破繭而出一個強迫症患者在治療中的覺醒

Come Out in a Cocoon An OCD Male Awakened in Psychotherapy

本研究以一位男性強迫症患者為對象，以其25 次諮商歷程中之敘說為文本，詮釋其生命故事中不斷重複出現主題的背景與脈絡。研究主要採敘事分析法中「整體--內容」的分析方法，依據第一次的會談記錄與其餘24 次的會談逐字稿，反覆閱讀，構築其整體的生命故事。並依據觀察自我的角度理解當事人的改變，歸納出理想化、孤獨、情色及變調的人際世界等四個主題，呈現當事人在主題上的改變。此外並依這四個主題歸納出當事人的核心防衛與模式、以及打破循環覺醒的歷程。本研究進一步討論理想化的起源與發展、覺醒的要素以及移情與防衛的關係。

This research was conducted to understand one OCD male who was repeating themes constantly in his life story and to interpret his themes by free association narration in 25 counseling sessions. Narrative and Holistic-Content analytic methods were used for this study article. The first session’s process note and the other 24 sessions’ transcripts which were used to constructed his meta-story through repeated reading and analyzing. According to observing ego， the researcher understand and presented the participant’s changes which induced such four themes: as idealizing， loneliness， sex desire， and interpersonal world that lacks the intimate friends. In addition， the researcher sum med up the participant’s core defense mechanism and it’s applying model， as well as represent and interpret the client’s awakening process in psychotherapy. The author discusses further etiology and development of idealization， essential factors of awakened and the relationship between transference and defens.