佛教思想对心理治疗观的影响

心理治疗的主要目的是减轻人们的心理痛苦。佛教如同任何宗教一样都有帮助人们减轻精神痛苦的作用。心理治疗源自西方的相对科学的体系,其理念重在以不同的方式帮助人们更好地适应环境,或更好地满足自己的需要。佛教中的理念引导人们应对心理痛苦的方式是接受放下,是一种人生态度。在心理治疗中渗入这一理念,会更有效地帮助来访者,至少在受佛教思想影响的中国文化背景下。本文将以心理治疗实践中的案例为例具体阐述佛教思想对心理治疗观的影响,并与心理动力学治疗和其他的心理治疗方法的一些理念进行比较。     

催眠术在心理治疗中的应用

作为一种特殊的人类活动现象，催眠术一直披着神秘的外衣。催眠术曾被广泛地应用于心理治疗过程中，然而，催眠术本身并不是一种独立的心理治疗方法。本文复习有关文献，对催眠现象的定义和基本要素以及催眠术在治疗中的应用，做一简要的介绍。1催眠现象的定义自从催眠还象被人们观察和研究以来，有关催眠还象及其作用，一直是有争议的问题。催眠现象的表现丰富多采。不同的被催眠者有不同的要求、感受和反应，有的希望通过催眠重建他们的行为模式，如戒烟；有的希望能镇痛；有的出现幻觉；有的则出现“不自主”的运动；有的唤起了对被遗忘…     

心理治疗与（精神）药物治疗之间关系的探讨（Ⅱ）

引言 :在心理治疗中是否应使用药物 ,如果使用药物应在什么情况下使用 ,药物治疗与心理治疗的关系如何 ,这些问题曾在专业人员中引起激烈的争论。本刊在上一期的讨论专栏中己对此问题进行过专题讨论 ,本期的讨论是上一期讨论的继续。杨彦春 (华西医科大学附一院精神科　副教授　 610 0 41)精神科医师与心理治疗师最具挑战性的问题之一是如何将现代药物治疗与心理治疗技术整合起来使对患者的治疗达到最大的疗效。药物治疗和心理治疗作为改变和影响心理和行为的方法作用于不同的层面 ,有着不同的作用机制 ,并由此形成各自不同的理论系统和技术…     

孔子和老子思想在心理治疗中应用的可能性

发展我们中国人自己的心理治疗,其必要性的理由是,只有植根于文化的心理治疗对于该文化的人们才是最容易接受和最有效的。 不少中国心理治疗者在传统中医文献里进行挖掘,这是很不够的。道理很简单。阴阳五行不能成为现代心理治疗的指导思想,因为阴阳五行本身是一种自然哲学而非人文哲学,在这种自然哲学的基础上不可能发展任何一种确定的心理学理论。     

心理治疗在精神疾病临床的应用

目的探讨心理治疗在精神疾病临床患者的康复作用.方法将精神病患者进行分类,应激相关障碍、抑郁症、部分精神分裂症患者,在精神科药物治疗不变的情况下,进行心理治疗.结果患者充分发挥了心理防御机制作用,有效地改善患者与社会及环境不协调行为,减轻了焦虑、抑郁情绪和心理障碍.结论心理治疗提高了病人对治疗的依从性,精神疾病在药物治疗的同时应重视心理治疗.     

住院康复精神分裂症社交能力不足者的集体行为治疗

目的 对24例住院康复精神分裂症社交能力不足者在药物剂量相对稳定情况下，通过集体行为心理治疗，增强社会交往的主动性，减少和缓解退缩行为。方法 社会交往能力不足的精神分裂症康复期患者6～9人为1小组，在心理治疗师引导下，以社交技能训练、角色扮演、情景模拟等技巧训练，进行12次集体心理治疗。结果 治疗前后SANS量表分下降，部分阴性症状缓解，以较为积极的态度及行为与人交往。结论 集体行为心理治疗在住院康复精神分裂症社交能力不足者中的应用对提高其自信心，改善社交不足，提高生活质量，减轻家属负担有重要作用。     

心理治疗研究中安慰剂的设置和效应(综述)

安慰剂的心理治疗作用在其概念的理解和临床操作上颇有争议。近年来研究者关注安慰剂效应和心理治疗疗效的比较。心理治疗曾被认为是一种安慰剂,虽然良好设计的对照研究证实心理治疗疗效优于安慰剂作用,但安慰剂在很多时候可以通过心理暗示和积极观念等发挥治疗作用。临床实践中,重视心理治疗研究中安慰剂的设计,尤其是安慰剂的设置,关注心理治疗中的共同因素,可使安慰剂效应发挥到最大。     

边缘性人格障碍治疗脱落引发的思考

目的验证心理动力学为背景的辩证行为心理治疗技术(Dialectical behavior therapy,DBT)对边缘性人格障碍患者的疗效。方法药物治疗和门诊心理治疗相结合。结果治理过程中出现移情与反移情,最终导致治疗关系恶化,在第8次治疗后患者攻击治疗师。结论边缘性人格障碍患者将不稳定的人际关系投射到治疗关系中,医生往往会替代现实中的客体被攻击和指责,现阶段的心理治疗还处于艰难状态。     

心理治疗剂量效果研究简介

1952年,Eysenck提出一种论断:对于神经症来说,心理治疗并不比自然痊愈更有效[1].此说法引起了众多学者和临床医生对心理治疗效果的争论.但随着后期更多的研究证实,心理治疗不但有效还可以保持[2-5].此后研究者们将关注的焦点转向了这种效果是怎样在咨询会谈中发生的,以及哪种心理治疗在哪种情况下对哪种当事人最有效[6].由Howard等人引入和发展的剂量效果模型对这个问题作了很好的回答.     

人际心理治疗

人际心理治疗(ＩＰＴ)是由Ｋｌｅｒｍａｎ等人在1970年代发展起来的,起初主要用于门诊重性抑郁病人的维持心理治疗。由于一系列临床随机对照研究证实了ＩＰＴ对抑郁症病人治疗的有效性,使其逐渐发展并用于精神疾病的治疗,与认知行为治疗(ＣＢＴ)一道成为1980年代以来最引...     

Are Psychotherapists Out of Touch?

ABSTRACT. Touching - as well as not touching - conveys messages- It also constitutes aprimary experience with emotional and trophic effect Both functions arc important for psychotherapy.
Attachment theory logically implies (and experience confirms) that patients who lacked adequate mothering in early life require - like children - actual physical cam-giving. It may he necessary to communicate with some patients by touch before treatment can start, whereas others are at first afraid to be touched. However, an essential pan of psychotherapy is enabling patients to lose their fear of accepting what they need.
Objections m therapeutic touching are subjective and due largely to sexual fears. Problems in this area emphasise the imperative need for all psychotherapists to have regular access to therapeutic supervision.     

Moving From Acceptance Toward Transformation With Internal Family Systems Therapy (IFS)

Clients come to psychotherapy intent on changing, rather than accepting, their unwanted behaviors, emotions, or thoughts. The problem often is, however, that their lack of self‐acceptance is the primary obstacle to change. This article describes how one approach, the Internal Family Systems (IFS) model, fosters clients’ acceptance of all parts of themselves no matter how destructive, and how that acceptance can lead to the transformation of those parts and, in turn, of other people.     

抚触对人工喂养新生儿生长发育的影响

目的 探讨抚触对人工喂养儿生长发育影响。方法 选择30例人工喂养新生儿进行抚触,并随机选择条件相似的30例人工喂养儿做对照,100d时比较两组婴儿的身长、头围、体质量、日摄奶量、睡眠时间、大便情况。结果 抚触组人工喂养婴儿的体质量、摄奶量较对照明显增加,睡眠时间较对照组长,且较对照组大便正常,较少发生便秘。身高、头围无明显差异。结论 抚触能明显提高人工喂养儿的体质量及摄奶量,促进排泄,改善睡眠。     

Developing a Psychosomatic Imagination in Medical Students and Psychotherapy Trainees

How can we help medical students and psychotherapy trainees to develop an awareness of the mind in relation to the body, so that both can develop a psychosomatic imagination? This is an exploration of some of the difficulties that medical students have in appreciating the role of emotions in illness and of the difficulties psychotherapy trainees have in considering the importance of the body in psychotherapeutic work with patients with physical symptoms. Student Balint discussion groups and student psychotherapy schemes give clinical medical students the opportunity to explore their own and their patients’ emotional reactions to illness and to learn about the interplay of emotions with the body in physical illness. The Royal College of Psychiatrists is now encouraging the development of such Balint groups and/or psychotherapy schemes in all UK medical schools. Psychotherapy trainees studying the effects of emotions in psychosomatic illnesses often have difficulty in learning how to interpret physical symptoms that occur in psychotherapy. They tend to want to see such symptoms as having symbolic meaning and find it hard to appreciate the medical logic of physical illness. It is important that some medical understanding of these conditions is also included in seminars on psychosomatic conditions.     

Changes in the sense of agency: Implications for the psychotherapy of bulimia nervosa- A case study

A sense of agency is a transtheoretical concept that increases our understanding of important processes in psychotherapy. Agency can be described in terms of how strongly the person believes that she can have an impact on her problematic experiences and behaviors. In this case study, a patient's sense of agency in relation to symptoms of bulimia nervosa was assessed during 3 years of psychotherapy. Five distinct phases of agency in relation to eating disorder symptoms were identified: A false sense of agency or no agency at all, a weak sense of agency, a nascent sense of agency, a wavering sense of agency, and a strong sense of agency. A better understanding of patient agency can facilitate adapting approaches and methods best suited for the patient's capacity for change throughout treatment.     

Physiological and Subjective Reactions to Being Touched

The physiological and subjective effects of being touched on the wrist by another person were investigated in 20 normal adults at rest and during immersion of the hand in ice water. Touching reliably reduced heart rate compared to an immediately preceding baseline and compared to an alpha biofeedback condition. Heart rate during painful ice water stimulation was also lower when the subject was touched as compared to when he/she practiced alpha biofeedback, but this effect was not mediated by a reduction in the perceived painfulness of the ice water. Instead, touching and pain had independent, additive effects on heart rate. Touching did not produce generalized reductions in respiratory rate, SRR frequency, or frontalis EMG activity, although subjects did rate being touched as more pleasant and more relaxing than practicing alpha.     

Prior experience and current goals affect muscle-spindle and tactile integration

We previously have shown that reports of illusory elbow extension from biceps vibration can be attenuated by touching a stationary cue-surface with the index fingertip of a vibrated arm. However, this was not the case if the subject had previously felt genuine motion of the cue-surface without biceps vibration. Two potential explanations for this are that the sense of elbow orientation results from tactile and muscle stretch cues that are integrated based on (1) an awareness of the tactile cue’s mobility or (2) specific patterns of tactile and muscle spindle activity resembling the elbow motion during previous interactions with the tactile cue. We tested these hypotheses by comparing how touching the cue-surface attenuated the reports of arm movement during biceps vibration after a demonstration of the cue- surface mobility without involving any elbow motion versus simultaneously touching the cue-surface as it moved and extending the elbow to correspond exactly to the elbow extension illusion during vibration. Touching the cue-surface stopped attenuating the reports of elbow extension during biceps vibration only after experiencing actual cue-surface motion while moving the elbow . This supports the second hypothesis that tactile and muscle stretch feedback that are integrated based on specific patterns of tactile and muscle spindle activity recalled from previous interactions with the tactile cue. We also tested the influence of motor set on the sense of elbow position in this paradigm. We found that even after touching the stationary cue-surface had ceased to attenuate illusory elbow motion during biceps vibration, illusory elbow motion during vibration still could be attenuated. This was possible if the subjects intended to actively use their wrists rather than the elbow to maintain fingertip contact. We conclude that muscle stretch and tactile cues are integrated to locate the arm within a highly specific context associated with tactile and proprioceptive feedback from prior experience and current movement goals.     

Parental sensitivity to infant distress: what do discrete negative emotions have to do with it?

Parental sensitivity, a crucial element of attachment theory, refers to the ability to correctly interpret and respond appropriately to infants' signals. The question of whether infants' emotional expressions communicate discrete negative emotions has been widely debated in the literature on infant emotional development, but it has rarely been discussed in the parental sensitivity literature. This article explores how insights from the parental sensitivity literature and from evolutionary and dynamical systems perspectives on infant emotion expressions can be brought together to enhance our understanding of parental responsiveness to infant distress. The current research concludes that sensitivity does not rely on reading discrete negative emotions in infant signals, but rather on an integration of complex, graded distress expressions with contextual factors and iterative interaction processes.     

Assessing both safe haven and secure base support in parent–child relationships

Parental sensitivity, a crucial element of attachment theory, refers to the ability to correctly interpret and respond appropriately to infants’ signals. The question of whether infants’ emotional expressions communicate discrete negative emotions has been widely debated in the literature on infant emotional development, but it has rarely been discussed in the parental sensitivity literature. This article explores how insights from the parental sensitivity literature and from evolutionary and dynamical systems perspectives on infant emotion expressions can be brought together to enhance our understanding of parental responsiveness to infant distress. The current research concludes that sensitivity does not rely on reading discrete negative emotions in infant signals, but rather on an integration of complex, graded distress expressions with contextual factors and iterative interaction processes.     

Targeting emotion dysregulation in the treatment of self-injury

Clinically useful definitions of emotion regulation with respect to deliberate self-harm (referred to here as self-injury) focus on adaptive ways of responding to emotional distress rather than on the control of emotions or dampening of emotional arousal. According to one such definition, emotion regulation is a multifaceted construct involving a) the awareness, understanding, and acceptance of emotions; b) ability to engage in goal-directed behaviors, and inhibit impulsive behaviors, when experiencing negative emotions; c) the flexible use of situationally appropriate strategies to modulate the intensity and/or duration of emotional responses rather than to eliminate emotions entirely; and d) willingness to experience negative emotions as part of pursuing meaningful activities in life (Gratz & Roemer, 2004). This article addresses the role of emotion dysregulation in self-injury and discusses two treatments for self-injury that explicitly focus on increasing emotion regulation. These treatments are based on the premise that the reduction of emotion dysregulation will decrease the need for maladaptive behaviors that function to regulate emotions, such as self-injury. A case illustration describing how one of these treatments (an acceptance-based, emotion regulation group therapy) is used to treat self-injury is provided.