論妄想之醫學定義與人文關懷

On Medical Definition of Delusion and Humanistic Concern

林國慶(Kuo-Ching Lin) ； 廖鳳池(Feng-Tsu Liao)

《高醫通識教育學報》 5期 (2010/12) Pp. 48-63

https://doi.org/10.6453/KMUJGE.201012.0048

摘要

妄想一詞同時具有臨床意義或生活經驗之精神意向性，為人們普遍使用的名詞、形容詞或動詞。自有臨床妄想定義迄今，有關的爭議不斷，現行之定義概念不免被抨擊為一種實用性與方便性上的妥協，欠缺認識論上的清楚明晰性，宜重新檢驗與建構。本文評析近代有關之醫學、心理學領域之見解與辯證，試從人類生活經驗中反思妄想症狀背後隱含的精神意涵，其中包括宗教、文學、哲學等面向所指涉之人文關懷，所審視之命題由妄想之定義出發，然後延申至學者傾向抱持的假設與態度，進而引出治療進路之邏輯基礎。本文的討論有助於醫者以全人觀點去面對此人類特有之精神產物或病變，以利理解當事人的精神世界。

關鍵字

妄想 ； 醫學定義 ； 人文關懷

並列摘要

The meaning of delusion imply either clinical significance or psychic intentionality in our ordinary life experience, it is a very common word used as a noun, adjective, or verb. It has been a long time from the start to define the symptom, yet the controversy about the definition does not end till nowadays. The current definition in DSM-Ⅳ was depreciated for its compromise of pragmatism and convenience, lack of clarity of epistemology, and need to be examined and redefined. The article reviewed and commented on the early-modern major hypothesis of psychiatry and psychology about delusion, and reflected on the deeper dimension of the symptom with a stance on human life experience. What was discussed include religious belief, literary works, and philosophical propositions, all related to humanistic concerns. The commentary involved the definers' hypothesis and attitudes to the phenomena, and consequential treatment approach, and aids medician in encountering the very unique psychic phenomena with a holistic view.

並列關鍵字

Delusion ； Medical definition ； Humanistic concern