心理創傷敘事療癒的理論與實務探討

Theoretical and Practical Implications of Narrative Healing of Psychological Trauma

本文以敘事來考量心理創傷療癒的問題。敘事是穿越掩飾記憶甚至掩飾痛苦的創傷的一種方式。敘事療 癒不宜只停留在技術的層面，更應去探討敘事本身的理論，這包括敘事形成的時間結構（敘事的時間） 與在情節組構所根據的意義（敘事的意義）。前者涉及敘事如何穿越創傷，後者涉及敘事何以能療癒痛 苦。這些從呂格爾的《時間與敘事》來闡述，涉及奧古斯丁、亞里斯多德、海德格與鄂蘭。

敘事時間是主觀與客觀時間的綜合，超越了奧古斯丁與海德格本真的時間所代表的主觀時間，及亞 里斯多德與海德格流俗的時間所代表的客觀時間，而以海德格的「時間內狀態」為依據，但鄂蘭致力於 人的不朽性也有所關連。敘事的意義可溯及亞里斯多德的「淨化」與佛洛伊德的「悼念」概念。寬恕所 本的尊重或愛固然不是敘事的條件，但涉及敘事整合的問題，可加持敘事意義對創傷療癒的說明。

理論為臨床實務來檢驗。余德慧基於詮釋現象心理學對敘事指出的兩個路數：（1）敘事乃建構出 文化心理學；（2）敘事要以個案的間距化為形成的條件。它們由余德慧與余安邦的研究案例來驗證， 也為懷特與艾普斯頓的敘事方法來補充，林耀盛對於「九二一」震災的研究更詳細呼應與檢討本文所處 理的敘事理論。

本文一個中心議題是：敘事療癒源於受苦也在擺脫受苦，受苦是個案可衝破有限性的臨界點，敘事 是衝破此臨界的方式之一。余德慧後來所致力的「人文臨床」就是在開展這受苦的臨界意義。

 

This article considers the problem of healing of psychological trauma from the narrative perspective. Narrative is a way to travel through the trauma of concealing memory, and even pain. We should not stick on the technical side, but rather look into the narrative theory. It includes the temporal structure of narrative formation (narrative time), and the meaning that a narrative composition of a series of events is based on (narrative meaning). The former involves how to form the time of narrative, and the latter involves the reason why narrative can heal pain. These are expounded in Ricoeur’s ""Time and Narrative,"" and refer to Augustine, Aristotle, Heidegger, and Arendt.

The narrative time is a synthesis of subjective and objective time, beyond the subjective time on the one hand, represented by Augustine, and Heidegger’s authentic time, and the objective time on the other, represented by Aristotle and Heidegger’s vulgar time, and on the basis of Heidegger’s concept of ""within-timeness."" Arendt’s commitment of human immortality is also related to that. The meaning of narration can be recurred to Aristotelian ""catharsis,"" and Freudian ""mourning"". Respect or love for forgiveness is not a condition of narrative, but they involve the issue of narrative integration, and can back up the narrative meaning to explain the healing of trauma.

Theory is examined by clinical experience. In the practical part, I first clarify the two ways Der-Heuy Yee emphasizes on narrative based on the hermeneutic phenomenological psychology: narrative presupposes distanciation of a client from his or her involvement in a trauma situation, and narrative can constitute cultural psychology. This can be verified by the practical research conducted by him and An-Bang Yu, and can be supplemented by the narrative methods proposed by Michael White and David Epston who recently have been introduced into Taiwan. Distanciation is a way for narrative to travel through trauma concealing painful memories. This is also clear from the discussion of a research report by Yaw-Sheng Lin who carried out narrative research on the case of the September 21 earthquake and demonstrated how the narrative could begin from the traumatic situation. In addition, according to this research, the importance of narrative exchange and integration can be verified. The meaning of narration can be linked to Aristotle’s Poetics, but the research shows the particularity of Chinese culture, which also proves the way that narrative constitutes cultural psychology emphasized by Der- Heuy Yee.

To put it concretely, narration is after all a way for people to devote themselves to self-satisfaction, but as far as narration is concerned, because the mother in this case lives in a network of relationships with her eldest son to whom her psychological trauma is imputed. It is necessary for her to establish a narrative relationship with him to exchange memories to achieve narrative effect. In this case, the eldest son himself, and his wife, should also tell the story through interviews, and the exchange of memories between them and the mother should be the researcher’s consulting strategy. Yaw-Sheng Lin has tried to enable this mother to gradually get along with his eldest son and daughter-in-law. However, the establishment of this relationship between mother and son and daughter-in-law has not been realized in the actual process of consultation. Nevertheless, this mother can finally get some healing for her soul, and her life is peaceful because of her psychological shift to take care of her grandchildren. The reason is that Chinese people often suffer due to the break in the relationship between relatives and friends, and their suffering is often overcome by a new connection with relatives and friends. This case in which the psychological shift of a client to the care of grandchildren and so a connection with them leads to a peaceful life shows an example. It is manifested that the peaceful result of mother’ soul is not affected by a new narrative relationship; however, this result is acquired though a narrative consulting, which can inspire us to think about how narrative strategy should take cultural background into consideration. This is a viewpoint of that narrative can constitute cultural psychology.

One central theme of this article is: Narrative therapy originates from suffer and aims to release a person from suffer; suffer is the borderline for a person to transcend his/her limitation; narrative is a kind of way to cross the borderline. Der-Heuy Yee aimed to develop the significance of the borderline of suffering in terms of his later foundation of ""humanistic clinical practice.""