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超越病理学:不孕治疗中女性对忧郁和哀悼的亲身经历。

Beyond pathology: women's lived experiences of melancholy and mourning in infertility treatment.

机构信息

Institute of Health and Society, University of Oslo, Oslo, Norway

Department Culture Studies, Tilburg University School of Humanities & Digital Sciences, LE Tilburg, The Netherlands.

出版信息

Med Humanit. 2020 Sep;46(3):214-225. doi: 10.1136/medhum-2018-011586. Epub 2019 Jun 6.

Abstract

Throughout history, melancholy and mourning are predominantly understood within the tradition of psychopathology. Herein, melancholy is perceived as an ailing response to significant loss, and mourning as a healing experience. By taking the philosophies of Freud, Ricoeur and Kristeva together with relevant social scientific research as a theoretical framework and by drawing on women's accounts of melancholy and mourning in infertility treatment, we offer an exploration of melancholy and mourning beyond this pathological ailing/healing logic. We do so by asking what it means for women to actually live with melancholy and mourning in infertility treatment. In answering this question, we show that women in infertility treatment may have different kinds of melancholic longings: they desire their lost time as a pregnant woman, lost love life and lost future. Within these longings, women derive their sense of self predominantly from their lost past: they understand themselves as the mothers or lovers they once were or could have been. We further reveal that some of these women attempt to escape this dwelling of identity and mourn their losses by (re)narrating their pasts or through performing rituals. While these results show how melancholy and mourning are coshaped in relation to these women's embodied, temporal, sociocultural and material lived context, they also give insight into how melancholy and mourning may be understood beyond infertility treatment. We reveal how the binary dynamic between melancholy and mourning is inherently ambiguous: melancholy instigates a joyous painfulness, something that is or is not overcome through the agonising exertion of mourning. We show, moreover, that underlying this melancholy/mourning dynamic is a pressing and uncontrollable reality of not being able to make (sufficient) sense of oneself. At the end of this work, then, we argue that it follows out of these conclusions' urgency to have context-sensitive compassionate patience with those who live with melancholy and mourning.

摘要

纵观历史,忧郁和哀悼主要在精神病理学传统中被理解。在这里,忧郁被视为对重大损失的病态反应,哀悼则被视为一种治愈体验。通过将弗洛伊德、里克尔和克里斯蒂娃的哲学与相关的社会科学研究结合起来作为理论框架,并借鉴女性在不孕治疗中对忧郁和哀悼的描述,我们提出了超越这种病态的患病/治愈逻辑的对忧郁和哀悼的探索。我们这样做是通过询问女性在不孕治疗中实际承受忧郁和哀悼意味着什么。在回答这个问题时,我们表明,不孕治疗中的女性可能有不同类型的忧郁渴望:她们渴望自己作为孕妇、失去的性生活和未来的时光。在这些渴望中,女性主要从她们失去的过去中获得自我意识:她们将自己理解为曾经或可能成为的母亲或爱人。我们进一步揭示,这些女性中的一些人试图通过(重新)叙述她们的过去或通过执行仪式来逃避这种身份的存在,并哀悼她们的损失。虽然这些结果表明忧郁和哀悼是如何与这些女性的身体、时间、社会文化和物质生活背景相关联的,但它们也让我们深入了解忧郁和哀悼如何在不孕治疗之外得到理解。我们揭示了忧郁和哀悼之间的二元动态本质上是模糊的:忧郁引发了一种愉快的痛苦,这种痛苦是通过哀悼的痛苦努力而克服还是没有克服。我们还表明,在这种忧郁/哀悼动态的背后,存在着一种无法(充分)理解自己的紧迫和无法控制的现实。因此,在这项工作的最后,我们认为,从这些结论的紧迫性出发,我们应该对那些承受忧郁和哀悼的人表现出有语境意识的同情和耐心。

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