哀悼時刻：照顧者從臨床陪伴到「後臨終」情感現象的心理轉化經驗

The Temporality of Mourning Processes: Caretakers’ Psychological Affective Experiences

研究目的：以心理適應觀點而言，哀悼涉及病理到復原的歷程。本文進一步以家庭關係與存有脈絡探討，探究喪親者的主體經驗。研究方法：以文獻批判法與現象還原閱讀，擱置心理病理概念進行解析。研究結果：喪親者的主體經驗包含「死後身體感知與夢境敘事」、「位格保留」、「與逝者的夙緣關係」、「文化與宗教信念」、「空間與時間的流轉」和「倫理絆轉向」。以家庭關係來看，置身安寧病房，病人或家屬保有「留一口氣回家」習俗，背後反映出臨終處境所感到無居家感、流離失所；藉由回家找到日常性的熟悉，由此對抗臨終處境所產生的生活失序與陌生。經由熟悉與陌生迴路的交接，使病人安撫面對死亡的恐懼。本文認為，喪親不僅是個體哀悼經驗，更是家人關係的召喚。研究結論：本文暫時性提出哀傷時刻沒有終結，而是一種超越「內化」與「外化」的「默化」現象。回返文化默會的實踐智慧，無論理學、經學或心學，乃至儒釋道，都是華人潛移默化的日行實踐，是在日常事上磨工夫的修養論。或許，這樣的默識不易察覺，但這是回到受苦處境的源頭，而非陷溺認知系統的漩渦的生命體驗。透過現象還原，顯示死亡作為一種本成事件，哀傷是有所彰顯的情感反應，更體現深刻化的倫理關係意涵。

Purpose: The mourning experience of a bereaved person involves psychopathology and healing. A few studies adopted the adaptive view to explain the process. This article explores family affective bereavement experiences from the existential approach. Methods: Critical literature reviews to related studies were used and bracket the taken for granted viewpoint to explore the alternative possibility to comprehend the affective phenomenology. Results: We found that the experience of bereavement entails 6 elements: body perceptions and dream narratives, personhood identity reservations, remnants of existing relationships with the deceased, cultural and religious beliefs, transference of space and time, and ethical bond dilemmas. In Chinese societies, there is a custom of dying at home. In dying, the meaning of existence is challenged. If a patient is in hospice care and they return home, they find familiar routines and feel ontological security, which helps them remain strong in the face of the disorder of dying. Returning home may soothe patients with a fear of death. We argue that bereavement is not only an individual mourning experience, it also constitutes an ethical conflict to families. Conclusion: We tentatively conclude that mourning is an implicit phenomenon. It requires self-cultivation in order to carry out daily activities. This tacit knowledge is not easy to identify, but it can be a route for identifying and addressing the root of suffering that is superior to explanations based in cognition.