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自杀——另一面。自杀动机中的现实因素。

Suicide--the other side. The factor of reality among suicidal motivations.

作者信息

Lowental U

出版信息

Arch Gen Psychiatry. 1976 Jul;33(7):838-42. doi: 10.1001/archpsyc.1976.01770070068007.

Abstract

A prevalent feature of many investigations of suicide is a degree of recoil from true empathic closeness to a suicidal person. The motives for this lie within the investigator's own dynamics--they are anxiety over one's own suicide proneness, together with guilt, shame, contempt, and the avoidance of medicolegal involvement. These motives are not altogether unrelated to the suicidal motives themselves, and they hamper the capacity of objective, neutral assessment. With a recognition of these resistances, the seldomly mentioned realistic determinant of suicide becomes discernible, the act sometimes being a clever, courageous choice of death, and not, as usually diagnosed, a pathologically generated escape from life. All suicidal motives should be evaluated according to several concomitant ratings simultaneously, while emphasizing the realistic rating. A neutral, unbiased approach to suicide should reduce the dangerous false glory sometimes attributed to the act, thus contributing to the discrimination of sickness, therapy, and health.

摘要

许多自杀调查的一个普遍特征是,在真正与自杀者产生共情亲近方面存在一定程度的退缩。其动机存在于调查者自身的心理动态之中——包括对自身自杀倾向的焦虑,以及内疚、羞耻、轻蔑,还有对医疗法律责任的回避。这些动机与自杀动机本身并非毫无关联,它们妨碍了进行客观、中立评估的能力。认识到这些阻力后,很少被提及的自杀现实决定因素就变得清晰可见了,自杀行为有时是一种明智、勇敢的死亡选择,而并非如通常所诊断的那样,是一种因病理原因导致的逃避生活的方式。所有自杀动机都应同时依据几个相关的评定标准进行评估,同时要强调现实评定。对自杀采取中立、无偏见的态度应能减少有时赋予该行为的危险的虚假荣耀感,从而有助于区分疾病、治疗和健康状况。

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