行为成瘾中的自我间断性:一个心理动力学框架。
Self-discontinuity in behavioral addictions: A psychodynamic framework.
作者信息
Santoro Gianluca, Musetti Alessandro, Costanzo Antonino, Schimmenti Adriano
机构信息
Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43121 Parma, Italy.
Department of Human and Social Sciences, UKE-Kore University of Enna, 94100 Enna, Italy.
出版信息
Addict Behav Rep. 2025 Mar 22;21:100601. doi: 10.1016/j.abrep.2025.100601. eCollection 2025 Jun.
Models based on substance use criteria have been employed to classify maladaptive engagement in various everyday activities as genuine addictions. However, symptom-based models have potential limitations, which includes in some cases reduced clinical utility and an increased risk of diagnostic inflation. The current article presents an alternative psychodynamic theoretical framework to elucidate the psychological processes underlying the development of putative behavioral addictions. According to this framework, behavioral addictions are conceptualized as strategies for regulating overwhelming feelings rooted in childhood trauma. Exposure to childhood trauma may lead to the segregation of unbearable trauma-related mental states from awareness through persistent dissociative processes. Thus, behavioral addictions may provide individuals with an illusory sense of control over unbearable feelings while simultaneously reinforcing the segregation of trauma-related mental states. The compulsive engagement in such activities can be seen as an attempt at self-medication, though it ultimately exacerbates discontinuities in self-experience. This theoretical framework is further illustrated through a clinical vignette, highlighting its implications for both assessment and treatment.
基于物质使用标准的模型已被用于将各种日常活动中的适应不良行为归类为真正的成瘾。然而,基于症状的模型存在潜在局限性,包括在某些情况下临床效用降低以及诊断膨胀风险增加。本文提出了一种替代性的心理动力学理论框架,以阐明假定的行为成瘾发展背后的心理过程。根据这一框架,行为成瘾被概念化为调节源于童年创伤的压倒性情绪的策略。童年创伤的暴露可能导致通过持续的解离过程将无法忍受的创伤相关心理状态与意识分离。因此,行为成瘾可能为个体提供一种对无法忍受的情绪的虚幻控制感,同时加强创伤相关心理状态的分离。对这些活动的强迫性参与可被视为一种自我治疗的尝试,尽管它最终会加剧自我体验的不连续性。通过一个临床案例进一步说明了这一理论框架,突出了其对评估和治疗的意义。