Baumann Philipp S, Söderström Ola, Abrahamyan Empson Lilith, Duc Marwood Alessandra, Conus Philippe
Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Prilly, Lausanne, Switzerland.
Psychiatrist, Rue du Pont-Neuf 2, 1110 Morges, Switzerland.
Schizophr Bull Open. 2021 Nov 18;3(1):sgab051. doi: 10.1093/schizbullopen/sgab051. eCollection 2022 Jan.
Recently, there has been a growing interest in the interaction between the urban milieu and the development of psychosis. While growing up in an urban environment constitutes a risk factor for developing psychosis, patients who develop a first episode of psychosis tend to avoid city centers and suffer from isolation. These observations have fostered emerging interest in ways of developing contexts in cities that are favorable to mental health and that may help service users in their paths to recovery. Building on work on place attachment as well as systemic therapy, we present a new approach to map the urban spaces experienced by service users. We propose two tools, the "place attachment diagram" and "life space network," to situate emotional bond and spatial dimension respectively at their center and help service users to map meaningful places in the city. We also suggest that different facets of the illness such as epidemiological risk factors (residential mobility, migration, urban living, trauma), early place attachment and abnormal space experience, may shape individual space and place experience in psychosis. Psychotherapeutic process with patients should aim at turning urban "spaces" into "places" characterized by a sense of familiarity, security and opportunity. Finally, we argue that the "spatial" is a forgotten dimension in psychotherapy and should be taken into account when treating individuals with psychosis.
最近，城市环境与精神病发展之间的相互作用越来越受到关注。虽然在城市环境中成长是患精神病的一个风险因素，但首次发作精神病的患者往往会避开市中心并遭受孤立。这些观察结果激发了人们对在城市中营造有利于心理健康且可能有助于服务使用者康复的环境方式的新兴趣。基于关于场所依恋以及系统治疗的研究，我们提出一种新方法来绘制服务使用者所体验的城市空间。我们提出了两种工具，即“场所依恋图”和“生活空间网络”，分别将情感纽带和空间维度置于中心位置，并帮助服务使用者绘制城市中有意义的场所。我们还认为，疾病的不同方面，如流行病学风险因素（居住流动性、移民、城市生活、创伤）、早期场所依恋和异常空间体验，可能塑造精神病患者的个人空间和场所体验。对患者的心理治疗过程应旨在将城市“空间”转变为具有熟悉感、安全感和机遇感的“场所”。最后，我们认为“空间”在心理治疗中是一个被遗忘的维度，在治疗精神病患者时应予以考虑。
