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[强迫症患者的心理治疗]

[Psychotherapy in patients with obsessive-compulsive disorder].

作者信息

Karasu T B

机构信息

Département de Psychiatrie, Bronx Municipal Hospital Center, New York 10461.

出版信息

Encephale. 1990 Jul-Aug;16 Spec No:355-8.

PMID:2209495
Abstract

The present paper is a study of the role of psychotherapy in the treatment of obsessive-compulsive disorders (OCD). It also includes an attempt to integrate several paradigms in order to obtain the best possible approach in helping each patient on an individual basis. The aim of this psychotherapy may limit itself to simple verifications in the pharmacotherapeutic follow-up, or it may be as ambitious as an attempt to modify the character structure of the individual. In the process of the latter case, one expects the defensive aim of symptoms to be no longer relevant, insofar as the patient successfully solves the conflicts that caused the symptoms. We can only use tags or labels to bear witness of the efficiency of such ambitious use of psychotherapy, and even these tags or labels seem to be concerned with compulsive personality rather than with OCD proper. At each end of the range of aims (encouraging the follow-up of pharmacotherapeutic or behavioral treatments vs character modification), the therapist is inevitably confronted with a multitude of features frequently present in the obsessive patient. Because it is a disorder which invades and influences the patient's feelings, thoughts, behavior and relationships with other people, the obsessive patient's mind is a constant prey to special problems at every meeting with his therapist, whether they be related to the administration of drugs or to a behavioral therapy regime. Obviously, such problems will multiply if one initiates systematic psychotherapy in such patients.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本文是一项关于心理治疗在强迫症(OCD)治疗中作用的研究。它还包括尝试整合多种范式,以便在个体基础上为每位患者找到最佳治疗方法。这种心理治疗的目标可能仅限于药物治疗随访中的简单验证,也可能像试图改变个体性格结构一样雄心勃勃。在后一种情况下,人们期望症状的防御性目标不再相关,前提是患者成功解决了导致症状的冲突。我们只能使用标签或标记来证明这种雄心勃勃的心理治疗使用的有效性,而这些标签或标记似乎更多地与强迫性人格有关,而非与真正的强迫症有关。在目标范围的两端(鼓励药物治疗或行为治疗的随访与性格改变),治疗师不可避免地会面对强迫症患者经常出现的众多特征。由于这是一种侵袭并影响患者情感、思想、行为以及与他人关系的疾病,强迫症患者每次与治疗师会面时,其思维都会不断受到特殊问题的困扰,无论这些问题与药物管理还是行为治疗方案有关。显然,如果对这类患者开展系统的心理治疗,此类问题将会增多。(摘要截选至250词)

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