婚姻治療中依戀創傷者的人我意義改變

Conceptual Knowledge Changes in the Identity of Self in Relation to Others: A Case Study of an Attachment Trauma Survivor in Marital Therapy

10.3966/156092512019120071004

董秀珠(Hsiu-Chu Tung)；陳秀蓉(Hsiu-Jung Chen)；楊連謙(Lien-Chien Yang)

人我意義 ； 他人回應 ； 依戀創傷 ； 負向性意義 ； 敘事形式 ； 婚姻治療 ； identity of self in relation to others ； marital therapy ； negative meaning ； narrative fragmentation ； responsiveness

應用心理研究

71期（2019 / 12 / 01）

81 - 136

繁體中文

本文旨在初步探詢、找尋婚姻治療歷程中，能反映依戀創傷者於互動中人我意義變化的敘事指標；因創傷者傾向以負向意義的評定解讀事件，並困難整合創傷的經歷至原來的生命故事線、而造成自我統合困境。本研究是立基於詮釋現象學的敘說分析，並在一著重社會建構與協同合作取向的婚姻治療場域，針對一位因丈夫外遇衝擊而致依戀創傷之妻子的治療歷程中310個分析單元之敘事語句分析，並分就人我意義的敘事內涵與形式兩面向，進行編碼與資料分析。治療初期的丈夫無能給予情感性回應，創傷的妻子不斷跳轉在緬懷過往婚姻美好的「對夫正」意義與對現狀難以消化接受的「對己負」意義之間，於是創傷者也越來越敘說一個模糊且孤立的我知識，但隨著治療的推進創傷者再歷情緒、增加返歸自身的自我檢視，以及透過夫妻關係中彼此正向回應的促進，終使創傷者統整出更多針對事件的關係性角度反思，及助益個人問題解決能動性提升的正向性意義。

The present study explored the changing trajectory of conceptual knowledge regarding the identity of self in relation to others of a wife who survived attachment trauma caused by an extramarital affair. Psychological trauma is usually overwhelming; due to avoidance of both negative feelings and intimate contact with her husband, memory disturbances disabled the wife from making self-referential meanings and from achieving a sense of self-continuity. The present study aimed to explore two aspects of a client's meaning-making regarding how the self relates to others. The infidelity event caused the traumatized wife to experience narrative fragmentation. Through analysis and the identification of narrative indicators, the study demonstrates how practitioners can improve the outcomes of marital therapy.

1. 王秀槐, H. H.(2002)。人我之際：臺灣大學生的生涯建構歷程。本土心理學研究，17，165-242。
   連結：
2. 孫頌賢, S. H.,修慧蘭, H. L.(2007)。成人依附的測量：成人世界中不同依附對象的測量差異與關聯。中華心理衛生學刊，20(1)，31-51。
   連結：
3. Adler, J. M.(2012).Living into the story: agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy.Journal of Personality and Social Psychology,102(2),367.
4. Anderson, H.(2007).Collaborative Therapy.New York:Routledge.
5. Berntsen, D.,Rubin, D. C.(2006).The centrality of event scale: A measure of integrating a trauma into one’s identity and its relation to posttraumatic stress disorder symptoms.Behavior Research and Therapy,44(2),219-231.
6. Brewin, C. R.(2011).The nature and significance of memory disturbance in posttraumatic stress disorder.Annual Review of Clinical Psychology,7,203-227.
7. Brewin, C. R.,Patel, T.(2010).Auditory pseudo-hallucinations in United Kingdom war veterans and civilians with posttraumatic stress disorder.The Journal of Clinical Psychiatry,71(4),419-425.
8. Chafe, W.(2001).The handbook of discourse analysis.
9. Chiu, P.,Casas, B.,Casas, B.,Deldin, P.(2012).Linguistic predictors of post-traumatic stress disorder symptoms follow-ing 11 September 2001.Applied Cognitive Psychology,26,316-323.
10. Conway, M. A.(2005).Memory and the self.Journal of Memory and Language,53(4),594-628.
11. Crespo, M.,Fernández-Lansac, V.(2016).Memory and narrative of traumatic events: A literature review.Psychological Trauma: Theory, Research, Practice, and Policy,8(2),149.
12. Ehlers, A.,Clark, D. M.(2000).A cognitive model of posttraumatic stress disorder.Behavior Research and Therapy,38(4),319-345.
13. Feeney, J. A.(2005).Hurt feelings in couple relationships: Exploring the role of attachment and perceptions of personal injury.Personal Relationships,12(2),253-271.
14. Fehr, B.,Harasymchuk, C.(2005).The experience of emotion in close relationships: Toward an integration of the emotion in relationships and interpersonal script models.Personal Relationships,12(2),181-196.
15. Foa, E. B.,Huppert, J. D.,Cahill, S. P.(2006).,未出版
16. Foa, E. B.,Molnar, C.,Cashman, L.(1995).Change in rape narratives during exposure therapy for posttraumatic stress disorder.Journal of Traumatic Stress,8(4),675-690.
17. Franzosi, R.(Ed.)(2010).Quantitative narrative analysis.Los Angeles:SAGE Publications.
18. Greenhoot, A. F.,Sun, S.,Bunnell, S. L.,Lindboe, K.(2013).Making sense of traumatic memories: Memory qualities and psychological symptoms in emerging adults with and without abuse histories.Memory,21(1),125-142.
19. Hayes, A. D.,Feldman, G. C.,Goldfried, M. R.(2006).The change and growth experiences scale: a measure of insight and emotional processing.Insight in Psychotherapy,New York:
20. Johnson, S. M.,Makinen, J. A.,Millikin, J. W.(2001).Attachment injuries in couple relationships: A new perspective on impasses in couples therapy.Journal of Marital and Family Therapy,27(2),145-155.
21. Labov, W.(2006).The social stratification of English in New York city.Cambridge University Press.
22. Makinen, J. A.,Johnson, S. M.(2006).Resolving attachment injuries in couples using emotionally focused therapy: Steps toward forgiveness and reconciliation.Journal of Consulting and Clinical Psychology,74(6),1055.
23. McAdams, D. P.,McLean, K. C.(2013).Narrative identity.Current Directions in Psychological Science,22(3),233.
24. McLean, K. C.,Mansfield, C. D.(2012).The co-construction of adolescent narrative identity: narrative processing as a function of adolescent age, gender, and maternal scaffolding.Developmental Psychology,48(2),436.
25. Mlotek, A. E.,Paivio, S. C.(2017).Emotion-focused therapy for complex trauma.Person-Centered & Experiential Psychotherapies,1-17.
26. Park, C. L.(2010).Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events.Psychological Bulletin,136(2),257.
27. Riessman, C. K.(2008).Narrative methods for the human sciences.Los Angeles:SAGE Publications.
28. Römisch, S.,Leban, E.,Habermas, T.,Döll- Hentschker, S.(2014).Evaluation, immersion, and fragmentation in emotion narratives from traumatized and non-traumatized women.Psychological Trauma: Theory, Research, Practice, and Policy,6,465-472.
29. Sutherland, K.,Bryant, R. A.(2007).Autobiographical memory in posttraumatic stress disorder before and after treatment.Behavior Research and Therapy,45,2915-2923.
30. White, M.,Epston, D.(1990).Narrative Means to Therapeutic Ends.New York:W. W. Norton.
31. 涂陽軍, Y.,陳建文, J.(2009)。創傷後成長：概念與測量。中國社會醫學雜誌，26(5)，31-51。
32. 游淑瑜, S. Y.(2003)。國立臺灣師範大學教育心理與輔導研究所=National Taiwan Normal University, Department of Educational Psychology and Counseling。
33. 麗斯夢, C. K.,王勇智（譯）,鄧明宇（譯）(2003).敘說分析.臺北:五南圖書.