Lewis O, O'Brien J
General Child Psychiatry Clinic, Babies Hospital, Columbia-Presbyterian Medical Center, New York, NY 10032.
Am J Psychother. 1991 Oct;45(4):527-43. doi: 10.1176/appi.psychotherapy.1991.45.4.527.
Although various authors have discussed the technical modification required for dream interpretation with children, the basic conceptualization of the psychotherapeutic use of the dream with children has remained virtually identical to that with adult analysands. Examining various sources including formal studies on the nature of children's dreams, clinical case reports and series, and cognitive theories, the authors conclude that a dream arising in the course of a child's therapy must be conceptualized theoretically as a posttraumatic phenomenon. This holds whether or not there has been overt trauma to the child. The reasons for the conceptualization include both the heightened degree of anxiety contained in a dream reported in the course of psychotherapy as well as the specific cognitive abilities of children to contain anxiety and abstract and generalize symbolic meanings. A specific technique based on this conceptualization is then detailed that calls for translation of the dream into more tangible expression (drawing, play, etc.) and a noninterpretative approach. The authors also discuss the more general problem of the nature of insight in children.
尽管已有多位作者探讨了对儿童进行梦的解析所需的技术调整,但对儿童使用梦进行心理治疗的基本概念化实际上仍与对成年分析对象的做法相同。通过研究包括关于儿童梦的本质的正式研究、临床病例报告及系列以及认知理论等各种资料来源,作者们得出结论,在儿童治疗过程中出现的梦在理论上必须被概念化为创伤后现象。无论儿童是否遭受过明显的创伤,都是如此。进行这种概念化的原因既包括心理治疗过程中报告的梦中所含焦虑程度的提高,也包括儿童控制焦虑以及抽象和概括象征意义的特定认知能力。然后详细介绍了基于这种概念化的一种具体技术,该技术要求将梦转化为更具体的表达形式(绘画、游戏等),并采用非解释性方法。作者们还讨论了儿童洞察力本质这一更普遍的问题。