Scott John Glenn, Warber Sara L, Dieppe Paul, Jones David, Stange Kurt C
Department of Family Medicine, Northeastern Vermont Regional Hospital, Corner Medical, Lyndonville, Vermont, USA.
Department of Community and Family Medicine, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA.
BMJ Open. 2017 Sep 13;7(8):e016771. doi: 10.1136/bmjopen-2017-016771.
To elucidate pathways to healing for people having suffered injury to the integrity of their function as a human being.
A team of physician-analysts conducted thematic analyses of in-depth interviews of 23 patients who experienced healing, as identified by six primary care physicians purposefully selected as exemplary healers.
People in the sample experienced healing journeys that spanned a spectrum from overcoming unspeakable trauma and then becoming healers themselves to everyday heroes functioning well despite ongoing serious health challenges.The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.In the healing journey, bridges from suffering are developed to healing resources/skills and connections to helpers outside themselves. These bridges often evolve in fits and starts and involve persistence and developing a sense of safety and trust.From the iteration between suffering and developing resources and connections, a new state emerges that involves hope, self-acceptance and helping others. Over time, this leads to healing that includes a sense of integrity and flourishing in the pursuit of meaningful goals and purpose.
Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.
阐明那些作为人其功能完整性受到损伤的人的康复途径。
一个由医生分析人员组成的团队,对23名经历康复的患者进行了深入访谈的主题分析,这些患者是由6名被特意挑选出来作为模范康复者的初级保健医生确定的。
样本中的人经历了康复之旅,范围涵盖从克服难以言表的创伤然后自己成为康复者,到尽管面临持续严重的健康挑战仍能正常发挥作用的日常英雄。每个人所经历的痛苦程度和质量受到多种背景因素的影响,这些因素包括个人特征、在发育生命周期中初次或持续受伤的时间以及过去和当前的人际关系。在康复之旅中,从痛苦到康复资源/技能以及与自身之外的帮助者建立联系的桥梁得以搭建。这些桥梁往往断断续续地发展,需要坚持并培养安全感和信任感。通过痛苦与发展资源及建立联系之间的反复作用,一种新的状态出现了,其中包括希望、自我接纳和帮助他人。随着时间的推移,这会带来康复,包括一种完整感以及在追求有意义的目标和目的过程中的蓬勃发展。
从受伤,历经痛苦到康复是有可能的。建立安全、信任的关系以及积极的重新构建有助于实现这一过程,这种重新构建从责任的重压过渡到应对的能力。