治疗中该说什么?
时间:2018年08月06日|853次浏览|2次赞

本文翻译自《The therapist's answer book》
What Do I Say? (Technique)
我说什么?(技术)

Doing any type of psychotherapy involves you telling people things that affect them. What you say to them falls, essentially, into two groups: 

做任何类型的心理治疗都会涉及你告诉他们的事情,这些事情会影响到他们。你对他们说的话,基本上可以分为两类:
  • things that calm them down and
    让他们平静下来的事情;
  • things that stir them up.
    扰动他们的事情。

Calming interactions are often called “supportive,” whereas stirring comments are often referred to as “clarifying,” “understanding,” or “interpretive.” In Problem 2, you will fi nd my thoughts about when to use each type of intervention, and throughout this book, I give illustrations of each. 

镇静的互动被称为“支持”,扰动的评论通常是指“澄清”、“理解”、以及“诠释”。在问题2中,你会发现我是如何选择运用这两项技术的时机的,而且,这本书的通篇都在勾勒这两种技术。

Supportive techniques involve things you say to people to make them feel better—sort of like giving an analgesic for physical pain. Explanatory techniques are more like surgery: The things you tell people may hurt a bit at fi rst and require some time to take effect, but they aim to remove or correct the problem in the long run. 

支持性技术是指,你说的话,会让他们感到更舒服——类似于给身体疼痛的病人服用止痛药。解释性技术更像是外科手术:你对他们说的话,或许一开始会有一些伤害,但需要一段时间才起效,但是这些话语终究的目的是移除或纠正问题。

Cognitive-behavioral techniques are a bit of an amalgam of supportive and explanatory approaches, but they are mainly supportive. You are basically attempting to help people feel better and think more rationally. 

认知行为技术是支持性技术和解释性技术的混合体,但是他们主要是支持性的。从根本上说,你试图帮助人们感觉更好,更理智的思考。

So what is it that you should say? (I address the question of when in Problem )

那么,你应该说些什么呢?(这个问题,我会在问题2中处理这个问题。)

SHORT ANSWER 简短回答

Support 支持

Support requires careful attunement to people’s emotions and the realities of their lives. You are interested in where people are making errors in judgment and communication so that you can discuss solutions with them. You also try to fi nd their overwhelming emotions and express openly (as you are able) your attunement to these. 

支持需要仔细的调整自己的接受频率,以便与人们的情绪和生活现实同频。你感兴趣的是人们在判断和交流方面犯了什么错误,这样你就可以和他们讨论解决方案。你也可以试着找到他们势不可挡的情绪,并且(在你有能力的似乎)公开表达你对这些的同频。

If you decide supportive therapy is required, you
如果你决定必需要进行支持治疗,你需要:

  • ask people questions about their current situation in order to obtain details,
    询问他们当前的情况,以获得细节
  • explore areas of difficulty in their work situations and their current personal relationships, and
    探讨他们现在工作情景和目前的人际关系中的困难
  • try to intervene to help people make better decisions and to feel better about themselves.
    尝试干预,以便帮助人们更好的作出更好的决策,让自己感觉更好。

Some therapists add cognitive-behavioral techniques to
有些治疗师加入的认知行为技术包括:

  • clarify areas of people’s unrealistic expectations about themselves or others, 
    澄清人们对自己或他人的不切实际的期望。
  • have them write about significant events and their thoughts and reactions to them (“homework”),
    让他们写一些重大事件,以及他们对这些事情的想法和反应(家庭作业),
  • consider alternative ways of viewing issues causing dysfunctional emotions,
    考虑以不同的方式监视引起不良情绪的问题。
  • validate their correct perceptions and help them learn to modify incorrect perceptions, and
    验证他们的感知能力,并帮助他们学会修改不正确的认知,以及
  • teach relaxation exercises/guided imagery.
    传授放松技术/意象引导

Understanding (“Interpretation”) 理解(诠释)

Interpretation involves explaining to people what you think is causing their problems, whether they are aware of it or not (conscious and unconscious).
诠释包括向人们解释你认为的导致他们问题的原因,不管他们是否意识到这些(有意思的和无意识的)。

You are looking for elements of conflict among their
你可以从他们的以下方面寻找冲突元素

  • loving, sexual, and violent wishes;
    爱、性和暴力的愿望
  • guilt and shame;
    罪疚和羞耻
  • reality;
    现实
  • Eemotions (“affects”); and
    情绪(情感),以及
  • defense mechanisms.
    各种防御机制

You will find these elements as you listen closely to people’s descriptions of their symptoms, their troubled relationships, and sometimes their reactions to you.

当你仔细倾听人们描述他们症状、他们有问题的关系,以及他们对你的一些反应的时候,你会发现这些元素。

If you decide on an explanatory approach, you
如果你决定做解释的时候,你需要

  • Instruct people to tell you about their thoughts, dreams, and feelings about their problems in relationships, in life, and in treatment;
    指导人们告诉你他们在人际关系中、生活中和治疗中的问题,以及与这些问题有关的的想法、梦境和情绪感受。
  • Point out conflicts, present and past, among wishes, their conscience, people, and the environment;
    指出人们以及环境中的,过去和现在中的、愿望中的,以及意识中的冲突。
  • Clarify the bases for their anxiety and depressive affect; and
    澄清他们焦虑和抑郁情感的基础,以及
  • Confront the defensive operations that are interfering with adequate solutions to the conflicts.
    面质防御性操作,这些操作干扰了冲突的恰当解决。

When you have figured all this out with people, they may feel a bit unhappy at fi rst, but the knowledge they gain can help them understand their own actions, make better decisions, and obtain relief of symptoms.
当你和人们把这些弄明白的时候,他们起初可能有点不开心,但是他们获得的知识可以帮助他们理解他们自己的行为,可以让他们作出更好的决策,并获得症状的缓解。

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