創傷兒童之主要照顧者替代性創傷初探

Preliminary Research on Vicarious Traumatization of Caregivers

李慧芳(Huei-Fang Li)

《輔導與諮商學報》 43卷2期 (2021/06) Pp. 59-87

https://doi.org/10.3966/181815462021064302003

摘要

主要照顧者的替代性創傷（vicarious traumatization），來自於因密集的與受照顧者的互動，目睹或感受到受照顧者痛苦、無助，長期身處受傷害的感受中，開始有了重複經歷或想像自己的小孩受創傷的畫面，造成過度同理，同時心理開始有耗竭感，這樣的替代性創傷經常發生在創傷救助工作者。本文整理替代性創傷相關文獻，並以質性研究探討兩位具創傷經驗的兒童之主要照顧者為例，了解其替代性創傷的各項情緒跟行為，以及親子互動關係。研究結果發現高度責任感、低自尊、想法遲疑、壓抑之主要照顧者，以及當主要照顧者感受兒童的消極、內向壓抑面，較容易誘發替代性創傷的可能，他們之間形成相互矛盾的互動方式，且又互相加深對方用矛盾的方式應對。研究最後提出主要照顧者因應的策略：增加對加害者感受的覺察、增進辨識替代性創傷並且接納自己的感覺、避免過度苛責孩子受創之細節、與孩子建立適度界線、提升對自我人格特質的了解、尋求社會支援等，能幫助預防替代性創傷之形成。

關鍵字

主要照顧者 ； 兒童 ； 性侵害 ； 替代性創傷 ； 暴力

並列摘要

The vicarious traumatization of the caregiver comes from a long period of the intensive interaction with the victim during which the caregiver witnesses or feels the victim's pain and helplessness. The long-term feeling of being hurt causes the caregiver to start repeatedly experiencing or imagining their own children being traumatized on their mind, which further leads to the caregiver being overly empathetic and meanwhile with a growing sense of exhaustion. Such vicarious traumatization often occurs in trauma rescue workers. This article collated literature on vicarious traumatization, and adopted qualitative research to explore the two caregivers of children with traumatic experience as examples. The research results found that caregivers with high sense of responsibility, low self-esteem, negative thoughts, and depression, as well as dependence etc., are likely to induce vicarious traumatization, and there is a contradictory interaction between caregivers and tramatised children. Finally, the research also proposes strategies for the caregiver to increase the awareness of the feelings, enhance the identification of vicarious traumatization, accept their own self, avoid excessively criticizing traumatized children, establish boundaries with children, understand the personality traits of themselves, and seek social support to help prevent the caregiver from developing vicarious traumatization.

並列關鍵字

caregiver ； child ； sexual assault ； vicarious traumatization ； violence

參考文獻

黃雅筠（2018）：社工工作人員悲憫疲憊之初探－以大台北地區從事老人日間照顧與居家服務領域為例〔未出版之碩士論文〕。國立台灣師範大學。https://doi.org/10.6345/THE.NTNU.GSW.003.2018.F04

邱琇琳（2005）：專業助人者的替代性創傷與因應策略：以公部門家訪社工為例 〔 未出版之碩士論文 〕 。 國立台灣大學 。 https://doi.org/10.6342/NTU.2005.02165

Banyard, V. L., & Englund, D. W. (2001). Parenting the traumatized child: Attending to the needs of nonoffending caregivers of traumatized children. Psychotherapy: Theory, Research, Practice, Training, 38(1), 74-87. https://doi.org/10.1037/0033-3204.38.1.74

Brown, L. S. (2011). [Review of the book Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors, by L. A. Pearlman & K. W. Saakvitne]. American Journal of Clinical Hypnosis, 38(4), 298-299. https://doi.org/10.1080/00029157.1996.10403354

Byrne, M. K., Lerias, D., & Sullivan, N. L. (2006). Predicting vicarious traumatization in those indirectly exposed to bushfires. Stress & Health: Journal of the International Society for the Investigation of Stress, 22(3), 167-177. https://doi.org/10.1002/smi.1092