Department of Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany.
Psychology Clinic, York University, Toronto, Canada.
Clin Psychol Psychother. 2019 Jan;26(1):1-13. doi: 10.1002/cpp.2325. Epub 2018 Sep 25.
Anxiety disorders are characterized by high levels of anxiety and avoidance of anxiety-inducing situations and of negative emotions such as anger. Emotion-focused therapy (EFT) and psychodynamic psychotherapy (PP) have underscored the therapeutic significance of processing and transforming repressed or disowned conflicted or painful emotions. Although PP provides sophisticated means of processing intrapsychic and interpersonal conflict, EFT has empirically tested a set of techniques to access, deepen, symbolize, and transform emotions consistent with current conceptualizations of emotions and memory. Based on our clinical experience, we propose that an integrative emotion-focused and psychodynamic approach opens new avenues for treating anxiety disorders effectively, and we present a transdiagnostic manual for emotion-focused psychodynamic psychotherapy. The therapeutic approach takes into account both the activation, processing, and modification of emotion and the underlying intrapsychic and interpersonal conflicts. The short-term treatment is based on the three phases of initiating treatment, therapeutic work with anxiety, and termination. Emotional poignancy (or liveliness) is an important marker for emotional processing throughout treatment. Instead of exposure to avoided situations, we endorse enacting the internal process of generating anxiety in the session providing a sense of agency and access to warded-off emotions. Interpretation serves to tie together emotional experience and insight into the patterns and the nature of underlying intrapersonal and interpersonal conflict. Treatment modules are illustrated by brief vignettes from pilot treatments.
焦虑障碍的特点是焦虑水平高，以及回避引起焦虑的情境和愤怒等负面情绪。情绪聚焦疗法（EFT）和心理动力学心理疗法（PP）强调了处理和转化压抑或否认的冲突或痛苦情绪的治疗意义。虽然 PP 提供了处理内心和人际冲突的复杂手段，但 EFT 已经通过实证检验了一套技术，以获取、深化、象征化和转化与当前情感和记忆概念一致的情绪。基于我们的临床经验，我们提出，整合的情绪聚焦和心理动力学方法为有效治疗焦虑障碍开辟了新的途径，我们提出了一种情绪聚焦心理动力学心理疗法的跨诊断手册。该治疗方法考虑了情绪的激活、处理和改变，以及潜在的内心和人际冲突。短期治疗基于治疗启动、治疗焦虑和治疗结束三个阶段。情感生动性（或活力）是整个治疗过程中情绪处理的一个重要标志。我们不主张暴露于回避的情境，而是支持在治疗中表现出产生焦虑的内在过程，从而赋予个体代理权并接触到被回避的情绪。解释有助于将情感体验与对潜在的人际和内心冲突的模式和本质的洞察力联系起来。治疗模块通过来自试点治疗的简短案例进行说明。
