精神病患生活世界之時間現象

The Phenomenon of Temporality within Psychiatric Patients' Life World

許樹珍(Shuh-Jen Sheu)；游淙祺(Chung-Chi Yu)；林湫雯(Chiu-Wen Lin)；魯思翁(Sy-Ueng Luu)

時間性 ； 現象學 ； 精神病患 ； phenomenological approach ； psychiatric patient ； temporality

本土心理學研究

19期（2003 / 06 / 01）

149 - 200

繁體中文

本研究運用現象學方法，透過精神病患本身對疾病與照顧的看法、感受和經驗，來理解及展現精神疾病與時間性的議題。資料收集採多重的技巧，主要包括深入性個別及團體的會談、實地參與性觀察，和相關田野記錄。資料分析時主要是從病人所描述的每日生活世界中，疾病與受照顧的自我及他我的關係、感受、看法等經驗，做時間性範疇的觀看與推敲，再試將精神患者感受時間的生活世界表達出來。研究結果將分兩大部分作介紹－第一大部分「精神病患生活時間的不穩固」可歸納為：(l)內在時間意識的失真錯亂；(2)日常生活時間線與時間三向度的斷落；(3)與外在社會腳步與脈動脫節等三方面。第二大部分「自我的生命時間性的調度」包括(l)拒絕流動、自我封閉；(2)分辨世界的虛幻與真實；(3)因果歸順、時空定位；(4)保有穩固常規的生活時間流等四個主題。最後本文試圖刻劃自我置身於自然與社會週遭共同世界的時空定位與脈動配合的最大可能性，對精神患者過去、現在、未來時間流的導引，日常生活時間性的帶動，和自我在虛幻與現實、內在與外在時間性整合之理解及行動的討論。另外，本論文也試圖將現象學研究法與產生時間論述間之關係，及可能的臨床運用做一連結。時間的解構與建構不僅關聯於個體精神和意識之轉移，時間性療護的原則和行動更在於如何促使週遭他者和關照機構能召喚出接納共現與時間共振的關係與功夫。

This study adopts a phenomenological approach to understand and represent issues of temporality in psychiatric patients' descriptions of their mental illness experiences. Multiple techniques including in-depth individual interviews, focus groups, participant observation, and field notes are applied for data collection. Psychiatric patients' unstable life temporality included three themes: 1) an unreal and bewildered sense of internal temporality, 2) a broken daily life time-line and the three dimensions of past, present, and future, and 3) lack of synchronization between self and social pace. Four themes were uncovered with respect to self-adjustment of life temporality: 1) self-closure and refusing to let time move around, 2) differentiation between real and unreal worlds, 3) causality and repositioning of personal sense of time and space, and 4) preserving and maintaining daily life routines. Exploration f the descriptive phenomenon of psychiatric patients' unstable temporality and self-adjustment is aimed at allowing health personnel to further understand and discuss ways to lead, initiate, and reintegrate patients' life temporality. The reflection of the indigenous social-natural temporal environment and the ultimate possibility of the synchronization between the self and society are also discussed.

1. 許樹珍 Sheu, Shuh-Jen、 曹慶英 、 崔翔雲 Tsui, Hsiang-Yun(2001)。精神病患家庭照顧存在性的現象學探討 The Existential Phenomenology of Family Care of Psychiatric Patients。護理研究 The Journal of Nursing Research，9(3)
   連結：
2. Antony, M. V.(2001).Conceiving Simple Experiences.Journal of Mind ＆ Behavior,22(3)
3. Bateman, A.、 Holmes, J.、 林玉華 Lin, Yu-Hua、 樊雪梅(1999)。當代精神分析導論：理論與實務 Introduction to Psychoanalysis: Contemporary Theory and Practice。台北:五南圖書公司。
4. Beiser, M., Hyman, I.(1997).Refugees' Time Perspective and Mental Health.American Journal of Psychiatry,154(7)
5. Bergson, H.(1989).Zeit und Freiheit.Frankfurt am Main:Athenaum.
6. Berrios, G. E.(1993).Phenomenology and Psychopathology: Was There Ever A Relationship?.Comprehensive Psychiatry,34(4)
7. Beumont, P. J.(1992).Phenomenology and the History of Psychiatry.Australian ＆ New Zealand Journal of Psychiatry,26(4)
8. Blakely, T. A.(1991).Orientation in Time: Implications for Psychopathology and Psychotherapy.American Journal of Clinical Hypnosis,34(2)
9. Bouffard, L., Bastin, E.(1994).The Future Time Perspective of Older Adults as Function of Loss of Autonomy and Type of Residence.International Journal of Psychology,29(1)
10. Breier-Williford, S., Bramlett, R. K.(1995).Time Perspective of Substance Abuse Patients: Comparison of the Scales in Stanford Time Perspective Inventory, Beck Depression Inventory, and Beck Hopelessness Scale.Psychological Reports,77(3, Pt 1)
11. Byrne, R. M. J., Segura, S., Culhane, R., Tasso, A., Berrocal, P.(2000).The Temporality Effect in Counterfactual Thinking about What Might Have Been.Memory ＆ Cognition,28
12. Canham, H.(1999).The Development of the Concept of Time in Fostered and Adopted Children.Psychoanalytic Inquiry,19(2)
13. Costello, E. J.(1989).The Utility of Care: Behavioral Decision Analysis and the Development of Depression.Development ＆ Psychopathology,1(1)
14. Crow, T. J., Stevens, M.(1978).Age Disorientation in Chronic Schizophrenia: The Nature of the Cognitive Deficit.British Journal of Psychiatry,133
15. De Leval, N. S.(1999).Quality of Life and Depression: Symmetry Concepts.生命品質研究 Quality of Life Research,8(4)
16. Diekelmann, N. L., Allen, D., Tanner, C. A.(1989).The NLN Criteria for Appraisal of Baccalaureate Programs: A Critical Hermeneutic Analysis.New York:National League for Nursing Press.
17. Ellenberger, H. F.、 宋文里 Soong, Wen-Li(1988)。精神醫學的現象學及存在分析之臨床導論。思與言：人文與社會科學雜誌 Thought and Words: Journal of the Humanities and Social Science，25(6)
18. Fuchs, T.(2001).Melancholia as A Desynchronization: Towards A Psychopathology of Interpersonal Time.Psychopathology,34(4)
19. Gibson, D.(1994).Time for Client: Temporal Aspect to Community Psychiatric Nursing.Journal of Advanced Nursing,20
20. Goldberg, C.(2002).Loneliness and Dread as Time Sense Disturbances.Journal of Contemporary Psychotherapy,31(4)
21. Hawking, S. W.、 許明賢 、 吳忠超(2000)。時間簡史：從大爆炸到黑洞 A Brief History of Time: From the Big Bang to Black Holes。台北:藝文印書館。
22. Heidegger, M.(1993).Sein und Zeit.Tubingen:Max Niemeyer.
23. Heidegger, M.、 陳嘉映 、 王慶節(1989)。存在與時間 Sein und Zeit。台北:唐山書店。
24. Husserl, E.(1980).Vorlesungen zur Phanomenologie Des Inneren ZeitbebuBtseins.Tubingen:Max Niemeyer.
25. Kazakina, E.(1999).Time Perspective of Older Adults: Relationships to Attachment Style, Psychological Well-Being, and Psychological Distress.Dissertation Abstracts International: Section B: The Science ＆ Engineering,60(1-B)
26. Kraus, M. R., Csef, H.(1995).Perspectives and Time as Relevant Phenomena in the Psychopathology of Obsessive-Compulsive Disorder.Zeitschrift Feur Klinische Psychologie, Psychiatrie und Psychotherapie,43(3)
27. Levine, R.、 馮克芸 、 黃芳田 、 陳玲瓏(1998)。時間地圖：不同時代與民族對時間不同的解釋 A Geography of Time: The Temporal Misadventure of A Social Psychologist。台北:臺灣商務書局。
28. Loftus, E.、 Ketcham, K.、 洪蘭 Hung, Daisy L.(2001)。記憶與創作 The Myth of Repressed Memory。台北:遠流出版公司。
29. Mcfadden, S. H.(1985).Attributes of Religious Maturity in Aging People.Journal of Religion ＆ Aging,1(3)
30. Meisenhelder, T. M.(1985).An Essay on Time and the Phenomenology of Imprisonment.Deviant Behavior,6(1)
31. Menninger, K. A.、 林克明 Lin, Keh-Ming(1983)。精神分析術 Theory of Psychoanalytic Technique。台北:志文文化事業公司。
32. Moustakas, C. E.(1994).Phenomenological Research Methods.Thousand Oaks, Calif.:Sage.
33. Mundt, C., Richter, P., Van Hees, H., Stumpf, T.(1998).Time Perception and Time Estimation in Depressive Patients.Nervenarzt,69
34. Neuberger, R. J.(1996).Time to Care.Nursing Standard,10
35. Newton, I.(1964).Problems of Space and Time.New York:Macmillan.
36. Parker, J. M.(1996).Space, Time and Radical Imagination: Nursing in the Here and Now.Journal of Advanced Nursing,24(6)
37. Pinter, F.(2000).Psychodynamic Analysis of the Proustian Time-Experience.Magyar Pszichologiai Szemle,55(2-3)
38. Rappaport, H.(1990).Marking Time.New York:Simon ＆ Schuster.
39. Ravenna, M., Ricci Bitti, P. E.(1982).The Temporal Perspective of the Aged: A Research Contribution.Giornale Italiano di Psicologia,9(1)
40. Schlosberg, A.(1984).Temporal Perspective as An Ego Function in Schizophrenia.Beer Yaakov Psychiatric Hosp,1
41. Schutz, A.(1992)。舒茲論文集第一冊 Collected Papers, Vol. I.。台北:桂冠圖書公司。
42. Schutz, A.(1932).Der Sinnhafte Aufbau der Sozialen Welt.Frankfurt am Main:Suhrkamp.
43. Schutz, A.(1982).Das Problem der Relevanz.Frankfurt am Main:Suhrkamp.
44. Schutz, A., Luckmann, T.(1990).Strukturen der Lebenswelt.Frankfurt am Main:Suhrkamp.
45. Schwartz, A. E.(1977).Being-in-Time: A Phenomenological Exploration of the Existential Past, Present and Future.Review of Existence Psychology ＆ Psychiatry,15
46. Stein, D. J.(1991).Philosophy and the DSM-III.Comprehensive Psychiatry,32(5)
47. Suto, M., Frank, G.(1994).Future Time Perspective and Daily Occupations of Persons with Chronic Schizophrenia in A Board and Care Home.American Journal of Occupational Therapy,48(1)
48. Tassi, N.、 李牧華(2001)。克服時間的壓力 Urgency Addiction: How to Show Down Without Sacrificing Success。台北:九歌出版公司。
49. Terr, L.、 陳玲瓏(1996)。推開記憶的囚門 Unchained Memories。台北:遠流出版公司。
50. van Manen, M.(1990).Researching Lived Experience: Human Science for An Action Sensitive Pedagogy.New York:Sate University of New York.
51. Vander, A. J.、 Sherman, J. H.、 Luciano, D. S.、 潘震澤 、 楊至剛(1999)。人體生理學 Human Physiology。台北:合記圖書出版社。
52. Walsh, M.(1997).Watson's Clinical Nursing ＆ Related Sciences.London:Bailliere Tindall.
53. Warin, M., Baum, F., Kalucy, E., Murray, C., Veale, B.(2000).The Power of Place: Space and Time in Women's and Community Health Centres in South Australia.Social Science ＆ Medicine,50(12)
54. Wyrick, R. A., Wyrick, L. C.(1977).Time Experience During Depression.Archives of General Psychiatry,34(12)
55. 汪文聖 Wang, Wen-Shang(2001)。現象學與科學哲學。台北:五南圖書公司。
56. 汪文聖 Wang, Wen-Shang(2001)。現象學與科學哲學。台北:五南圖書公司。
57. 許樹珍 Sheu, Shuh-Jen(2001)。「照顧存在性」研究的準備工作與實務理論之建構 "The Existentiality of Caring": The Research Preparation and Theoretical Construction Work。國立政治大學哲學學報 The National Chengchi University Philosophical Journal，7
58. 游淙祺 Yu, Chung-Chi(1999)。論舒茲的實質行動概念。臺灣哲學研究，2
59. 關永中(1997)。中山文庫社會系列－神話與時間。台北:臺灣書店。

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