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抑郁症患者的心理治疗。

Psychotherapy of depressives.

作者信息

Battegay R

出版信息

Psychopathology. 1986;19 Suppl 2:118-23. doi: 10.1159/000285142.

Abstract

People in depressions are submitted to a suffering which always necessitates, in addition to pharmacotherapy, a psychotherapeutic approach. In all the psychotherapies known, a certain attitude of the therapist, which includes an unconditional openness for the patient is necessary. Depressives cannot bear banal optimism, but need the therapist's confidence in their future. This human participation helps to fill up, at least to a certain degree, their lack of narcissism. Special points of psychotherapy of depressives are described: positive emotional attention, empathy, unconditional listening, asking questions (to give the patient's word and attitudes a meaning and to activate cognitive processes), more orientation than interpretation (during depressive phases), giving advice: Whereas in most psychotherapies it is counterindicated to counsel the patient, in major depressions it can be necessary to formulate recommendations, getting conscious about what happened during the therapeutic session in the patient and in the therapist, since otherwise the therapist may get too involved in the depressive's unrealistic expectations or too defensive against him. Psychotherapy with depressives does not only mean individual treatment, but can include--possibly in addition--their social environment: Partner therapy, family therapy, of the use of a social system as a milieu for psychotherapy (group psychotherapy). Whereas psychotherapy in the depressive phases consists mainly in the named procedure, in the intervals, the experiences of the depressive phases and the emotional and cognitive life and behavior patterns should be worked through focally, in an analytically oriented short-term psychotherapy. A long-term analytic treatment is only indicated in depressive neurotics.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

抑郁症患者承受着痛苦,除药物治疗外,心理治疗方法总是必不可少的。在所有已知的心理治疗中,治疗师的某种态度是必要的,其中包括对患者无条件的开放态度。抑郁症患者无法忍受平庸的乐观主义,但需要治疗师对他们的未来抱有信心。这种人文关怀至少在一定程度上有助于填补他们自恋的缺失。文中描述了抑郁症患者心理治疗的特殊要点:积极的情感关注、同理心、无条件倾听、提问(赋予患者的言语和态度以意义并激活认知过程)、更多的引导而非解释(在抑郁阶段)、给予建议:在大多数心理治疗中,向患者提供建议是禁忌的,但在重度抑郁症中,可能有必要提出建议,让患者和治疗师意识到治疗过程中发生了什么,否则治疗师可能会过度陷入抑郁症患者不切实际的期望中,或者对其过度防御。对抑郁症患者的心理治疗不仅意味着个体治疗,还可能包括——此外——他们的社会环境:伴侣治疗、家庭治疗,或将社会系统用作心理治疗的环境(团体心理治疗)。虽然抑郁阶段的心理治疗主要包括上述程序,但在间歇期,应以分析为导向的短期心理治疗,重点梳理抑郁阶段的经历以及情感、认知生活和行为模式。长期分析治疗仅适用于抑郁性神经症患者。(摘要截选至250字)

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