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体感疗法:将内感受和本体感受作为创伤治疗的核心要素。

Somatic experiencing: using interoception and proprioception as core elements of trauma therapy.

作者信息

Payne Peter, Levine Peter A, Crane-Godreau Mardi A

机构信息

Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth Lebanon, NH, USA.

Foundation for Human Enrichment Boulder, CO, USA.

出版信息

Front Psychol. 2015 Feb 4;6:93. doi: 10.3389/fpsyg.2015.00093. eCollection 2015.

Abstract

Here we present a theory of human trauma and chronic stress, based on the practice of Somatic Experiencing(®) (SE), a form of trauma therapy that emphasizes guiding the client's attention to interoceptive, kinesthetic, and proprioceptive experience. SE™ claims that this style of inner attention, in addition to the use of kinesthetic and interoceptive imagery, can lead to the resolution of symptoms resulting from chronic and traumatic stress. This is accomplished through the completion of thwarted, biologically based, self-protective and defensive responses, and the discharge and regulation of excess autonomic arousal. We present this theory through a composite case study of SE treatment; based on this example, we offer a possible neurophysiological rationale for the mechanisms involved, including a theory of trauma and chronic stress as a functional dysregulation of the complex dynamical system formed by the subcortical autonomic, limbic, motor and arousal systems, which we term the core response network (CRN). We demonstrate how the methods of SE help restore functionality to the CRN, and we emphasize the importance of taking into account the instinctive, bodily based protective reactions when dealing with stress and trauma, as well as the effectiveness of using attention to interoceptive, proprioceptive and kinesthetic sensation as a therapeutic tool. Finally, we point out that SE and similar somatic approaches offer a supplement to cognitive and exposure therapies, and that mechanisms similar to those discussed in the paper may also be involved in the benefits of meditation and other somatic practices.

摘要

在此,我们基于体感疗法(SE)的实践,提出一种关于人类创伤和慢性应激的理论。体感疗法是一种创伤治疗形式,强调引导来访者关注内感受、动觉和本体感受体验。SE声称,这种内在关注方式,除了运用动觉和内感受意象外,还能导致慢性和创伤性应激所致症状的缓解。这是通过完成受阻的、基于生物学的自我保护和防御反应,以及释放和调节过度的自主唤醒实现的。我们通过一个SE治疗的综合案例研究来阐述这一理论;基于此案例,我们为其中涉及的机制提供一种可能的神经生理学原理,包括一种将创伤和慢性应激视为由皮层下自主神经、边缘系统、运动和唤醒系统构成的复杂动力系统功能失调的理论,我们将该系统称为核心反应网络(CRN)。我们展示了SE方法如何帮助恢复CRN的功能,并强调在应对压力和创伤时考虑基于本能的身体保护反应的重要性,以及将对内感受、本体感受和动觉感觉的关注作为一种治疗工具的有效性。最后,我们指出SE和类似的躯体方法为认知疗法和暴露疗法提供了补充,并且与本文所讨论机制类似的机制可能也参与了冥想和其他躯体练习的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87d0/4316402/82fbaa46cba7/fpsyg-06-00093-g0001.jpg

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