身心違常－－女性自我在父權結構網中的「迷」途

Psychosomatic Disorder: The Straying of a Woman’s Self within the Patriarchal Structure

為了解釋歷來女性有較高的身心違常罹患率，本文嘗試將探究心理病理之焦點放在深植於文化∕社會中的父權結構，並層層揭露父權主義（paternalism）如何透過社會化的歷程，同時配合親屬網絡中的社會期待、文化中的習俗規範，共同形成天羅地網式的共犯體系，讓生存於其中的女性掙脫不出，而深陷身心違常的困境，甚而瀕臨精神崩潰之邊緣。本研究以向精神科求診的已婚中年婦女為案例，約20小時的敘說資料為分析素材，並以文化自我建構論與女性主義社會建構論為二度詮釋之觀點，以個案的自我發展為論述主軸，逐步鋪陳其文化自我與父權主義之對話，及其罹患身心違常之過程。個案在青春期是一位受現代化教育且具有「功能性獨立」的少女，在保護性父權主義的社會教化下，欠缺「情感性獨立」的發展；結婚後，卻誤入傳統性的父子軸家庭，與其所希冀的現代性夫妻軸家庭有所背離。當個案在婚姻生活中面對男性中心的孝道觀、男性中心的性愛觀，及以暴力展示權力的父權主義所形成的三岔路時，因其「自我執迷」於情愛忠貞及夫妻平權之婚姻倫理觀，而不斷地與其深具支配性父權的先生發生糾葛式衝突，且被迫自我消音（silencing self），因而逐漸地身心能量耗竭，導致「自我迷失」而無所適從，甚至走向自我解組的危機邊緣。論文最後對目前台灣的精神科之心理治療過度醫療化與專業治療人員之養成缺乏性別意識之現象提出反思，同時也對攸關女性自我的充權（empower）與發展之道提出一些建議。

This study focuses on the analysis of cultural factors involved in female psychopothology in the Chinese paternalistic structure in attempt to explain women’s higher rate of psychosomatic disorder. The socialization process which forms the social expectations, habits, and norms that together create a cooperative system for the formation of female psychopathology is explored. These social constructions are so prevalent that a Chinese woman under their sway have no way to escape, and so may fall into a psychosomatic disorder, even to the extent of paranoid disorder. This study is based on the case of a married middle-aged woman who requested psychological treatment. Using the data of 20 hours of narrative, and adopting the constructive approach to the cultural self and the feminist social constructionist approach, the pathological process for the case was analyzed. As a well-educated woman who had developed the functional independence during her teenage years, the case lacked the affective independence due to her protective patriarchal social education. After entering a paternalistic-oriented dominant married life, she faced conflict with the male-centered beliefs of shiao dao (filial piety) and sexuality and with a strong-arm approach for power display. Due to her persistence with traditional concepts of loyalty and chastity as well as the modern, equalitarian concept of family, she constantly experienced the entanglement type of conflict with her husband to the extent that she gradually lost her energy and almost collapsed into paranoid disorder. In addition to providing an interpretation of the dialectic between the self and the paternalistic culture that led to the disorder, this study suggests some feasible methods for women’s empowerment and self-development.