性侵者、家暴者、酒藥癮者的創傷知情：行為四關鍵療法與兼愛輔導法

Trauma-Informed on Sex Offenders, Domestic Abusers, Addicts: Four-Factor Behavior Model of Assessment and Treatment

創傷知情是近十年來在心理治療界的熱門主題，但只有暴力被害者有創傷嗎？本文的目的在於確認性侵者、家暴者、酒藥癮者過去多有創傷的情況，再就如何做創傷知情的輔導與社工處置，以更周全地做好心理與生理上三類案主的行為原因評估與輔導。筆者以三十年的經驗確認家暴者、性侵者、成癮者幾乎或九成以上都有創傷。根據所累積對三類人的評估治療經驗，而發展出「行為四關鍵評估輔導法，即人類行為分悶來的、學來的、想法來、神經營養不足或生理異常來的共四個關鍵」。並舉出案例。其中悶來的是指過去的不舒服經驗而啟動案主的偏差動機、學來的是指行為學派的三種學習模式但學到偏差行為，而想來的則是錯誤的思考過程與結果。神經營養不足則是根據近年研究發現慢性發炎與粒線體失能才是慢性精神障礙的生理主因。兼愛（又稱大愛）輔導法則是因為筆者近年發現自私合理化於社區日加嚴重並開始帶領投入討論「尊重自己與尊重別人，哪個重要？還是一樣重要？」發現部分案主會選擇自己重要，再詢問「是否喜歡被尊重？是否所有人都喜歡被尊重？」後再問前句，則全部案主都可回答一樣重要，也都改變心態到平等愛人的大愛。最後將相關結論與建議放在文末。

Trauma-Informed Care has been a popular topic in psychotherapy over the past decade, but is it only victims of violence who experience trauma? The purpose of this paper is to identify the prevalence of trauma in offenders, including sexual offenders, domestic violence perpetrators, and individuals with alcohol or drug addictions. It further aims to explore how trauma-informed counseling and social work interventions can be applied to provide a more comprehensive assessment and counseling of the psychological and physiological causes of these three types of clients' behaviors. Based on the author's 30 years of experience, it has been confirmed that almost or more than 90% of domestic violence perpetrators, sexual offenders, and addicts have a history of trauma. Drawing on accumulated experience in assessing and treating these three groups, the author has developed the ''Four-Factor Behavior Model of Assessment and Treatment,'' which categorizes human behavior into four critical factors: (1) behaviors stemming from repression, (2) learned behaviors, (3) behaviors arising from thoughts, and (4) behaviors caused by neuro-nutritional deficiencies or physiological abnormalities. The paper includes case studies to illustrate the approach. 'Repressed behaviors' refer to deviant motivations triggered by uncomfortable past experiences; 'learned behaviors' refer to behaviors acquired through three learning modes in behavioral theory but resulting in deviant actions; and 'thought-based behaviors' arise from faulty thought processes and outcomes. Neuro-nutritional deficiencies, as supported by recent research, indicate that chronic inflammation and mitochondrial dysfunction are the primary physiological causes of chronic mental disorders. The paper concludes with relevant findings and recommendations.