DIAGNOSTIC CRITERIA 诊断的标准
So how does the analyst actually arrive at a diagnosis? In ‘On Beginning the Treatment’, Freud was not very forthcoming about how to distinguish practically neurosis from psychosis, yet he did warn his readers about the deceitfulness of the clinical picture:
所以,精神分析家实际上获得诊断没有?在“论治疗的开始”,弗洛伊德并没有直接提出如何实践时区别神经症与精神病。可是,他确实警告他的读者,关于这个临床画面的欺骗性。
Often enough, when one sees a neurosis with hysterical or obsessional symptoms, which is not excessively marked and has not been in existence for long—just the type of case, that is, that one would regard as suitable for treatment—one has to reckon with the possibility that it may be a preliminary stage of what is known as dementia praecox (‘schizophrenia’, in Bleuler’s terminology; ‘paraphrenia’, as I have proposed to call it), and that sooner or later it will show a well-marked picture of that affection.
经常地,当我们看见一位神经诊者具有癔症或妄想症的症状时,这并不是过分明显,并且并没有长久存在。它仅是这种个案,换句话说,我们将会认为这位神经症是适合于治疗。我们必须考虑这个可能性:这可能是一个初期的阶段,对于众所周知的“精神病”(精神分裂症schizophrenia,用布鲁尔的术语,paraphrenia,依照我对它的建议称呼)。迟早,它将会显示一个属于那种情感的明显的画面。
(Freud 1913c:124) 8 Jacques Lacan and the Freudian practice of psychoanalysis Freud contended that ostensibly neurotic symptoms (such as elusive bodily pains and compulsive behaviours) should not be taken as unambiguous signs of an underlying neurotic illness, however conspicuous they may be.