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[基于深度心理学的心理治疗——特点与干预方式]

[Depth psychologically founded psychotherapy--characteristic and intervention style].

作者信息

Heigl-Evers A, Heigl F

出版信息

Z Psychosom Med Psychoanal. 1982;28(2):160-75.

PMID:7080696
Abstract

We consider the depth psychologically grounded psychotherapeutic principle as being distinct from the principle of the classical psychoanalysis, on the one hand, and from the interactional principle derived from ego-psychology and ego-pathology on the other. In our attempt to more closely define the depth psychologically grounded principle we started out from the definition of a psychotherapeutic approach named depth psychotherapy in the so-called psychotherapy guidelines and additionally from an attempt at distinguishing this type of psychotherapy psychoanalysis by Loch. While the definition in the psychotherapy guidelines is at once a localization and a centration and therefore also a specification, Loch in the comparison of depth psychologically grounded psychotherapy and psychoanalysis merely observes differences in quantity, but not in quality. In differentiating the definition of a psychotherapy based upon depth psychology, we oriented ourselves on the intersection metaphor of the origin of neuroses. According to this metaphor, a necrosis manifests itself at a point where, in a manner of speaking, the vertical axis of the life history and the horizontal axis of the actual situation of an individual cross. The crossing signifies that latent pathogeneity with its origin in the life history may, under specific interpersonal conditions which, for their part, are mostly subject to specific socioeconomic and sociocultural conditions or both (pathogenic field), lead to a clinical manifestation. Latent neurotic conflicts are actualized in this way. When an actualized conflict of this kind can be distinguished the following possibilities for focussing on a therapeutic technique offer themselves: 1. The specific triggering (interpersonal) situation (situation of temptation and refusal) for the symptoms in question. 2. The pathogenous social fields, in which the triggering situation arose. 3. The actual interpersonal relationship between patient and therapist. The objective of this psychotherapy in the sense of a modification of the "triangle of insight" (Menninger; Menninger and Holzmann) consists in affording the patient an insight into the triggering (interpersonal) situation, into its inherent pathogenous social field, into the actual interpersonal relationship between patient and therapist, and finally, into the connections existing between these components; in this manner a limited insight into basic internal conflicts can be reaches, and in addition to a diminishing of the symptoms a partial internal reorganization is attempted. The means of reaching this objective present themselves, on the one hand, in the setting, the therapeutic arrangement (neutrality and abstinence of the therapist, handling of the frequency and duration of the individual meetings, and, should the occasion arise, occasional inclusion of significant others), and on the other, in certain types of therapeutic interventions...

摘要

我们认为,深度心理学基础上的心理治疗原则一方面有别于经典精神分析原则,另一方面也有别于源自自我心理学和自我病理学的互动原则。在试图更精确地界定深度心理学基础上的原则时,我们首先依据所谓心理治疗指南中对一种名为深度心理治疗的心理治疗方法的定义,此外还参考了洛赫对这种心理治疗与精神分析进行区分的尝试。虽然心理治疗指南中的定义既是一种定位也是一种集中,因而也是一种具体说明,但洛赫在比较深度心理学基础上的心理治疗与精神分析时,仅仅观察到数量上的差异,而非质量上的差异。在区分基于深度心理学的心理治疗的定义时,我们以神经症起源的交叉隐喻为导向。根据这个隐喻,一种坏死表现在这样一个点上,即可以说,个体生活史的垂直轴与实际状况的水平轴相交之处。这种交叉意味着,起源于生活史的潜在致病性在特定的人际条件下(这些人际条件本身大多受特定的社会经济和社会文化条件或两者的制约,即致病场)可能导致临床表现。潜在的神经症冲突就这样被激活。当能够区分出这种被激活的冲突时,就会出现以下几种聚焦于治疗技术的可能性:1. 针对相关症状的特定触发(人际)情境(诱惑与拒绝情境)。2. 引发该情境的致病社会场。3.患者与治疗师之间的实际人际关系。这种心理治疗在改变“洞察三角”(门宁格;门宁格和霍尔兹曼)的意义上的目标在于,使患者洞察触发(人际)情境、其内在的致病社会场、患者与治疗师之间的实际人际关系,最终洞察这些成分之间存在的联系;通过这种方式,可以有限地洞察基本的内心冲突,除了减轻症状之外,还尝试进行部分内心重组。实现这一目标的手段一方面体现在治疗设置、治疗安排(治疗师的中立和节制、对个别会面的频率和时长的处理,以及如有需要偶尔纳入重要他人)中,另一方面体现在某些类型的治疗干预中……

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