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  • When one is in a bad place in one's head, the modern world offers three main sources

    當人抑鬱時,現今醫療提供三種主要的

  • of help: psychiatric medication, CBT and psychotherapy. Each has its own advantages

    治療方式:精神科藥物、認知行為療法、以及心理治療。各有其優點

  • and drawbacks. Medication can be exemplary in a crisis, at points when the mind is so

    與缺點。藥物在病發危險期效用最大,因為當心智已

  • under siege from fear, anxiety or despair that thinking things through cannot be an

    飽受恐懼、焦慮、絕望等情緒籠罩時,要病人理性思考已非選項

  • option. Correctly administered, without requiring any conscious cooperation from us, pills play

    只要正確用藥,無須病人有意識地配合,藥物

  • around with our brain chemistry in a way that helps us get through to the next dayand

    會發揮作用於腦內的神經傳導物質,幫助我們撐到隔日,以及

  • the one after. We may get very sleepy, a bit nauseous or rather foggy in the process, but

    往後的日子。服藥過程中,可能感到嗜睡、噁心或思緒混亂,但

  • at least we're still aroundand functioning, more or less. Then there is Cognitive Behavioural

    至少我們能挺住過活。再來是認知行為療法

  • Therapy (CBT), normally administered by psychologists and psychiatrists in six to ten hour-long

    通常由心理學家與精神科醫師執行,進行 6 到 10 小時

  • sessions which teach us techniques for arguing rationally with, and with any luck at points

    的療程,指導如何與他人理性討論,有幸的話某階段

  • controlling, the ghoulish certainties thrown up by our internal persecutors: paranoia,

    能控制一連串心魔所拋出的執念:偏執

  • low self-esteem, shame and panic. Lastly there is psychotherapy, which from a distance looks

    低自尊、羞恥及恐慌。最後是心理治療,遠觀彷彿

  • like it has only drawbacks. Psychotherapy has a very hard time showing its efficacy in scientific

    只有缺點,但它經歷了試煉,才證明於科學試驗的成效

  • trialsand has to plead that its results are too singular neatly to fit the models

    並以結果特殊為由,而無法符合

  • offered by statisticians. Also, It takes up a large amount of time, demanding perhaps two sessions

    統計學家的模型。再者,它極費時,大約一週兩次療程

  • a week for a couple of yearsand is therefore by far the most expensive option on the menu.

    要持續數年,難怪是最昂貴的醫療方式

  • Finally, psychotherapy requires active engagement from its patients and sustained emotional effort;

    最後,病人必須高度參與療程,並持續改善情緒

  • one can't simply allow chemistry to do the work. And yet, psychotherapy is, in certain

    而不能只仰賴藥物。然而,心理治療在某些

  • cases, a hugely effective choice, which properly alleviates pain not by magic or chance , but

    病例中極具療效,它並非僥倖或神奇地減輕患者痛苦,而是

  • for three solidly-founded reasons: – Firstly, our unconscious feelings become conscious. A founding

    根基於三個理念:首先,我們的感知從無意識變得有意識

  • idea of psychotherapy is that we get mentally unwell, have a breakdown or develop phobias

    心理治療創立的其中一個信念是:人們罹患心理疾病、崩潰、形成恐懼

  • because we are not sufficiently aware of the difficulties we have been through. Somewhere

    源於沒有覺察到過往遭受的困境

  • in the past, we have endured certain situations that were so troubling or sad, they outstripped

    過去,我們曾承受相當困擾或悲傷的事件,它們壓過

  • our rational faculties and had to be pushed out of day-to-day awareness. For example,

    我們的理性機制,甚至平時也沒意識到這些狀況。舉例而言

  • we can't remember the real dynamics of our relationship with a parent; we can't see

    關於和父母的實際互動,我們的記憶很模糊

  • what we do every time someone tries to get close to us, nor trace the origins of our

    每當他人意圖靠近,我們無感於自身的舉動,更別說

  • self-sabotage or panic around sex. Victims of our unconscious, we can't grasp what

    去追溯自我毀滅的根源,或對性的恐懼。作為無意識的受害者,我們無法明白

  • we long for or are terrified by. In such cases, we can't not be healed simply through rational

    所渴求或恐懼之物為何。所以,光從

  • discussion, as proponents of CBT implicitly propose, because we can't fathom what is

    認知行為療法所倡導的「理性討論」是無法治癒的,因為我們首先就沒釐清

  • powering our distress in the first place. Psychotherapy is a tool for correcting our self-ignorance

    痛苦的來源為何。心理治療是扭轉忽視自我的利器

  • in the most profound ways. It provides us with a space in which we can, in safety, say

    它以深度探討的方式進行、提供一個讓人安心

  • whatever comes into our heads. The therapist won't be disgusted or surprised or bored.

    抒發己見的空間。 諮商師絕不會面露反感、驚訝或無聊

  • They have seen everything already. In their company, we can feel acceptable and our secrets

    他們閱歷豐富,在他們的陪伴下,我們感到被接納,隱私

  • sympathetically unpacked. As a result, crucial ideas and feelings bubble up from the unconscious

    得到保護。因此,我們從原本無意識的狀態,察覺到了關鍵的想法與感觸

  • and are healed through exposure, interpretation and contextualisation.

    並經由揭露、詮釋和情境理解的過程中,改善心理狀態

  • We cry about incidents we didn't even know, before the session started that we'd been through or felt so strongly

    接受心理治療前,我們會為一些莫名的事件、遭遇或感觸強烈的事而掉淚

  • about. The ghosts of the past are seen in daylight and are laid to rest. There is a

    療程中,如鬼魅般的過往浮上檯面,而後得到安寧

  • second reason why psychotherapy can work so well: Transference: Transference is a technical

    心理治療有效的第二個原因:移情。它是一個心理學專業術語

  • term that describes the way, once therapy develops, a patient will start to behave towards

    描述病人在療程時,會用他們在過往關係中的方式

  • the therapist in ways that echo aspects of their most important and most traumatic past

    和諮商師互動,這方式反映了病人過去最關鍵或最創傷的層面

  • relationships. A patient with a punitive parent mightfor exampledevelop a strong

    舉例來說,病患的父母若在他們小時經常懲罰,他們可能會強烈認為

  • feeling that the therapist must find them revolting, or boring. Or a patient who needed

    諮商師一定對他們感到反感或無趣。或者當病人孩提時需要

  • to keep a depressed parent cheerful when they were small might feel compelled to put up

    振奮憂傷的父母,長大後就覺得應該換上

  • a jokey facade whenever dangerously sad topics come into view. We transfer like this outside

    幽默的一面來化解任何突來的悲傷話題。我們經常將上述模式轉移到生活中

  • therapy all the time, but there, what we're doing doesn't get noticed or properly dealt

    只是我們沒有意識到、或妥善處理自己的行為

  • with. However, psychotherapy is a controlled experiment that can teach us to observe what we're

    而心理治療就像個控制下的實驗,它教我們覺察當下的行為

  • up to, understand where our impulses come fromand then adjust our behaviour in

    理解衝動所為何來,再調整我們的行為

  • less unfortunate directions. The therapist might gently ask the patient why they're

    朝較好的方向前進。諮商師也許會溫和地問病人:為何這麼深信

  • so convinced they must be disgusting. Or they might lead them to see how their use of jokey

    自己惹人厭惡,或者指引他們發現,自己會用幽默

  • sarcasm is covering up underlining sadness and terror. The patient thereby starts to spot the distortions

    諷刺來掩飾深層的哀傷與恐懼。病人於是注意到了

  • in their expectations set up by their historyand develops less self-defeating ways

    過往如何扭曲了他們對人或事的看法,進而發展出較不激進的方式

  • of interacting with people in their lives going forward. Then the third reason why psychotherapy works. It is the first good relationship

    有利於未來的人際互動。心理治療成功的第三個原因:開始建立良好的人際關係

  • We are, many of us, critically damaged by the legacy of past bad relationships. When

    很多人都在過往不良的關係中,深深受到傷害

  • we were defenceless and small, we did not have the luxury of experiencing people who

    當我們年幼無力對抗時,沒有機會和

  • were reliable, who listened to us, who set the right boundaries and helped us to feel

    可信賴、願意傾聽、保持良好界線的人相處,他們讓我們

  • legitimate and worthy. However, when things go well, the therapist

    感到自身是有意義與價值的。不順遂時,諮商師

  • is experienced as the first truly supportive and reliable person we've yet encountered.

    是我們至今所遇到,第一個可靠又真心支持我們的人

  • They become the good parent we so needed and maybe never had. In their company, we can regress

    他們變成了我們或許此生渴求不到的好父母。在他們的陪伴中,我們得以回到

  • to stages of development that went wrong and relive them with a better ending. Now we can

    以前糟糕的階段,放下它,改變人生的劇本。現在我們能

  • express need, we can be properly angry and entirely devastated and they will take it

    大聲表達需求、適當表達憤怒、就算承受巨大打擊,諮商師都會協助

  • thereby making good years of pain. One good relationship becomes the model for

    於是過往傷痛成為蛻變的養分。在諮商室建立的好的人際關係,成為

  • relationships outside the therapy room. The therapist's moderate, intelligent voice

    日常生活的模範。諮商師溫和、有智慧的話語

  • becomes part of our own inner dialogue. We are cured through continuous, repeated exposure

    轉變成我們內在對話的一部分。長期浸淫於

  • to sanity and kindness. Psychotherapy won't work for everyone; one has to be in

    覺察與慈悲中,我們得以療癒。心理治療不是人人適用,需要患者

  • the right place in one's mind, one has to stumble on a good therapist and be in a position

    思緒清楚、遇到一位好諮商師

  • to give the process due time and care. But all that said, with a fair wind, psychotherapy

    還要能給予療程時間和關照。儘管如此,在一切條件具足下,心理治療

  • also has the chance to be the best thing we ever get around to doing.

    仍有可能是最佳的治療選擇

  • If you are interested in trying psychotherapy, The School of Life offers a service in person in London,

    如果您有興趣嘗試心理治療,The School of Life 在倫敦提供面對面心理諮商服務

  • or by Skype around the world. Click on the link for further details.

    或透過 Skype 提供世界各地諮商服務。欲知更多資訊,請點擊連結

When one is in a bad place in one's head, the modern world offers three main sources

當人抑鬱時,現今醫療提供三種主要的

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B2 中高級 中文 美國腔 心理治療 諮商師 療程 過往 理性 意識

心理治療是如何運作的?(How Psychotherapy Works)

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    Evangeline 發佈於 2018 年 08 月 01 日
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