一位新住民之子的依附創傷與修復歷程：從心智化角度理解個案與諮商過程

The Attachment Trauma and Recovery Process of a New Immigrant Child: Applying the Mentalizing Perspective to Understand the Counseling Process

起源於精神分析及依附理論的「心智化」，指的是從主觀狀態和心智活動層面，內隱和外顯地理解他人及自己的過程，它詳細探討了「依附創傷」的產生、影響及治療。研究目的：由於新住民父或母在台的特殊境遇，新住民之子可能遭遇依附創傷。本文從心智化角度探析一位母親為大陸籍的新住民之子的依附創傷與藉助諮商修復創傷的歷程。研究方法：本文是個案報告，個案為17歲高中女生，因情緒和思維混亂，害怕退縮，常哭泣，無法繼續就學前來求助，由精神科診斷為憂鬱症，轉介心理諮商。心理師透過建立安全的關係，鏡映與涵容，協助個案自我覺察，理解與區分自我與他人，敘說和修復創傷。研究結果：經過42次諮商，個案逐漸改變與創傷的關係，自我覺察與自信增強，恢復求學動力及與他人建立關係的能力。研究結論：來自與主要照顧者依附關係的創傷，也需要在安全的關係中修復；而關係的修復，又透過心智化的互動達成。本文提出依附創傷修復的三個指標：（1）個案在敘述自我與創傷時具有連貫一致性，且不會被情緒吞沒；（2）敘述的同時不會與內容和情緒疏離；（3）個案依附的安全感提升，和主要照顧者關係和／或當前關係得到改善。

Originating from psychoanalysis and attachment theory, mentalizing is a process of understanding others and oneself implicitly and explicitly in terms of subjective states and mental activity. The theory of mentalization has been widely applied to explore the origin, implication, and treatment of attachment trauma. Purpose: Given the special situation that new immigrant mothers or fathers may encounter in Taiwan, their children possibly experience attachment trauma. This paper, therefore, aims to explore the attachment trauma and the recovery process, with the assistance of counseling, of a child whose mother is an immigrant from mainland China. Method: We employed a case-report approach to analyze the attachment trauma and recovery process of a 17-year old female student. The student sought help because she was experiencing chaotic emotions and thinking, frequent crying, constant fear, withdrawal from social activities, and low motivation for school. She was diagnosed with depression disorder and referred for counseling. By establishing a secure relationship, mirroring, and containing, the counselor assisted the student to gain selfawareness, understand and differentiate herself from others, and to narrate and recover from her trauma. Results: Through 42 counseling sessions over a year, the student gradually transformed the relationship between herself and her trauma. Her self-awareness and selfconfidence were enhanced. She regained motivation in school, and the ability to build relationships with others. Conclusions: Attachment trauma with the main care-giver can be healed by a secure relationship between clients and counselors. Patient’s dysfunctional social relationships can be repaired through counseling. Based on the results of this case study, we propose three indicators of attachment trauma recovery: the patient’s narrations of herself and trauma become coherent and consistent without being overwhelmed by emotions; the patient does not become apathetic to the content of the narration; and, the patient’s sense of security increases and the relationships with the main care-giver and others improve.