從文化心理學到人文臨床心理學：臨床心理學本土化論述與踐行

From Cultural Psychology to Humanistic Clinical Psychology: The Indigenization of Clinical Psychology

《本土心理學研究》25年在臨床心理學方面所顯現本土化的進程可以這樣描述：以「面對受苦之人」來定義本土化的意義，借助存在現象學反省知識的生產過程，得以經由生活世界的回歸，揭示華人生活苦痛的關鍵，為奠基於情感性而構成的生活秩序，亦即倫理；從而以「倫理療癒」為核心，深入人類受苦與療癒的本源，發展出能夠於專業場域實踐的本土臨床心理學。從文化論議來看，這是以「在地轉化」策略來建構「文化緩衝」的心理學，以親近與肯認當代本土社會的文化心理生活。本文回顧與綜述這個進程，藉此將整個臨床心理學本土化的軸線提取出來，顯現其學術與踐行的雙重意義。首先，綜觀本土臨床心理學25年進程。其次，專題導向地闡述本土化之知識論與方法論問題與解方。再來，展示心理受苦經驗還回社會文化生活脈絡後的理解成果。最後，呈現從觀察、思考、研究、理解、行動等一連串過程而獲得的倫理療癒心理治療形式。本文總結指出臨床心理學的本土化踐行的結果即是人文臨床心理學的開展，而這是尚未完成正在進行「之間」的路途。在歷經25年來研究成果溯源之後，朝向未來，本土臨床心理學仍將持續對「成人」（human becomings）的根本探問。這樣的流變轉化（becomings），是包含但不限於專業場域，而是回到我們作為存有者所關心的土地、文化、社會、歷史。我們的生活世界，都是人文臨床心理學的踐行田野。

The existence of clinical psychology in Taiwan dates to the 1950s. Not until 2001 did clinical psychology achieved legitimacy as a profession when it was included in the licensure examinations for medical professionals. In its early stage, clinical psychologists did not care about indigenization. Even as the indigenous movement in social and personality psychology grew, clinical psychologists in Taiwan did not show much interest. Their indifference to indigenous reflection can be understood in terms of a post-colonial third-world mindset in which western scientific disciplines are viewed as representing universal knowledge. In addition, the acceptance of biomedicine as the legitimate form of health care meant that clinical psychology as a form of health care had no need to be concerned with the socio-cultural conditions of people's lives. The task of indigenizing clinical psychology was thus twofold. It was necessary to reflect upon the subtle process of knowledge colonization to build a tangible epistemological foundation for indigenization. It was also important to develop efficient interventions for professional practice. As a consequence, the East/West dichotomy employed in the indigenization of social and personality psychology cannot be a proper starting point for an indigenized clinical psychology. Mental illness requires clear medical standards for identification, and concrete and efficient treatment solutions, rather than just academic arguments. An indigenous clinical psychology should both recognize that mental suffering is always social and cultural, and also be manageable through the professional health care system. It should be not only an academic movement but also feasible for clinical practice. Throughout its 25 years, Indigenous Psychological Research in Chinese Societies has supported discussion about the path for indigenization of clinical psychology in both theoretical and practical dimensions. This path can be described as defining the meaning of being indigenous as a face-to-face encounter with the sufferer, taking the route of phenomenology for epistemological reflection, returning to the life world, and disclosing interpersonal order (i.e., ethicality) as the core of psychological distress in Chinese societies. Ethical healing is the key concept for exploring the essential structure of suffering and recovery. We reviewed the progress and the main agenda concerning both the academic and practical aspects of indigenized clinical psychology in Taiwan. In our review we: (1) provided an overview of the 25-year indigenization process, whose core feature can be described as an engineering of constructing 'cultural buffer' between modern biomedical practice and local people's psychological lives; (2) thematically articulated the problems and solutions in the epistemology and methodology of the indigenization of clinical psychology in terms of the differentiation of two models of indigenization: the horizontal model of East-West dichotomy and the vertical model of returning to the life world; (3) provided evidence of the understanding obtained by returning sufferers' experiences back to their cultural and social contexts in which 'ethical predicament' emerged as the hidden thread underlining Taiwanese psychological suffering; and (4) introduced the forms of psychotherapy as ethical care, focusing on the 'self for being ethical,' the acting agent concerned mostly with the interpersonal ordering in its life, and therefore, finding ways to re-order the interpersonal constellations. We thus present a path of restoring the fertile ground of psychological life within the modern profession of clinical psychology. We define the clinical practice as witnessing to the suffering rather than the techne of cure. The ultimate concern, in the end, is not to define one's psychopathology, but to reveal one's ethicality towards others. We conclude that the pursuit of a proper indigenous clinical psychology will ultimately lead to the development of a humanistic clinical psychology, which focuses not just on human beings but also human becomings in clinical practice. In the future, the indigenization of clinical psychology in Taiwan will continue connecting clinical practice to culture, society, and history in order to ground us as human becomings.