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[挪用还是让渡?理智的需求与关于“成功的精神病”的挑衅性问题]

[Appropriation or Alienation? The Need of Sense and the Provocative Question on a "Successful Psychosis"].

作者信息

Bock Thomas

机构信息

Universitätsklinik Hamburg-Eppendorf (UKE).

出版信息

Psychiatr Prax. 2018 Jul;45(S 01):S26-S30. doi: 10.1055/s-0043-124637. Epub 2018 Jul 3.

DOI:10.1055/s-0043-124637
PMID:29969816
Abstract

Are mental disorders on the rise, or rather the willingness to disclose them and ask for help? Is humanity becoming increasingly ill or is illness becoming more and more human? Which perspective on mental disorders, especially psychosis, helps the patient to integrate their own experience, and others to avoid social distance? Can psychiatry learn and eventually teach to view these distinct human characteristics not only as pathologic foreignness and abnormality, but also from an anthropological perspective, as a profoundly human expression that exists on a continuum? What value can categories such as purpose and happiness have in this context? The paper introduces the example of Hamburg as city of contradictions with high levels of sickness absence, but simultaneously top scores in the happiness index. Then follows an attempt to outline which perspective on mental illness and which therapeutic stance might be helpful, so that illness and happiness are no longer seen as mutually exclusive. The final case history asks the provocative question if there can be a "successful psychosis".

摘要

是精神障碍在增加,还是更确切地说是披露这些障碍并寻求帮助的意愿在增加?是人类变得越来越病态,还是疾病变得越来越人性化?哪种看待精神障碍,尤其是精神病的视角有助于患者整合自身经历,又能让他人避免产生社会距离?精神病学能否学习并最终教导人们不仅从病理学上的陌生性和异常性角度,而且从人类学角度将这些独特的人类特征视为一种深刻的人类表达,且这种表达存在于一个连续体中?在这种背景下,诸如目标和幸福等类别能有什么价值?本文介绍了汉堡这个矛盾之城的例子,该市病假率很高,但同时在幸福指数方面得分名列前茅。接着试图概述哪种看待精神疾病的视角以及哪种治疗立场可能会有所帮助,以便疾病和幸福不再被视为相互排斥。最后的病例记录提出了一个挑衅性问题,即是否可能存在“成功的精神病”。

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