动力性心理治疗过程的质性个案研究

发布时间：2018-01-24 10:49

本文关键词： 动力性心理治疗精神分析过程研究质性研究质性内容分析叙说分析个案研究　出处：《中南大学》2014年博士论文　论文类型：学位论文

【摘要】：目的：本研究旨在描记、分析、解释动力性心理治疗过程中来访者发生治疗性变化的主题内容及其变化机制,并探索与来访者发生改变的内容主题相关的言语和非言语信息交流形式的特点。方法：本研究基于质性倾向、以个案研究为总设计策略、以多种质性工具组合为研究方法。采取目的性抽样,选取一位创伤后应激障碍来访者,进行为期2个月(2013年8月-2013年9月)、总计25次的短时程动力性心理治疗。 1以个案的全程25次动力性心理治疗录像及每次治疗后来访者和治疗师分别填写的事件报告单(共计50份)为材料,制作成文字转录稿。通过预设的动力性心理治疗来访者变化的6个主题,进行材料筛检。将检出的质性数据,通过叙说分析法,以动力性演变的视角,对来访者发生治疗性改变的主题内容及其变化机制进行细节描记和机制阐述。 2探索来访者在治疗过程中信息交流(即言语交流和非言语交流)形式的特点和变化。从上述文字转录稿筛选出包含引用、象征、典故、比喻、类比等5种特殊言语形式的片段。分析各个特殊语言片段的内涵和功能,并给出相应的心理动力学理论解释。收集和分析来访者在治疗过程中非言语信息的特点和变化。以McNeill姿势语言模型和Ekman面部表情神经文化模型共同组成的非言语信息矩阵作为筛检工具。找出伴随来访者发生治疗性改变的过程中,非言语交流形式的特点和变化。结果： 1来访者变化分为6个主题,分别为主题1中心情感变化、主题2防御机制变化、主题3自尊变化、主题4依恋模式变化、主题5人际关系模式变化、主题6病态信念变化。每一个主题中,来访者创伤所致相关问题解决路径、治疗师介入路径、动力性心理治疗技术应用等相互作用,促使各个主题发生具有治疗意义的变化。 2与来访者变化相关的27个特殊语言片段呈现出5种特殊言语形式,分别为引用、象征、典故、比喻、类比。与来访者变化相关的姿势语言分为形象姿势、隐喻姿势、节奏姿势、指示姿势、象征姿势等5类,共计5650个。其中2997个姿势语言携带快乐、悲伤、愤怒、恐惧、厌恶和惊讶等6种情绪意义。结论： 1本案来访者在动力性心理治疗会谈中发生的治疗性改变及其机制与来访者信息交流形式有密切关系。 2动力性心理治疗过程中的言语交流方式和非言语交流方式均能提供具有治疗意义的信息,应在实践和研究中予以重视。 3质性研究工具的配伍使用,能挖掘心理治疗过程中重要却易被忽略的信息,从而将个案价值最大化。
[Abstract]:Objective: The purpose of this study is to record, analyze and explain the subject content and mechanism of the therapeutic changes in the process of dynamic psychotherapy. And explore the characteristics of verbal and non-verbal information communication related to the subject matter of the change of the visitor. Methods: This study is based on qualitative tendency, case study as the overall design strategy, with a variety of qualitative tool combinations as the research method, take a purposeful sampling, select a post-traumatic stress disorder visitor. A total of 25 short-term dynamic psychotherapy was performed for 2 months (August 2013-September 2013). 1 based on the video of 25 times of dynamic psychotherapy in the whole course of the case and the incident report form (50 copies in total) completed by visitors and therapists respectively after each treatment. Through the design of dynamic psychotherapy visitors change of 6 themes, screening materials. The qualitative data will be detected through narrative analysis, with the perspective of dynamic evolution. The theme and mechanism of the therapeutic change were described in detail. (2) to explore the characteristics and changes of the forms of information exchange (i.e. verbal communication and non-verbal communication) in the course of treatment. The transcripts of the above texts were selected to contain references, symbols, allusions and metaphors. The meaning and function of each special language fragment are analyzed and the corresponding psychodynamics theory is given. To collect and analyze the characteristics and changes of non-verbal information in the course of treatment. A nonverbal information matrix composed of McNeill postural language model and Ekman facial expression neurocultural model was used. For screening tools. Identify the course of therapeutic changes that accompany visitors. The characteristics and changes of non-verbal communication. Results: The changes of visitors were divided into six themes, namely, theme 1, theme 2, defense mechanism, theme 3, self-esteem, attachment mode, and interpersonal relationship model, respectively. Topic 6 changes in pathological beliefs. In each topic, the interaction between the client's trauma related problem solving pathway, the therapist's intervention path, and the application of dynamic psychotherapy techniques. To bring about therapeutic changes in each theme. (2) the 27 special language fragments related to the changes of the visitors showed five special speech forms, namely, citation, symbolism, allusions, metaphors, analogy. The postural language related to the changes of the visitors was divided into image postures. There are 5 categories of metaphorical postures, rhythmic postures, indicative postures, symbolic postures, among which 2,997 postures have six emotional meanings: happiness, sadness, anger, fear, disgust and surprise. Conclusion: (1) the therapeutic change and its mechanism occurred during the dynamic psychotherapy talks were closely related to the form of information exchange between the visitors. (2) both verbal and nonverbal communication in the process of dynamic psychotherapy can provide information of therapeutic significance, which should be paid more attention to in practice and research. The compatibility of qualitative research tools can excavate the important but neglected information in the process of psychotherapy, thus maximizing the value of individual cases.
【学位授予单位】：中南大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：B849

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