經歷九二一：災民安置所的心理重建經驗

Experiencing ‘921’ Earthquake: Experiences of Psychological Rehabilitation with Victims in a Temporary Shelter

在九二一震災後，對災民心理層面所造成的影響最常用的論述是所謂的「創傷後壓力疾患」（Post-traumatic Stress Disorder，簡稱PTSD），即是災難造成直接的心理創傷，而心理重建的主要任務就被期許為篩檢出高危險群的心理創傷疾患，並進一步治療心理創傷。本文是對前述的論述提出補充與修正，認為災難對心理層面衝擊的地位是「災難做為一個觸發事件」，因為我們發現，對大部分的災民來說，由災難事件所觸發的其他心理層面問題才是災後生活中所關切的，而這些心理層面的問題關係著災後心理適應的品質。在這樣的認識底下，心理重建的原則就必須撇除單純地以遭受創傷壓力的「心理症狀」的角度來看待，而應該拉大視野，擴及到對災民整體生活的關懷。本文除了對災民的心理世界進行分析外，還包括四個主要部分，其一是對心理師在災後心理重建的角色定位及介入方式的反省與建議；其二是發展「災難情結」及「災難現場的心理輻射」兩個假說；其三是提出一個心理重建介入的概略模式及應用；其四是對人為措施的建議。

The most frequently used discourse about the victims’ psychological dimension after the ‘921’ earthquake is Post-traumatic Stress Disorder (PTSD): that is, psychological trauma created directly by catastrophes. The main task of rehabilitation is then expected to screen out high-risk psychologically traumatized population for further treatment. The present article, however, suggests that, for the psychological difficulties in such victims, the earthquake is a triggering event which evokes previous psychological problems that play major roles in life after catastrophe. With this understanding, psychological rehabilitation should not only focus on “symptom” induced by traumatic stress, but should have a broader horizon in order to attend to the victims’ lives as a whole. Besides the analysis of the psychological world of the victims, the present article also includes four other major parts: first, reflections and suggestions about the role and intervention of psychologists in the rehabilitation; second, two hypotheses, “catastrophe complex” and “psychological radiation”; third, a model of post-catastrophe psychological intervention; and fourth, suggestions for government administration.