Mans E J
Klinischen Institut, Heinrich-Heine-Universität Düsseldorf.
Z Psychosom Med Psychoanal. 1993;39(4):333-45.
As a disorder of an ego-function, functional voice disorders display a remarkable sensitivity and variability towards psychosocial factors and an often immediate connection with the underlying psychic conflict constellation. Being concentrated on their symptomatics, patients with functional voice disorders command a good capacity of observing their complaints and factors affecting them. Symptom-centered short-term psychotherapy makes use of the particular character of the voice symptom and of the patient's capacity in a focal treatment of the symptom. First, a symptom-focus is established on the basis of an analysis of speech conflict situations which contains essential psychosocial factors and is structured by a psychic conflict constellation. In the further course of psychotherapy, the symptom focus is used as a heuristic device in the treatment of material of the voice symptomatics. In working through present and past speech conflict constellations patients reach an understanding of the psychosocial conflict contained in the voice symptomatics and are enabled to develop alternatives for changing the maladaptive speech interaction patterns.
作为一种自我功能障碍，功能性嗓音障碍对心理社会因素表现出显著的敏感性和变异性，并且常常与潜在的心理冲突格局直接相关。由于专注于自身症状，功能性嗓音障碍患者具有很好的观察自身症状及影响因素的能力。以症状为中心的短期心理治疗利用嗓音症状的特殊性质以及患者的能力，对症状进行针对性治疗。首先，在对言语冲突情境进行分析的基础上确定症状焦点，该情境包含重要的心理社会因素，并由心理冲突格局构建而成。在心理治疗的后续过程中，症状焦点被用作处理嗓音症状相关材料的启发式工具。在梳理当前和过去的言语冲突格局时，患者能够理解嗓音症状中所包含的心理社会冲突，并能够找到替代方法来改变适应不良的言语互动模式。
