一位接受心理治療的轉化症女性：自體心理學的觀點

A Woman Patient with Conversion Disorder in Psychotherapy：From the Perspective of Self Psychology

背景：轉化症常表現神經學疾患之症狀但卻無法與神經學及其他身體病況相配。病因及復原機轉證據仍有限。本文以個案報告呈現自體心理學觀點中轉化症病人復原的可能機制。研究對象：一位三十一歲單身女性持續兩年有癲癇發作且被診斷為轉化症。後續被轉介接受自體心理學導向的個別心理治療。治療過程及整合陳述：病人與治療者互動形成新的自體經驗，且整合過往自體經驗並增進自體一致性。十個月後，病人不再服用抗癲癇藥物且無癲癇發作。結論：藉由同理來形成自體客體，與被轉化症阻隔的情緒連結。個體進而能面對情緒，轉化症也不再出現。

Background: Conversion disorder presents itself with symptoms suggesting a neurological disorder although they are incompatible to any recognized neurological or medical condition. Evidences of mechanism of etiology and restoration are limited. We presented a case for possible mechanism of restoration from the perspective of self psychology. The Study Subject: We reviewed the chart of a 31-year-old single woman suffering from seizures for two years, who was diagnosed as conversion disorder. She was referred to psychiatric clinic and received self psychology-oriented individual psychotherapy. Therapeutic Process and Formulation: The interaction between patient and therapist formed new self experience, which would have integrated with past self experience and improve self cohesiveness. The seizures were gradually subsided after about ten-month psychotherapy without the use of any anti-epileptic drugs. Conclusion: With empathy, there would be formation of selfboject which could connect with the emotion isolated by conversion. The individual could fi nally face his/her emotion and the conversion would not be presented.