School of Public Health, La Trobe University, Melbourne, Australia.
J Trauma Dissociation. 2010;11(1):108-23. doi: 10.1080/15299730903491322.
Psychogenic nonepileptic seizures (PNES), somatoform symptoms that diminish quality of life, can be difficult to treat. A previously proposed conceptualization of PNES is further developed using grounded theory methodology to explore the understandings of therapists who successfully treated clients with PNES. Participants conceptualized PNES as nonverbal communication behaviors that usually evolved in traumatic, interpersonal systems in which verbal expression of affect was proscribed and nonverbal communication of affect was prescribed. Clients without significant trauma and psychiatric comorbidity were successfully treated by means of sensitive delivery of the diagnosis and brief cognitive interventions. Traumatized clients with compromised orientation to the present required a process of cultural transformation in a safe therapeutic relationship. Implications for clinical practice, research methodology, professional training, and service funding are discussed.
心因性非癫痫性发作（PNES）是一种躯体症状，会降低生活质量，且较难治疗。本研究运用扎根理论方法对先前提出的 PNES 概念进行了进一步的拓展，旨在探讨成功治疗 PNES 患者的治疗师的理解。研究参与者将 PNES 概念化为非言语交流行为，这些行为通常发生在创伤性人际系统中，在这些系统中，情绪的言语表达是被禁止的，而情绪的非言语表达是被规定的。对于没有明显创伤和精神共病的患者，通过对诊断的敏感表达和简短的认知干预可以成功治疗。对于定向到当前状态受损的创伤患者，则需要在安全的治疗关系中进行文化转变过程。本文还讨论了对临床实践、研究方法、专业培训和服务资金的影响。
