Gutheil T G, Simon R I
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Psychiatr Serv. 1997 Nov;48(11):1403-7. doi: 10.1176/ps.48.11.1403.
Controversy over cases involving so-called recovered memories of sexual abuse has threatened to divide the mental health field, just as lawsuits based on recovered memories have sometimes divided children from parents and others. The authors review issues in this controversy, including the role of misdirected advocacy for recovered memory by some practitioners, the distinction between the actual events and patient's narrative truth as a factor in the therapeutic alliance, and the contrast between therapeutic and legal remedies. They recommend nine clinically based risk management principles to guide clinicians in dealing with cases involving recovered memory. They include the need for documentation and consultation; the value of psychotherapeutic neutrality, maintaining a calm perspective, and understanding the difference between historical and narrative truth; the incompatibility of the roles of treater and forensic expert; the risks of special therapies such as hypnosis; awareness of the roles of other professionals and the significance of the patient's family; and the importance of knowing when to end treatment.
涉及所谓性虐待恢复记忆的案例引发的争议，有可能使心理健康领域产生分歧，就像基于恢复记忆的诉讼有时会使孩子与父母及其他人产生隔阂一样。作者回顾了这一争议中的诸多问题，包括一些从业者对恢复记忆进行错误引导式倡导所起的作用、实际事件与患者叙述性真相作为治疗联盟因素的区别，以及治疗补救措施与法律补救措施的对比。他们推荐了九条基于临床的风险管理原则，以指导临床医生处理涉及恢复记忆的案例。这些原则包括记录和咨询的必要性；心理治疗中立性的价值、保持冷静的视角以及理解历史真相与叙述性真相之间的差异；治疗师与法医专家角色的不相容性；催眠等特殊疗法的风险；认识其他专业人员的角色以及患者家庭的重要性；以及知道何时结束治疗的重要性。
