领域。与共生对象的融合困难以及该对象在这些困难中所起的潜在作用值得关注。但不可能从直接因果关系的角度对它们进行概念化,因为该对象还具有反恐惧功能,既能弥补主体的空虚,也能弥补自我的解体。同时还存在一种类偏狂精神分裂的方面,表现为有一种蜷缩在对象内部的倾向。来自现实的信息或要求的突然闯入会引发惊讶、恐慌反应以及从对象世界中退缩。他者引发精神痛苦以及共生纽带的动摇。因此,对现实的回避和退缩以及诉诸妄想性思维,尤其是当试图用僵化的系统进行控制失败并产生欺骗时。对侵入和失去控制的威胁被体验为精神分裂和解体的威胁。相比之下,严格维持相同性并蜷缩在对象内部的策略对主体内部平衡的威胁要小得多。

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