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动力心理治疗中与儿童期创伤相关的人际模式的处理:基于证据的案例研究。

Working through childhood trauma-related interpersonal patterns in psychodynamic treatment: An evidence-based case study.

机构信息

Department of Psychoanalysis and Clinical Consulting.

出版信息

Psychol Trauma. 2020 Jan;12(1):64-74. doi: 10.1037/tra0000438. Epub 2019 Feb 4.

Abstract

OBJECTIVE

Adult interpersonal difficulties are considered 1 of the core consequences of childhood trauma exposure. However, research concerning the nature of interpersonal patterns associated with childhood trauma is scarce. The aim of this case study of a supportive-expressive psychodynamic therapy with a woman with a traumatic background, is to provide a detailed understanding of the nature of interpersonal patterns at the beginning and throughout therapy, and to provide an in-depth investigation of the therapeutic process.

METHOD

The Core Conflictual Relationship Theme method (Luborsky & Crits-Christoph, 1998) and the Penn Adherence/Competence Scale for Supportive Expressive Dynamic Psychotherapy (Barber & Critis-Christoph, 1996) were applied to study dominant interpersonal patterns and therapeutic interventions, respectively.

RESULTS

At the beginning of therapy, the patient was unable to safely express herself because others were perceived as critical and rejecting. This relationship pattern originated in her primary (traumatic) childhood relationships and was repeated in her adult relationships. As treatment progresses, the patient aspired more proactively to assert herself and felt more self-confident in interactions, although she consistently perceived the reactions of others in a negative way. The neutral, acknowledging and empowering attitude of the therapist created a new relational experience, through which change (on the interpersonal level) appears to be achieved.

CONCLUSIONS

We conclude that to adequately address interpersonal difficulties in therapy, it is fundamental to recognize dominant interpersonal patterns and to apprehend their dynamics within the broader context of the case. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

摘要

目的

成人人际困难被认为是儿童创伤暴露的核心后果之一。然而,关于与儿童创伤相关的人际模式本质的研究很少。本项针对一名具有创伤背景的女性的支持表达动力心理治疗的案例研究旨在深入了解治疗开始和整个治疗过程中人际模式的本质,并深入调查治疗过程。

方法

核心冲突关系主题方法(Luborsky & Crits-Christoph,1998)和宾夕法尼亚支持表达动态心理治疗依从性/能力量表(Barber & Critis-Christoph,1996)分别用于研究主要人际模式和治疗干预措施。

结果

在治疗开始时,由于他人被认为是批评和拒绝的,患者无法安全地表达自己。这种关系模式源于她的主要(创伤)童年关系,并在她的成人关系中重复出现。随着治疗的进展,患者更积极地渴望表达自己,并在互动中感到更加自信,尽管她始终以消极的方式感知他人的反应。治疗师中立、认可和赋权的态度创造了一种新的关系体验,通过这种体验,似乎在人际层面上实现了改变。

结论

我们得出结论,为了在治疗中充分解决人际困难,必须认识到主导的人际模式,并理解它们在案例更广泛背景下的动态。(美国心理协会,2020)

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