Sachsse Ulrich
Fachklinik für Psychiatrie und Psychotherapie, Rosdorfer Weg 70, 37081 Göttingen.
Prax Kinderpsychol Kinderpsychiatr. 2003 Oct;52(8):578-94.
Actual results of brain research show that we might have more than one system to cope with distress. The most archaic one might be the system freeze/dissociation. The second one is the system attachment/relationship/herd/support. Articles by Allan N. Schore show that the central regulation of the self, the affects, and the interpersonal relations are impaired permanently by relational traumata/attachment traumata during early childhood. Jaak Panksepp differentiates the distress systems panic versus fear. On the one side we find the cluster panic--periaqueductal gray PAG--lateral septum--gyrus cinguli--glutamate--opioids--attachment--parasympathetic autonomic nerve system--trophotorphic state--hypometabolism--freeze reaction--dissociation, on the other side the cluster fear--enemy--sympathetic autonomic nerve system--ergotrophic state--hypermetabolism--fight and flight--cognition and learning. It can be helpful for therapy strategies to differentiate these systems.
大脑研究的实际结果表明,我们可能有不止一种系统来应对痛苦。最古老的可能是“冻结/解离”系统。第二个是“依恋/关系/群体/支持”系统。艾伦·N·肖尔的文章表明,在幼儿期,关系创伤/依恋创伤会永久性地损害自我、情感和人际关系的中枢调节。雅克·潘克塞普区分了“惊恐”与“恐惧”这两种痛苦系统。一方面我们发现“惊恐”集群——中脑导水管周围灰质(PAG)——外侧隔区——扣带回——谷氨酸——阿片类物质——依恋——副交感自主神经系统——滋养状态——代谢减退——冻结反应——解离,另一方面是“恐惧”集群——敌人——交感自主神经系统——营养状态亢进——代谢亢进——战斗和逃跑——认知和学习。区分这些系统对治疗策略可能会有帮助。