悲傷輔導新觀念－從心靈成長到悲傷轉化

New Concept of Grief Counseling-from Spiritual Growth to Grief Transformation

10.6880/TJON.200806_8(1).03

石世明(Shih-Ming Shih)

癌症病人 ； 家屬 ； 悲傷輔導 ； 靈性 ； 悲傷轉化 ； cancer patient ； family ； grief counseling ； spiritual ； grief transformation

腫瘤護理雜誌

8卷1期（2008 / 06 / 01）

27 - 33

繁體中文

早期西方悲傷輔導的論述，是將情感分離視為主要的哀傷工作。到1990年代之後，哀傷者和逝者維繫正向的聯繫關係(Continuing Bonds)開始被認可，喪親的哀傷經驗，被視為一個成長的契機。本文主要在說明陪伴病人度過臨終階段時，家屬能完成和病人之間的生命課題，如世俗恩怨的化解，未竟之事的完成等，來達家屬及病人彼此雙方重新療癒的過程。此外，家屬在面對病人身體毀壞的臨終過程，應具備4個觀點，包括：1將臨終視為生命成長的最後階段，2尋求受苦的意義，3受苦的表象底下，是一個自性顯露的過程，4如何真正地接納，生老病死是一個生命的自然過程。當家屬能夠完成和病人之間的生命課題，即能見證到病人心靈的轉化歷程，再經由臨終階段的陪伴過程中，家屬對生命產生更深刻的理解，進而使家屬在親人過世後的悲傷受到轉化。期望本篇的論述能幫助醫療專業照顧者在幫助病人及家屬的悲傷輔導中，應先培養自己能看到病人心靈轉化的能力，才能夠引導家屬走過臨終陪伴的歷程，當家屬能體認病人的心靈轉化時，就能轉化家屬的哀傷，使得臨終陪伴成為家屬成長的一個開始。

From the literature review, the early discourses of Western Grief Counseling assumed that the emotional detachment was the primary grief work for the bereaved. From 1990s, maintaining positive continuing bonds between the bereaved and the deceased was started to be approved. The bereaved grieving experience was regarded as an opportunity for their personal growth. This article primarily articulated how to accompany with the patient at the terminal stage, and the clinical experiences of helping the families accomplish their life tasks with the patient such as the issues of settling gratitude and grudges in the world and accomplishing the unfulfilled ambition. The process of caring becomes a healing process, in which the families and the patient could renewably know each other. In addition, the families profoundly comprehend that physical deterioration does not only result in negative emotions, difficulties and challenges but also bring the opportunities for spiritual growth and transformation to cancer patients. To realize this process, caregivers have to develop the following perspectives: (1) dying process is viewed as the last stage of life from which the patient grows; (2) patients will search for the meaning of suffering; (3) the true nature of mind of a patient reveals itself under the surface of suffering; (4) how we can truly accept that birth, aging, illness and death is a natural process of life. When the families could finish their life tasks, unfinished businesses with the patient and witness the process of patients' spiritual transformation, they gained deeper insights into their life. This process helps the bereaved transform their grief after their beloved dies. Finally, this article indicates that medical and nursing care professionals have to foster their abilities to see the process of transformation in grief counseling for patents and families. Therefore, they can direct families to experience the process of end-of-life care, which becomes a starting point for families' self growth for the future.