受苦、轉化與療癒：從日常心理改變過程談「處境結構」取向的治療觀點與架構

盧怡任

doi:10.6251/BEP.202209_54(1).0004

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P85 - 105

社会科学 > 心理学
社会科学 > 教育学

DOI： 10.6251/BEP

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受苦、转化与疗癒：从日常心理改变过程谈「处境结构」取向的治疗观点与架构

Suffering, Transformation, and Healing: a Situational Structure-Based Therapeutic Approach Developed Based on Daily Psychological Change

卢怡任(Yi-Jen Lu)

教育心理学报； 54 卷 1 期 (2022 / 09 / 01) ， P85 - 105

繁体中文 DOI： 10.6251/BEP.202209_54(1).0004

处境结构取向；心理改变过程；存在现象学；谘商与心理治疗； situational structure therapeutic approach ； process of psychological change ； existential phenomenology ； counseling and psychotherapy

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摘要 │ 参考文献 (40) │ 被引用文献 (1) │ 国际计量

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Suffering, transformation, and healing are key aspects of counseling and psychotherapy. In this study, we explored daily psychological change to develop corresponding therapeutic perspectives and frameworks. Empirical existential phenomenology studies on suffering and psychological change have revealed that an individual's perception of suffering arises from the rejection of an existing situation and the unfeasibility of an expected situation to come into being; the disaccord between the existing and expected situations leads to a state of rootlessness. The steps involved in the transformation of suffering into healing are as follows: (1) The sufferer uses emotion as a tool to reflect on the feasibility of the original project and the meaning of the world. (2) The sufferer conceives of the experience of transformation as a process of learning, in which the key is to revise the original project and accept the world as a threat. (3) By perceiving transformation as learning in the context of painful emotions and accepting the new perspectives offered by others, the sufferer discovers that the unfamiliar situation they encounter differs from that encountered in the past and they start resolving the conflict between their past and present; this process includes the individual's willingness to resolve their problems, a new understanding, and acceptance of their past, and a struggle to resolve the contradiction across the three dimensions of time: past, present, and future. (4) After the painful learning process, the sufferer is presented with new situations or possibilities and can commit to a new future. The aforementioned learning process has several therapeutic implications. First, individuals should view suffering as a problem that must be solved and develop an expectation that the problem can be solved. A problem indicates that the existing situation can no longer be explained or managed based on the individuals' previous experience and they must develop another strategy to solve it. Expectation suggests that the sufferer is impatient with their current situation and must find another means to solve their problem. Therefore, at this stage of therapy, emotional exploration and determination should be the central aspects. Second, the process of learning involves a new understanding of the past, an exploration of future expectations, and an integration of the differences across the three dimensions of time. Therefore, therapists should not only help their patients to explore the past but should also discuss with them the past in the context of future expectations. During treatment in the present (now), the differences between the past and future dimensions should be resolved. At this stage, treatment should be focused on facilitating the emergence of ＂polysemy＂ in the patient's situation. Third, learning is a process of problem-solving that involves perceiving previous experiences as false and developing the appropriate strategy to cope with a new situation. Therefore, while promoting the polysemization of their patient's situation, a therapist should also explore how the patient responds to a situation and gradually revise the existing project of their clients. Finally, in the process of learning, the individuals who are suffering perceive and approach their problems based on similar problems encountered by others and their acceptance and recognition of their problems; thus, these individuals consider the external or existing theories as a new framework that enables them to understand everything that happens to them. Therefore, treatment should include the provision of a new perspective and framework to help the sufferer to understand their own experience differently. Therefore, therapists, like others, must facilitate self-reflection among their patients and provide a new framework or formal theory, thus helping the patient to reflect on themselves and use the new framework to understand their situation better. In addition, therapists should recognize, accept, and witness the improvement in their patients as they move toward a different future. In this study, a therapeutic perspective and framework were developed based on the theory of situational structure, which comprises situations and projects. A situational structure is not subjective because it involves people and tools other than oneself. These situations cannot be selected or controlled. However, the situational structure is not objective either because the situation is illuminated for individuals' projection and the situational structure is unique across people and exists only for oneself. We can interpret the world and a situation in a certain manner, always projecting our next step and future. Fischer (1986) argued that a project is a basic unit and core construction of human psychology. Humans can be defined by a series of interrelated and sometimes discrepant projects. A project is ＂action from the past towards the future,＂ and projecting always relates to a situation. In situations, we make decisions and projects for the future; all our actions are bound within situations. Without reflection in our lives, we perceive situations as the cause and determinant of our actions; therefore, we often feel constrained and decisive by situations. Sartre (1943-2000) contended that a situation offers motives rather than causes. We tend to translate our factual understanding of ourselves into our situation. Our understanding of a situation is based on our previous and current experiences and forms the basis for our future actions. In this regard, a situation is a motive for future actions; an individual chooses to perceive a situation in a certain manner and respond to it. Therefore, in therapy, the situation is not considered a determinant of a patient's behavior but rather a motivator. Understanding the deep context motivating their patient's behavior may help therapists decipher what the patient is attempting to respond to through such behavior. Generally, a patient's behavior is a response to their situation, although they may not be aware of it sometimes. The psychological distress associated with a humanistic orientation arises from the conflict between an individual's project and the world in which they reside. Psychological distress may persist if one considers that the individual and the world are in an unchangeable fallen state. Symptoms and psychological distress are regarded as resulting from an individual's lack of patience to remain in an unauthentic state. Therefore, symptoms and psychological distress indicate a desire to pursue authenticity and positive outcomes. Heidegger's uncanny and Sartre's bad faith were used to explore the meaning of suffering and develop a therapeutic approach based on existential phenomenology. This article describes the therapeutic significance of emotion, situation, and project in detail. In addition, a specific framework of treatment is proposed, which includes the following: (1) The meaning of experiencing suffering emotions is explored. Emotions indicate the pain experienced by individuals from remaining in their current situation and the expectation of overcoming the situation. The contradictory meaning of a situation can be understood only by considering the meaning of it vis-à-vis in terms of emotions. (2) A patient's willingness to change must be strengthened. Through a discussion of the meaning of a situation based on emotions, therapists can help their patients view themselves as the cause of their actions, rather than as the result of their situation, and this can enhance the patient's willingness to change. (3) Polysemization of the situation is essential. Through Sartre's progressive-regressive method, therapists can discuss their patients' situations across the three dimensions of time. Furthermore, the patients' understanding of their situations can be polymerized through a discussion of existential anxiety and guilt. (4) The original project must be revised. Based on a new understanding of the past-present-future situation, therapists can discuss the dilemma or conflict in their patients' situations and help develop a framework for the future that the patients can project concretely. Furthermore, healing is a process of transformation from inauthenticity to authenticity.

参考文献 ( 40 ) 〈TOP〉

李维伦, W.-L.(2004)。以置身所在做为心理学研究的目标现象及其相关之方法论。应用心理研究，22，157-200。
连结：
刘淑慧, S.-H.,夏允中, Y.-J., ,王智弘, C.-H.,孙颂贤, S.-H.(2019)。自我及其在生活世界中的运作：从存在现象学处境结构观之。中华辅导与谘商学报，55，1-26。
连结：
卢怡任, Y.-J.,刘淑慧, S.-H.(2014)。受苦转变经验之存在现象学探究：存在现象学和谘商与心理治疗理论的对话。教育心理学报，45，413-433。
连结：
卢怡任, Y.-J.,刘淑慧, S.-H.(2013)。受苦经验之存在现象学研究：兼论谘商与心理治疗的理论视野。中华辅导与谘商学报，37，177-208。
连结：
Abraham, K. M.,Stein, C. H.(2015).Stress-related personal growth among emerging adults whose mothers have been diagnosed with mental illness.Psychiatric Reabilitation Journal,38,227-233.

被引用文献 ( 1 ) 〈TOP〉

(2024)。思觉失调症患者家属陪伴患者回归社区其生命经验之叙事研究。教育心理学报，55(3)，459-490。

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