苹果园（2017）

Coping...
那难道不是
Isn't that the sign of
一个人心理健康的表现吗 萨迪克医生
someone who's psychologically healthy, Dr Sadiq?
不一定 并非所有有人格障碍的病人
Not necessarily. Not all patients with disordered personalities
都过着混乱的生活
have chaotic lives.
那些非常聪明并有良好系统支持的人
Very intelligent people, with good support systems,
正是人们所谓的高功能病人
they can be what you could call high-functioning patients.
他们的应对方式事实上是更深层次的症状
Their coping, in fact, masks more deep-seated symptoms.
萨迪克医生 你能告诉我们
Could you tell us, Dr Sadiq, how a personality disorder
一个病人的人格障碍表现在
might be displayed in a patient...
你第一次见我的时候觉得我怎么样 坦白讲
What did you think of me, the first time you saw me? Honestly?
我觉得
I thought...
我会的
..I would.
你确实
Well, you did.
-你确实 -是啊
- I did. - Yeah.
就像刚才那样吗
So was it just that?
说真的 就像 "我会的"
Seriously, like, "I would"?
不是 我只是想
No, I just thought...
你似乎清楚自己在做什么
you seemed to know what you were doing.
不 不是那样
No, not like that!
是的 是那样
Well, yes, like that.
而你似乎
But you seemed...
是对的人
right.
可靠
Sound.
可靠
Sound...
所以 对于考斯特利来说 他抽离了
So, in Mr Costley's case, he dissociates.
他脱离现实生活
He detaches from real life
编造自己的独♥立♥的故事
and creates his own self-sustaining narrative.
原谅我 医生
Forgive me, Doctor.
你能说得更浅显易懂一些吗
Would you mind putting that in layperson's terms?
抱歉
Sorry.
像考斯特利这样的病人
Patients like Mr Costley,
他们把自己塑造成他们故事中的主角
they make themselves the hero of their own story,
就好像他们是在一部电影中 或书里
almost like they're in a film, or a book,
他们把自己当做主角
and they're watching themselves as the main character.
对其他人而言 这种编故事的趋势
And to other people, this tendency to make up stories,
他们会觉得病人像个妄想症患者
could it make the sufferer seem merely...a bit of a fantasist?
在外人看来 确实会这样
It could look like that, on the outside, yes.
但这代表精神功能异常
But it would represent an abnormality of mental functioning,
-这样说对吗 -对的
- is that correct? - That is correct.
萨迪克医生
What happens, Dr Sadiq,
如果一个患有这种病的人
when someone suffering from this type of disorder
处于极具压力的情况下 会发生什么呢
is put in an unusually stressful situation?
如果他们感觉自身安全
Well, if their sense of safety is challenged
因为失去稳定环境而受到威胁
by the loss of their stable environment,
他们就会代谢失调
they decompensate.
代谢失调 意味着什么
Decompensate... What does that mean?
有可能行为异常
Act oddly, if you like.
他们然后可能会开始行为混乱
They might then start showing chaotic behaviour,
举止不安 充满暴♥力♥或者表现出自毁倾向
disturbed behaviour, violent or self-destructive tendencies.
-你是说暴♥力♥吗 -是的
- Violent, you say? - Yes.
他们可能会胡乱击打 完全失控
They might lash out, lose control completely.
如果是争吵中 例如我们假设
And in an altercation, such as we can assume
发生在乔治·赛尔韦和马克·考斯特利之间
took place between George Selway and Mark Costley...
-反对 -伯纳尔女士
- Objection! - Ms Bonnard...
法官大人
My Lord.
说得更清楚些 萨迪克医生
To be clear, Dr Sadiq,
对于一个有人格障碍的人
in a personality-disordered individual,
就像你描述的这种类型的
such as the type you're describing,
一次争吵或者肢体威胁
could an argument or a physical threat
是不是就会削弱他们的判断力
substantially impair their ability to keep a grip
让他们不知道什么样的反应才是正确的
on what a reasonable response might be?
我想会的
I think so, yes.
好的 所以在这种情况下
Right, so their abnormality of mental functioning
他们的精神异常
would, in this situation,
会影响到他们自控的能力对吗
affect their ability to exercise self-control?
是的 会影响
Yes, it would.
再回到马克·考斯特利身上
Returning to Mark Costley,
你给他检查的时候 得出什么结论
during your examination of him, what conclusions did you draw?
我非常惊讶 他非常欠缺
I was struck by his almost inappropriate ability
正确面对压力大的环境的能力
to manage this very stressful situation he was in
好像他给自己编了一个完全不同的故事
as though he'd found a different story to tell himself.
他所犯罪行的性质
Added to the nature of the crime he's admitted to,
还有他之前危险艳遇的经历
his history of risky sexual encounters,
甚至与情报机构有关的诱人经历
even his attraction to the secret service...
在我看来 马克·考斯特利满足
In my opinion, Mark Costley fits the profile of someone
高功能人格障碍的特征
with a high-functioning personality disorder.
谢谢你
Thank you.
没有问题要问证人 法官大人
No questions for the witness, my Lord.
萨迪克医生 你的这个
Dr Sadiq, this theory of yours
关于所谓高功能人格障碍的理论
about so-called high-functioning personality disorders,
我可以说它是你在金斯顿大学的
am I correct in saying it formed the basis of your PhD thesis
-博士论文的基础 -是的 没错
- at Kingston University? - Yes, that's right.
那么我说它是你偏爱的理论不过分吧
So would it be fair to say it's your pet theory?
算是吧
Well...in a way.
我当然在这个理论上花了很多功夫
It's certainly a theory I've done a great deal of work on.
-在我看来它能解释很多问题 -确实
- It explains a lot, in my opinion. - Indeed.
但你的理论不是已经
But isn't it the case that your theory is countered
被精神病学上公认的诊断分类系统
by the recognised diagnostic categorisation systems
-驳回了吗 -我不觉得那是驳回
- used in psychiatry? - Well, I wouldn't say countered.
拿《世界疾病分类索引》来说
For instance, the Worldwide Disease Classification Index...
高功能人格障碍
Is high-functioning personality disorder
被收录在现行版本中吗 萨迪克医生
included in the current manual, Dr Sadiq?
它没有收录在第10版《分类索引》中
It isn't in WDCI-10.
但我们希望 等到第11版出版的时候
But we're hoping, by the time WDCI-11 comes out,
-它会被收录 -我毫不怀疑
- it'll be included. - No doubt.
但是高功能人格障碍
But does high-functioning personality disorder
有出现在这本广受认可的参考书的任何地方吗
appear anywhere in this highly respected reference work?
《分类索引》中 它尚未被列为独♥立♥诊断结论
It isn't yet classified as a separate diagnosis in the WDCI.
但在第11版中 为了基于连续范围
But in WDCI-11, the intention is to move to a spectrum-based...
谢谢你 萨迪克医生
Thank you, Dr Sadiq.
在2013年3月出版的半年刊
In the Biannual Study Papers Of Mental Disorders, Volume 24,
《精神障碍研究论文集》的第24卷中
dated March 2013,
在迈克尔·赛杜拉医生的一篇文章中
there is a specific refutation of your theory
明确驳斥你的理论
in an article by Dr Michael Sedora,
她是一位在界定人格障碍方面
an expert in borderline personality disorders
有22年的经验的专家
of some 22 years' standing.
在72页 法官大人 注释五
It's page 72, my Lord, footnote five.
可以看到 金斯顿·萨迪克
See Sadiq, Kingston,
《高功能人格障碍及
High-Functioning Personality Disorder
病理特征领域的伪装》
And The Disguise Of Pathological Trait Domains.
那是你博士论文的题目 萨迪克医生
That is the name of your PhD thesis, Dr Sadiq?
萨迪克医生
Dr Sadiq?
是的 没错
Yes, that's right.
我没有找到临床证据能证明
I find no clinical evidence that the so-called
所谓的高功能个体能够伪装
high-functioning individual is able to disguise traits
诸如强迫性和对抗性等病情特征
such as compulsivity or antagonism
不让家庭成员或医疗人员发现
from family members or medical professionals.
他们没有抓住我论文的重点
They're missing the fundamental point of my thesis,
即人格不是二元概念而是一个连续范围
which is that personality is not a binary concept but a spectrum.
我完全不能接受高功能分类
I discount entirely the existence of a high-functioning category
被从现行的人格障碍中单独分离出来
separate from the current definition of personality disorders.
有一群人 就像考斯特利先生一样
There's a group of individuals, like Mr Costley,
有着不同寻常的病理人格
who have significant personality pathology,
但又不符合现行的人格障碍的诊断结果
which may fall short of the current diagnosis of personality dis...
不符合
Fall short?
没错
Indeed.
高功能人格障碍这一子类
A subcategory of high-functioning personality disorder...
尚未得到证实
remains unsubstantiated.
没有其他问题了 法官大人
No further questions, my Lord.
疯子还是坏人