收斂與發散之間：從雙極性疾患病友的生命故事找尋復元的曙光

Between Divergency and Convergency: To See the Recovery Dawn from the Life Stories of Inpatients with Bipolar Disorder

黃秀文(Hsiu-Wen Huang)

指導教授 ： 蔡篤堅

共同指導教授 ： 黃嬡齡

臺北醫學大學/醫學院/醫學人文研究所/碩士(2008年)

https://doi.org/10.6831/TMU.2008.00003

摘要

本研究利用敘事取向口述歷史的方式，針對情感型疾患病友做訪談，這三位病友之診斷別為雙極性疾患。要了解精神病友的生病經驗，若非親自體驗擬像真實的奇異過程，唯有通過病友的口說或文字，將其記憶與經驗呈現出來。長期以來，種種有關精神病的誤解與歧視，最直接的因素就是源自於不了解。透過口說轉化文字過程呈現病友生命故事重要細膩的內涵，除使病友能夠透過口述歷史訪談經驗回溯、思考、再現的過程去獲得認識自我機會；過程中所產生的知識也滋養了科學與人文的領域，促成對精神病友的再認識。

研究結果：一、單一價值與多元行動的創造性追尋：病友早年因為情感支持結構的不穩定或缺乏，希望獲得一種社會網絡中穩定的位置及安定的連帶。單一的目標以多元發散方式追求，展現生命中種種具有創造性的生產力，反而將自身在人際之中的位置推得更遠，並進入一種精神疾病的經驗之中。二、精神病患的新身分與衝擊：初期精神疾病的治療對病友而言，只不過是從社區轉換到機構，一種場域不同的狂亂而已。三、趨於穩定單一價值的再現：然而因為疾病的緣故而獲得警醒與沉澱的機會，終將難以駕馭的發散行為漸漸收歛於單一，也因這般的體認，對於復元之路，照見了彼端的曙光。四、來自醫療機構的對話：重新詮釋後的治療性社區是一種良性的反思與轉向。

關鍵字

雙極性疾患、口述歷史、敘事認同、病識感

並列摘要

This study is to understand psychiatric patients’ ingoing and pectoral experiences of affective disorders in their real world and fantastic episodes. The narrative-approaching oral history method is used to interview three inpatients with bipolar disorder at the Yu-Li Veterans Hospital in Hualien. It is the only way to ascertain the essence of falling ill by listening to the inpatients’ utterance, in order to achieve the empathetic understanding of the unique manic and depressive processes in each patient. In addition the exquisite connotation of inpatients’ life stories could be found to avoid ever-evident misunderstanding and discrimination, from which these patients have been suffered for quite a long time. By taking oral history approach, these inpatients regain the chances of self-reflection by telling, recalling and rethinking their own bygones, and, furthermore, this research project will also nourish the fields of science and humanities.

Major findings of this study include: First, these cases had tried creative but seemly impractical means in pursuit of building a stable emotional supporting system and secure bond to their kith and kin before their morbidity; however their efforts turned out to be futile and disappointed. Second, their initial hospitalization and subsequent sick roles brought them into a more delirifacient situation, a strange and desperate place with no healing hope. Third, in a long-term rehabilitation institution, the Yu-Li Veterans Hospital, these inpatients made efforts to restrain their divergent thoughts and behaviors and could successfully develop coping strategies with their illness and look the past straight in their eyes. As a result, we will find the Yu-Li Veterans Hospital as “the therapeutically community”, which is a better transitional model for community-based rehabilitating program.

並列關鍵字

bipolar disorder, oral history, narrative identity, insight

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