時間與意義：疾病、創傷及敘說之交疊構面

Tempora1ity and Meaning: The Discursive Space of Chronic Illness, Trauma, and Narrative

林耀盛(Yaw-Sheng Lin)

《本土心理學研究》 15期 (2001/06) Pp. 221-270

https://doi.org/10.6254/2001.15.221

摘要

本文試圖經由「慢性病」與「九二一創傷」為媒介，探究風險因素下，人類心身狀況的現身情態。本文的立場，是以風險社會的概念為起點，以人類生活根本的存活與認同鋪陳論理的底層，嘗試檢討目前社會建構的有關慢性病與災難創傷之論述，並以「時間性」為軸度來溝通慢性病與創傷的存在受苦性，進而透過時間的肯認到意義的創構所糾結的記憶理路，反思「後創傷狀態」心理社會療癒的可能性。
本研究發現，無論是糖尿病患者或九二一受創者，其所涉及的時間性意涵包括無法理解的過去、改變中的現在、期待的未來。意義感意涵則包括存活者VS．受害者、感念他者VS.責難他者、生活世界的重建VS．生活世界的瓦解。此外，在時間變動不居的樣態下，受創者得以肯認生活崩解的經驗，進而修補創傷記憶的裂縫，將固著的情結記憶轉化為動態的意義建構，而非靜觀其變，方是提供個體療癒的具現脈絡。因此，後創傷記憶建構的真假與想像投射的虛實非關宏旨，如何敘說，遺忘什麼，記得什麼，亦即記憶的見證與想像的置換的象徵性，構連了本文討論時間性與意義感的關係。
總之，本文無論從文獻論梳考掘或田野觀察訪談的交叉徑路，可知從當代風險社會的脈絡出發，引入時間性與意義感的啟動概念，並經由記憶的見證與想像的置換的中介化，得以重塑、釐析人類處身「後創傷」受苦狀態裡尋求存活義理與破繭認同困局的蹇難路程。本文論述的後設理路，是植基於深層同理暸解人類的受苦世界及其療癒的可能性，這般的終極關懷是人文心理學精神的展露，也可說是心理學本土契合性研究具象化的接軌議題。

關鍵字

時間 ； 記憶 ； 敘說 ； 創傷 ； 意義 ； 慢性病

並列摘要

Diagnosis of chronic illness or experience of a major disaster can shatter ones' life beliefs, will to survive, and identity. The goal of this study is to understand the life worlds of disaster victims and people with chronic illness, and to explore the possibility of psychosocial healing in posttraumatic periods.
After encountering chronic illness or disaster, subjects perceived temporality in terms of incomprehensible past, altered present, and expected future. Subjects found that life continued to be meaningful and made psychological growth by understanding their post disaster lives in terms of the constructs survivorhood vs. victimhood, appreciate others vs. blame others, and life world reconstruction vs. life world disruption. Time itself cannot heal post-traumatic experiences. Only when sufferers recognize and transform their deep interpretations of their life disruption events through the medium of memory testimony and imagination displacement, can they reconnect their life worlds and rebuild their identity.
A hypothetical model of posttraumatic psychosocial dynamic processes is proposed in light of the discussion in the psychological and sociological literature and from the analyses of the narrative data.

並列關鍵字

temporality ； memory ； narrative ； trauma ； meaning ； chronic illness

參考文獻

(1995).Beyond trauma: Cultural and societal dynamics.New York:Plenum Press.

American Psychiatric Association(1994).Diagnostic and Statistical Manual of Mental Disorders: DSM-IV.Washington, D. C.:American Psychiatric Association.

American Psychiatric Association(1980).Diagnostic and Statistical Manual of Mental Disorders: DSM-III.Washington, DC:American Psychiatric Association.

Anderson, B.(1991).Imagined Communities: Reflections on the Origin and Spread of Nationalism.London:Verso.

Andreasen, N. C.(1995).Posttraumatic stress disorder: Psychology, biology, and the Manichaean warfare between false dichotomies.American Journal of Psychiatry.152(7)