遊戲治療空間的重演與修復：從多重迷走神經理論探討治療關係與療癒轉化回應【從多重迷走神經理論的觀點理解兒童中心遊戲治療之治療性設限】

Reenactment & Restoring in the Play Therapy Space: Explored the Therapeutic Relationship and Healing Transformation by the Polyvagal TheorySupervision—A Review of“Understanding the ACT Limit Setting of Child-Centered Play Therapy Through the Lens of the Polyvagal Theory＂

多重迷走神經理論（PVT）解釋與關注創傷經歷反映可能的「積極策略狀態」、「被動策略狀態」，以及「支持情感和社交參與」等三個路徑狀態。不良童年經歷（ACEs）的個體可通過安全的人際關係，以及於內在緊張激發時經驗撫慰等歷程，緩解威脅反應；加上良好的社會參與系統與關係，也可逐步減少創傷反應。本文於回應上銜接兒童中心學派遊戲治療CCPT之創傷介入理念，從設限之關係意涵與多重迷走神經理論之三個支點（階層運作、神經感知與共同調節）等概念，來論述與治療關係相連的重要意涵。並從SECURE架構所提供的綜合性的治療框架，強調在CCPT中建立安全、參與、共同調節、促進自我了解、調節擴展和探索等元素，來探討實務的啟發。亦連結神經生物學理論於兒童內在成因與變化（intra-client）、治療關係與歷程（inter-relationship）、遊戲治療師內在狀態（intra-therapist）系統，以及與脈絡互動意涵（inter-context）等四個層次，延伸探討相關實務應用或實踐反思之適用性。

The Polyvagal Theory (PVT) explains and focuses on trauma experiences reflecting possible“positive strategy state,”“passive strategy state,”and“support emotional and social engagement”as three pathways. Individuals with Adverse Childhood Experiences (ACEs) can mitigate threat responses through secure interpersonal relationships and experiences of comfort during internal arousal, along with good social engagement systems and relationships, gradually reducing trauma responses. This article integrates trauma intervention concepts from the childhood-centered play therapy (CCPT) with the Polyvagal Theory, discussing the important implications of therapeutic relationships in terms of the concept of limits and the three pillars of the Polyvagal Theory (hierarchical operation, neuroception, and co-regulation). It also discusses practical inspirations from the comprehensive treatment framework provided by the SECURE framework, emphasizing elements such as establishing safety, participation, co-regulation, promoting self-understanding, expanding regulation, and exploration in CCPT. It also connects neurobiological theories to four levels: intra-client, inter-relationship, intra-therapist, and inter-context, extending the exploration of relevant practical applications or reflections.