Blackmon W D
Am J Psychother. 1994 Fall;48(4):624-32. doi: 10.1176/appi.psychotherapy.1994.48.4.624.
A schizoidal young man made a methodical attempt at suicide. He revealed a paucity of object attachments leading to profound isolation. His early upbring led him to extreme isolation of affect and a fear of fragmentation. His inner life was not safely reachable by conventional therapy. After he became involved in playing a fantasy game, Dungeons and Dragons, the therapy was modified to use the game material as displaced, waking fantasy. This fantasy was used as a safe guide to help the patient learn to acknowledge and express his inner self in a safe and guided way. The patient ultimately matured and developed healthier object relations and a better life. The theoretical underpinnings of this process are explored, both in dynamic terms and in terms of the biologic correlation and equivalence of dreams and waking fantasy. The utility of this game as a vehicle for treatment of selected individuals is discussed.
一名患有精神分裂症的年轻人有条不紊地尝试自杀。他表现出缺乏客体依恋，导致极度孤立。他早年的成长经历使他情感极度孤立，且害怕精神崩溃。传统疗法无法安全触及他的内心世界。在他开始参与玩一款幻想游戏《龙与地下城》后，治疗方法被调整为将游戏素材用作替代的清醒幻想。这种幻想被用作安全指南，帮助患者学会以安全且受引导的方式承认并表达内心的自我。患者最终走向成熟，发展出更健康的客体关系，过上了更好的生活。本文从动力学角度以及梦与清醒幻想的生物学关联和等效性方面探讨了这一过程的理论基础。还讨论了这款游戏作为治疗特定个体的工具的效用。
