在九二一震災後，對災民心理層面所造成的影響最常用的論述是所謂的「創傷後壓力疾患」（Post-traumatic
Stress Disorder，簡稱PTSD），即是災難造成直接的心理創傷，而心理重建的主要任務就被期許為篩檢出高危險群的心理創傷疾患，並進一步治療心理創傷。本文是對前述的論述提出補充與修正，認為災難對心理層面衝擊的地位是「災難做為一個觸發事件」，因為我們發現，對大部分的災民來說，由災難事件所觸發的其他心理層面問題才是災後生活中所關切的，而這些心理層面的問題關係著災後心理適應的品質。在這樣的認識底下，心理重建的原則就必須撇除單純地以遭受創傷壓力的「心理症狀」的角度來看待，而應該拉大視野，擴及到對災民整體生活的關懷。本文除了對災民的心理世界進行分析外，還包括四個主要部分，其一是對心理師在災後心理重建的角色定位及介入方式的反省與建議；其二是發展「災難情結」及「災難現場的心理輻射」兩個假說；其三是提出一個心理重建介入的概略模式及應用；其四是對人為措施的建議。
關鍵詞︰災難、PTSD、觸發事件、心理師、災難情結、心理輻射、心理重建模式
作者簡介︰
李維庭
台灣大學心理研究所碩士 / 行政院衛生署八里療養院臨床心理科臨床心理師
通訊處：（249）北縣八里鄉華富山33號 八里療養院臨床心理科
電話：（02）26101660轉209
傳真：（02）86301776
E-mail：wtpsy@tpts7.seed.net.tw |
The most frequently used discourse about the victims'
psychological dimension after the '921' earthquake
is Post-traumatic Stress Disorder (PTSD): that is,
psychological trauma created directly by catastrophes.
The main task of rehabilitation is then expected
to screen out high-risk psychologically traumatized
population for further treatment. The present article,
however, suggests that, for the psychological difficulties
in such victims, the earthquake is a triggering
event which evokes previous psychological problems
that play major roles in life after catastrophe.
With this understanding, psychological rehabilitation
should not only focus on "symptom" induced by traumatic
stress, but should have a broader horizon in order
to attend to the victims' lives as a whole. Besides
the analysis of the psychological world of the victims,
the present article also includes four other major
parts: first, reflections and suggestions about
the role and intervention of psychologists in the
rehabilitation; second, two hypotheses, "catastrophe
complex" and "psychological radiation"; third, a
model of post-catastrophe psychological intervention;
and fourth, suggestions for government administration.
Keywords: catastrophe, PTSD, triggering events,
psychologist, catastrophe complex, psychological
radiation, psychological rehabilitation |
