Eletti P L, Peresson L
Minerva Med. 1983 Dec 30;74(51-52):2957-64.
Questions relating to communication and metacommunication during two forms of directive psychotherapy (Schultz's autogenous training and hypnosis) are examined. The concept of rigidity and cognitive flexibility with regard to the physician-patient relationship is discussed: abstract-concrete dynamics, abstract generalisation of diagnosis, linguistic egocentricity, stereotypical adaptation to conventional language. Some attention is devoted to Heider's balance theory as the first approach to psychological understanding of the therapeutic relationship. The communicative and metacommunicative process described by the Palo Alto (California) school is discussed. Autogenous psychotherapy and hypnosis extend through the concepts of symmetrical relation and inferior complementarity. The criteria for reaching these objectives are stated, along with the pragmatic methods devised for decoding messages and gaining access to metacommunication. Three clinical cases treated through autogenous training and one with hypnosis are analysed with respect to communication and from the relational standpoint. The patient's messages are decoded, the ambiguity of the communication is detected, and the physician's possible answers are examined at both the technical and the emotive level. It is felt that the correct use of the communicational perspective greatly extends the possibilities of autogenous training and hypnosis. It is not a question of combining relational and autogenous management, but of using the Palo Alto discoveries in the more complete understanding of cases in which psychotherapy is employed.
本文探讨了两种指导性心理治疗(舒尔茨的自我训练法和催眠法)过程中的沟通与元沟通问题。讨论了医患关系中的僵化和认知灵活性概念:抽象-具体动态、诊断的抽象概括、语言自我中心性、对传统语言的刻板适应。文中还对海德的平衡理论予以一定关注,它是对治疗关系进行心理学理解的首个方法。讨论了加利福尼亚帕洛阿尔托学派所描述的沟通和元沟通过程。自我心理治疗和催眠法通过对称关系和劣势互补的概念得以延伸。阐述了实现这些目标的标准,以及为解读信息和进入元沟通而设计的实用方法。从沟通和关系角度分析了三例通过自我训练法治疗的临床病例以及一例采用催眠法治疗的病例。对患者的信息进行了解读,发现了沟通中的模糊性,并从技术和情感层面审视了医生可能的回答。研究认为,正确运用沟通视角能极大地拓展自我训练法和催眠法的应用可能性。这并非是将关系管理和自我管理相结合的问题,而是利用帕洛阿尔托学派的发现,更全面地理解运用心理治疗的病例。