Viederman M, Perry S W
Gen Hosp Psychiatry. 1980 Sep;2(3):177-85. doi: 10.1016/0163-8343(80)90059-6.
Depression, unlike grief, is a maladaptive response to the crisis of illness. This crisis has certain characteristics: (a) psychic disequilibrium with confusion and uncertainty; (b) regression with intensified transferences; and (c) a tendency to examine the trajectory of one's life. This situation makes the patient not only more vulnerable but also more responsive to intervention. These characteristic reactions of illness can be considered in designing a therapeutic maneuver to treat depression. Three cases are used for illustration. In each case a depressed patient was presented a statement that placed his physical illness in the context of his life trajectory and demonstrated the psychodynamic logic of his depression. We call this intervention a "psychodynamic life narrative." The therapeutic effect of such a narrative and the type of patient most likely to benefit from such an intervention are discussed.
与悲伤不同，抑郁是对疾病危机的一种适应不良的反应。这种危机具有某些特征：(a) 伴有困惑和不确定性的心理失衡；(b) 退行并伴有强化的移情；以及 (c) 审视个人生活轨迹的倾向。这种情况不仅使患者更容易受到伤害，而且对干预措施的反应也更敏感。在设计治疗抑郁症的治疗策略时，可以考虑这些疾病的特征性反应。现举三个病例进行说明。在每个病例中，都向一名抑郁症患者陈述了一段话，这段话将他的身体疾病置于其生活轨迹的背景下，并展示了其抑郁的心理动力学逻辑。我们将这种干预称为 “心理动力学生活叙事”。本文将讨论这种叙事的治疗效果以及最有可能从这种干预中受益的患者类型。
