Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Institute of Regional Health Services Research University of Southern Denmark, Østre Hougvej, 55, 5500, Middelfart, Denmark.
BMC Musculoskelet Disord. 2012 Sep 6;13:166. doi: 10.1186/1471-2474-13-166.
There is continuing uncertainty in back pain research as to which treatment is best suited to patients with non-specific chronic low back pain (CLBP). In this study, Gestalt therapy and the shock trauma method Somatic Experiencing® (SE) were used as interventions in parallel with the usual cross-disciplinary approach. The aim was to investigate how these treatments influence a patient's capacity to cope with CLBP when it is coupled with depression.
In this qualitative explorative study, a phenomenological-hermeneutic framework was adopted. Patients were recruited on the basis of following criteria: A moderate depression score of 23-30 according to the Beck Depression Inventory Scale and a pain score of 7-10 (Box scale from 0-10) and attendance at five- six psychotherapeutic sessions. Six patients participated in the study. The data was comprised of written field notes from each session, which were subsequently analysed and interpreted at three levels: naive reading, structural analysis and critical interpretation and discussion.
Three areas of focus emerged: the significance of previous experiences, restrictions in everyday life and restoration of inner resources during the therapy period. The study revealed a diversity of psychological stressors that related to loss and sorrow, being let down, violations, traumatic events and reduced functioning, which led to displays of distress, powerlessness, reduced self-worth, anxiety and discomfort.Overall, the sum of the stressors together with pain and depression were shown to trigger stress symptoms. Stress was down-played in the psychotherapeutic treatment and inner resources were re-established, which manifested as increased relaxation, presence, self-worth, sense of responsibility and happiness. This, in turn, assisted the patients to better manage their CLBP.
CLBP is a stress factor in itself but when coupled with depression, they can be regarded as two symptom complexes that mutually affect each other in negative ways. When pain, stress and depression become overwhelming and there are few internal resources available, stress seems to become prominent. In this study, Gestalt therapy and the SE-method may have helped to lower the six patients' level of stress and restore their own internal resources, thereby increasing their capacity to cope with their CLBP.
在非特异性慢性下背痛（CLBP）患者中，哪种治疗方法最适合，腰痛研究仍存在不确定性。在这项研究中，格式塔疗法和冲击创伤方法躯体体验®（SE）与常规跨学科方法并行作为干预措施。目的是研究当 CLBP 伴有抑郁时，这些治疗方法如何影响患者的应对能力。
在这项定性探索性研究中，采用了现象学-解释学框架。根据贝克抑郁量表（Beck Depression Inventory Scale），患者符合以下标准后被招募：抑郁评分为 23-30 分，疼痛评分为 7-10 分（0-10 分箱式评分），并参加了五至六次心理治疗。六名患者参与了这项研究。数据包括每次会议的书面现场记录，随后在三个层面进行分析和解释：初始阅读、结构分析和批判性解释与讨论。
出现了三个关注重点：以前经历的重要性、日常生活中的限制以及治疗期间内在资源的恢复。研究揭示了一系列与失落和悲伤、失望、侵犯、创伤事件和功能下降相关的心理压力源，这些压力源导致了痛苦、无力感、自我价值降低、焦虑和不适等表现。总的来说，压力源与疼痛和抑郁一起，被证明会引发压力症状。在心理治疗中，压力被淡化，内在资源得以重建，表现为放松、存在、自我价值感、责任感和幸福感增加。这反过来又帮助患者更好地管理他们的 CLBP。
CLBP 本身就是一个压力因素，但当与抑郁结合时，它们可以被视为两个相互负面影响的症状复合体。当疼痛、压力和抑郁变得难以承受，内在资源有限时，压力似乎变得突出。在这项研究中，格式塔疗法和 SE 方法可能有助于降低六名患者的压力水平，并恢复他们自己的内在资源，从而提高他们应对 CLBP 的能力。
