災傷時刻——受創後心理復健的倫理面向思議

Calamitous Moments: Rethinking the Ethics of Post Disaster Psychological Reconstruction Programs

本文首先指出災難與創傷構成的災傷時刻，需長期注入研究和實務上的關懷。而災後心理復健的倫理面向思議，更是重要議程。由此，進行災傷心理復健和護理照顧，不要將人「個案化」，而是要將個案「人文化」，對於即使受苦者案例，需以人文關懷優先，而非僅著眼於症狀的消除。其次，作者以5T（眼淚、時間、說話、轉化與創傷）層次，進行倫理面向上的說明。之後，作者討論受創後心理成長的意涵，包含與苦痛共存的彈性力意涵。最後，作者指出災傷心理重建不能只有「執行」績效的認知，更需要「存有」關懷的實踐。

This article points out firstly that disaster and traumatic events resulting from calamitous moments must be the focus of dedicated long term research and of ontological caring in practice. Ethical issues related to the post disaster psychological reconstruction program represent an important agenda. Therefore, in the execution of serial programs and nursing care, it should not be taken for granted that sufferers are destined to be pathological clients. Rather, each sufferer should be attended to in a humanistic manner. In other words, the elimination of symptoms cannot be our only focus. Secondly, the author discusses the ethical dimensions of post-disaster psychological intervention within a “Five T” framework (namely, tears, time, talk, transformation, and trauma). The author then explores the meaning of posttraumatic psychological growth, which is relevant to the resilience that coexists with suffering. Finally, it is important to practice ontological care from the context of being “within” the relationship, rather from a rigid cognition regarding program efficiencies. ‘Being’ provides much greater depth than ‘doing’.