Donovan J M
Harvard Medical School, Boston, MA.
Psychiatry. 1989 Nov;52(4):446-61. doi: 10.1080/00332747.1989.11024469.
BRIEF dynamic psychotherapy has achieved widespread acceptance in the past 20 years but as yet has formed no satisfactory approach to effecting character change. The most frequently chosen path has been to select for treatment only those who readily demonstrate the capacity to investigate focal conflict, thus bypassing character armor. The strategy here flows in the opposite direction. Within brief dynamic treatment, what technical alterations might more effectively engage characterologic difficulty? I report on one such innovation. When patients are asked to sit close to but turned at 180 degrees from the therapist, those with character disorders--particularly patients suffering from mid-level disorders--can often suspend their defenses sufficiently to permit specific types of new material into the treatment. This alteration in process appears, in turn, to abet outcome.
短程动力心理治疗在过去20年中已获得广泛认可，但尚未形成令人满意的改变性格的方法。最常选择的途径是仅选择那些易于展现出探究焦点冲突能力的人进行治疗，从而避开性格防御。这里采用的策略则相反。在短程动力治疗中，哪些技术改变可能更有效地应对性格方面的难题呢？我报告一项这样的创新。当要求患者靠近治疗师坐下，但与治疗师呈180度转身时，患有性格障碍的患者——尤其是患有中度障碍的患者——通常能够充分暂停防御，从而允许特定类型的新材料进入治疗过程。反过来，这种治疗过程中的改变似乎有助于治疗效果。
