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  • 學位論文

實習諮商心理師面對案主自殺經驗之敘說研究

Narrative analysis on counseling psychology interns dealing with the experiences of clients suicide

指導教授 : 李佩怡
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摘要


本研究旨在透過實習諮商心理師之生命敘說,探討其在面對案主自殺過程中之經驗內涵、主觀需求與調適型態,並瞭解此事件對其個人生命及專業發展的影響。本研究以三位曾遭遇案主自殺經驗的實習諮商心理師為研究參與者,採用敘說研究方法,藉由故事的呈現讓研究參與者的經驗現身,並以「整體─內容」及「類別-內容」兩種方式進行資料分析,研究結果與發現如下: 一、在與自殺案主晤談的過程中,實習諮商心理師付出了關懷的代價,經歷獨特的角色身份而來的剝奪經驗,以及自殺情境引發的死亡焦慮;當遭遇案主自殺時,實習諮商心理師呈現出兼具遺族與專家角色的悲傷內涵,並透過心理交易(bargain)來回應自殺事件的衝擊。最後,案主自殺後的生死狀態,也可能是無從得知的,使得實習諮商心理師陷入曖昧不明的失落與懸而未決的悲傷之中。 二、隨著案主自殺經驗中各個階段的脈絡發展,實習諮商心理師也衍生出不同的主觀需求與調適型態。剛開始接觸到自殺危機時,他們需要危機處理的專業知能,並在助人關懷與自我照顧之間取得平衡。當展開晤談歷程後,實習諮商心理師則需要持續敏覺自己的情緒狀態、安全接納的支持環境和實習系統的整體資源,以協助他們因應沈重的危機壓力與自我照顧。當經歷自殺事件後,實習諮商心理師在創傷初期需要有人陪伴,知道自己並非獨自一人面對,接著需要釐清對自殺事件的困惑、從混亂中重拾秩序感,以及內外在資源的積極介入;藉由反覆書寫和敘說、完成心中的未竟事務、將關係轉化為內在連結、重建個人的生活步調與模式四種型態,則反映出實習諮商心理師因應自殺衝擊的調適歷程。 三、經歷案主自殺事件後,實習諮商心理師原有的信念也隨之解構與重新建構了。他們看見諮商並非全能的拯救而是有限度的助人,開始發展出對自殺危機的積極處遇與專業認同,並重新整合對自殺案主的助人信念。同時,他們重新省視個人對於死亡的態度與生命的價值觀,從對生命的覺察和體認中轉化為實際的行動,看見活著與死亡是一體的兩面,而逐漸學習與死亡共處。 最後,根據本研究結果與發現,針對實習諮商心理師、學校教育訓練系統、實習機構及未來研究方向提出相關的建議。

並列摘要


The purpose of this study was to explore the counseling psychology interns’ experiences, subjective demands and adjustment process when they dealt with clients’ suicide and to understand the impact of those cases on their personal lives and professional development. In this study, participants was three counseling psychology interns who have experienced clients’ suicide. The narrative analysis method is used and through the presentation of the story made that the experiences of the study participants appeared. The methods “ holism-content” and “category – content” are both used to analyze the data, the results and findings are as follows: 1.In the process of suicide cases interview, counseling psychology interns paid the cost of caring, who had disenfranchised grief experiences through the unique role and also experienced the death anxiety caused by the suicide situation. When the clients suicided, the counseling psychology interns showed grief of the bereaved families and specialist, and also responded to the impact of suicide through bargain. At the end, the counseling psychology interns probably cannot know whether their clients were dead or alive after suicide, it made them drop into the ambiguous loss and unresolved grief. 2.With the context developments of various stages of clients' suicide experiences, the counseling psychology interns also had different subjective demands and adaptation states. At the start of contacting suicide crises, they need professional knowledge to deal with crisis intervention and keep the balance between helping others and self-care. Once the counseling began, the counseling psychology interns have to keep sensitive their own emotional states, it is necessary to have an overall safety and supportable environment and also an internship system resource to assist them in response to the heavy pressure from the crisis and self-care. After experienced these suicide cases, the counseling psychology interns need companions in the early trauma and bear in mind that they are not alone to face the situation. After that they need to clarify the confusion of the suicide cases, in order to regain the order from chaos and positive intervention from intrinsic and extrinsic resources. There are four steps that reflect the counseling psychology interns' adaptation processes in response to the suicide impact:(1)repeatedly writing and narrative;(2)Accomplishment of unfinished business;(3)Transfer from the relationship to inner link,(4)Rebuilding the personal pace of life. 3.After experienced the suicide cases, the original faith of the counseling psychology interns will be deconstructed and reconstructed. They saw that the help that they could provide is not almighty but limited, then they started to develop professional identify and positively dealing with the suicide crises, they also re-integrated their belief of helping suicide clients. At the same time, they re-inspected their own attitude toward death and life's value, transformed their awareness of life into a real action, and they gradually managed to coexist with death seeing that the death or being alive are two sides of the same coin. Finally, according to the finding and results of this research, researchers will have some advices to the counseling psychology interns, school training systems, internship organization and other future researches.

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