什么是纯强迫症 (Pure OCD)？：英语精读讲义

Few mental afflictions are as humbling or as terrifying as what is known as pure OCD or more colloquially intrusive thoughts. 講解

很少有精神疾病能像所谓的“纯粹强迫症”（或通俗地称为“闯入性思维”）那样让人感到卑微或恐惧。

In standard obsessive-compulsive disorder,

在标准的强迫症中，

a person is haunted by a worry 習語

患者会被一种担忧所困扰，

that compels them to repeat 語法

驱使他们重复

an often counterproductive or fruitless action with manic intensity. 用詞

以狂热的强度去执行往往适得其反或徒劳无功的动作。

Hand-washing, turning off gas pipes, checking their pulse and so on.

洗手、关煤气管、检查脉搏等等。

But in pure OCD,

但在纯粹强迫症中，

there is no outward physical action.

没有任何外在的身体动作。

The problem unfolds,

问题的展开，

hence the name, 表達脈絡

顾名思义，

purely in the mind.

纯粹是在大脑中。

Yet, it is, if anything, 表達脈絡

然而，如果非要说的话，

an even more distressing condition.

它是一种更加令人痛苦的状况。

The pure OCD sufferer is tortured by thoughts that they want to do or have done 語法

纯粹强迫症患者会被想要做或已经做了某些事情的想法所折磨，

some of the most censored and abhorred acts in our societies,

那些在我们的社会中最受审查和痛恨的行为，

acts that they themselves despise and fear at an intellectual level. 短語搭配

那些他们在理智层面上都鄙视和害怕的行为。

They grow convinced of their wish, for example,

比如，他们会渐渐坚信自己有这种愿望，

to murder a loved one,

要谋杀亲人，

harm a child sexually,

对儿童进行性侵犯，

or assault a stranger.

或者袭击陌生人。

They cannot shut out the idea 短語動詞

他们无法把这种念头拒之门外，

that they may become or have already shown signs that they are

觉得自己可能会变成、或者已经显露出的迹象表明他们是

a psychopath,

一个精神病态者、

a rapist,

一个强奸犯，

or a pedophile.

或者一个恋童癖。

They scan their minds ceaselessly,

他们不断地审视自己的内心，

looking for evidence to confirm their dreadful apprehension. 短語搭配

寻找证据来证实自己那可怕的忧虑。

So burdened are they by these thoughts, 語法

这些想法给他们带来了如此沉重的负担，

they may not be able to go anywhere near children 短語搭配

以至于他们可能无法靠近儿童，

or may take fright at the sight of a knife in a drawer. 短語搭配

或者看到抽屉里的一把刀也会感到恐惧。

Left alone with a colleague,

和同事单独呆在一起时，

they may panic that they could lose control

他们可能会因为担心自己失控而恐慌，

and lunge inappropriately at them.

并对他们做出不适当的猛扑。

At the station,

在火车站，

they're flooded with anxiety with the feeling 習語

这种感觉让他们充满了焦虑：

that they may push their partner or their child

觉得自己可能会把伴侣或孩子

under a train.

推到火车下面。

Having to think of oneself in these terms

被迫如此看待自己，

quickly drains life of any of its pleasure. 習語

会迅速抽干生活中所有的乐趣。

The pure OCD sufferer wakes up every morning

纯粹强迫症患者每天早上醒来，

certain that they are one of the worst people ever to have walked on the planet.

都确信自己是地球上有史以来最糟糕的人之一。

There is not, as yet, 短語搭配

到目前为止，还没有

a foolproof way of treating the condition.

一种万无一失的治疗这种疾病的方法。

But discussions of how to approach it reveal large differences

但关于如何着手治疗的讨论，揭示了

in assessments of how the mind operates.

在评估大脑如何运作方面的巨大差异。

Psychiatrists tend to prescribe antidepressants

精神科医生倾向于开具抗抑郁药，

in order to lift the general mood of sufferers 語法

以提升患者的整体情绪，

and thereby lessen the tendency to ruminate to the point of exhaustion. 講解

从而减少反刍思维直至精疲力尽的倾向。

CBT psychologists will try to argue closely with the intrusive thoughts,

认知行为疗法（CBT）心理学家会尝试与侵入性想法进行严密的辩论，

so that eventually sufferers can logically acknowledge

以便患者最终能在逻辑上承认，

that they truly have no intention of harming anyone 短語搭配

自己是真的没有任何伤害他人

or doing anything obscene.

或做任何淫秽之事的意图。

But it is psychotherapists 語法

但精神分析治疗师

who have what is perhaps the most imaginative and unexpected solution.

拥有或许是最富想象力、最出人意料的解决方案。

They don't target the thoughts themselves

他们不把目标对准想法本身，

or argue with them directly.

也不直接与之辩论。

They don't try to reassure people logically

他们不会试图用逻辑来让人们安心，

that they're not about to murder a loved one or harm a child

告诉他们不会去谋杀亲人或伤害孩子，

because they don't believe that this is what is actually at stake 習語

因为他们认为这并不是真正的症结所在，

and judge that offering reassurance on these points

并且判定在这些点上提供安慰，

only legitimates a pattern of thinking that has no basis in reality. 短語搭配

只会使一种脱离现实的思维模式变得合理化。

They locate the origin of the problem somewhere quite different.

他们认为问题的根源在完全不同的地方。

The sufferer of pure OCD has first and foremost 表達脈絡

纯粹强迫症患者首先并且最重要的是，

a problem with self-esteem and shame.

在自尊和羞耻感方面存在问题。

The unfortunate person feels,

这个不幸的人会觉得，

at some level,

在某种层面上，

utterly disgusting and beyond the pale 習語

自己极其恶心、不可救药，

and will, in the background,

并且在内心深处，

have been feeling like this for a long time.

长期以来一直都有这种感觉。

Somewhere in their past,

在他们过去的某个地方，

normally as a result of very traumatic and degrading childhood relationships,

通常是由于非常痛苦和带有侮辱性的童年人际关系，

they will have derived an impression

他们会产生一种印象，

that they did not deserve to exist.

觉得自己不配存在。

Their current thoughts are not plans for the future.

他们现在的想法不是对未来的计划。

They are attempts by the mind to find a match

它们是大脑试图寻找一种契合，

between their basic sense of self

在其基本自我意识

and what would be needed by their society

和社会对他们的要求之间，

to concur with it.

以求达成一致。

They are a move to bring about a form of dreadful inner equilibrium, 短語動詞

它们是为了带来一种可怕的内在平衡，

ensuring that the judgment of the world

确保世界的评判

falls in line with the judgment of the self. 習語

与自我评判相一致。

Cases of pure OCD are sometimes diagnosed

纯粹强迫症病例有时被诊断出来，

just after sufferers have achieved something rather positive in the eyes of others. 習語

恰好在患者取得了一些在别人看来相当积极的成就之后。

They have been promoted or begun a fulfilling relationship

他们得到了晋升，或者开始了一段令人满意的感情，

or mastered a project.

或者是掌握了一个项目。

It should be a cause for celebration, 短語搭配

这本该是值得庆祝的事，

but happiness simply feels unwarranted.

但幸福感却让人觉得没有根据。

By latching onto thoughts of complete illegality, 短語動詞

通过抓住那些完全非法的想法，

one is assured that one's self-esteem

人们就能确信自己的自尊

will remain at rock bottom. 習語

会一直保持在谷底。

Interestingly, in societies that find religious transgression particularly abhorrent,

有趣的是，在那些认为宗教犯罪尤其令人痛恨的社会中，

pure OCD sufferers will be haunted by feelings

纯粹强迫症患者会被这种感觉所困扰：

that they have offended God

他们冒犯了上帝，

and are about to be outed as sinners. 短語動詞

并即将作为罪人被揭发。

Behind pure OCD is a person's need

纯粹强迫症背后是一个人的需要——

to find a reason to feel awful.

需要找个理由让自己感觉糟糕。

It isn't about this or that condemned act. 短語搭配

这与具体的某个受谴责的行为无关。

And as the definition of awful changes, 語法

而随着“糟糕”的定义发生变化，

so too will the manifest content of the intrusive thoughts.

侵入性想法的具体内容也会随之改变。

The disease is anchored in self-loathing, 習語

这种疾病扎根于自我厌恶之中，

not in blasphemy,

而不是亵渎神明，

incipient pedophilia,

萌芽的恋童癖，

or murderous intent.

或者杀人的动机。

This analysis opens the way to treatment. 習語

这种分析为治疗开辟了道路。

What the sufferer of pure OCD needs,

纯粹强迫症患者需要的，

above all else, 表達脈絡

首要的是，

is to begin to repair their self-loathing and shame.

开始修复他们的自我厌恶和羞耻感。

They need to learn,

他们需要去学习，

through repeated encounters with an outsider

通过与一个局外人反复地接触，

who casts a generous and sympathetic eye on them, 習語

一个对他们投以宽容和同情目光的人，

that they're not the worthless being they take themselves for. 短語搭配

明白他们并不是自己所认为的那种毫无价值的人。

Their problem began with a deficit of love

他们的问题源于爱的缺失，

and needs to be healed by a loving act of witnessing.

需要通过一种充满爱的见证之举来治愈。

Pure OCD thoughts are not wishes.

纯粹强迫症的念头不是愿望。

They are symptoms of radical self-distrust,

它们是极度自我怀疑的症状，

and these will start to lift 用詞

这些症状便会开始消散，

once the afflicted learn

一旦受折磨的人学会了

that most vital of arts,

那门最至关重要的艺术——

being a friend to oneself. 短語搭配

成为自己的朋友。

Our book What is Psychotherapy

我们的书《什么是心理治疗》

tells us exactly what going through therapy is like 短語動詞

确切地告诉了我们接受治疗是怎样一种体验，

and why it is so important.

以及为什么它如此重要。