憂鬱症患者在團體治療中之人際互動模式

目的：藉由探討憂鬱症患者在團體內的互動模式，了解憂鬱症患者之人際互動模式及內在心理運作。方法：以民國94年7月至11月間，某精神科學專科教學醫院門診，參加人際互動團體心理治療之七位憂鬱症患者為對象，其均符合重憂鬱症之診斷。團體為封閉式，共進行十六次。質性分析固體逐字稿內容。結果：固體人際互動模式可歸納為七種，其中「人際易受傷而自我保護的蠍子」、「只關心別人的喜鵲」、「活在別人眼光下的小白兔」、「無法拒絕別人的水牛」、「羞於與人競爭的蝴蝶」、「尋求良人依靠的無尾熊」之六種類型，他們共同的特徵為眨損自我、自我消失、你大我小、自我輕視及自卑：他們的自我均變得很小，人我之間的關係很不對等。但「盛氣淩人自我中心的鬥雞」之第七類型，他所展現的行為則是較為相反的模式，他的自我變得過大，過度重自己的需求，而輕忽別人。結論：以上的七個模式可以再歸納出一個共同的特質就是『輕』，他們不是輕忽自已，就是輕忽別人。導致他們無法以比較符合現實的狀態來看待其與和他人的人際互動，因此造成很多的人際不適應，也逐漸累積人際壓力，終致憂鬱症的發生和復發。

關鍵字

團體心理治療；人際互動；憂鬱症；模式

並列摘要

Objectives: Attempting to recognize the patterns of interpersonal interaction and intrapsychic process among depressive patients in group psychotherapy. Methods: There were 7 subjects in an interpersonal interaction group for depressive patients who all met the diagnosis of major depressive disorder. This particular group was close and run for 16 sessions at the OPD of a teaching mental hospital from July, 2005 to November, 2005. The content of tape-recording was transcribed verbatim, and subsequently analyzed with the method of qualitative research. Results: The ensuing following 7 interpersonal interaction patterns were abstracted as follows: 1. ”a scorpion who is easily injured in the relationship with others, and resulted in self-protection”, 2. ”a stork who are only concerned about others”, 3. ”a small white rabbit who lives in others' eyes”, 4. ”a buffalo who is unable to refuse others”, 5. ”a butterfly who is too bashful to compete with others”, and 6. ”a koala who seeks a dependable one”. They have common characters, such as self-devaluation, disappeared-self,” others being big and I being small”, self-neglect and inferiority complex. The ego of the aforementioned 6 patterns has become prominently weakened, and their relationship with others has been unequal. However, the seventh is the pattern of an ”over-confident and egoistic cockfighting” that has manifested a behavior of which the interaction pattern has been opposite to the other six patterns as illustrated above. Namely, his ego has been too expanded; he excessively emphasized his needs and neglects others. Conclusions: The aforementioned 7 interpersonal interaction patterns are concentrated with a common quality, ”neglect,” which means they neglect either self or others. The ”neglect” leads the patients to become unable to treat the interaction with other people in reality. Consequently, it renders not only many interpersonal maladjustments, but also lead to the occurrence and recurrence of depression due to the gradual accumulation of interpersonal stressors.