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一例偏执型人格障碍的心理治疗-给力心理
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一例偏执型人格障碍的心理治疗

一例偏执型人格障碍的心理治疗
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发表时间:2015-02-06 14:58:24 365 0 0

一、求助者基本资料

    张佳颖(化名),26岁,女,家族长女,祖籍上海,并在沪念完小学教育,后因父亲经商,随家迁居北京,在京完成中学教育。家庭条件优越,极受家族长者宠爱,但父母管教极严,期望其能承担家族产业。

     二、求助者自述(摘自求助者本人写给美龄老师的求助信  

    老师,您好!我在网上遇到一位病友,她说是您给治好的,我在网上听了您的讲座并查了很多您做的案例,我感觉您能帮助我解决问题,我现在很痛苦,不敢出门,什么事情都做不了,我希望老师您能帮助我。我开始讲我的故事了,我好像特别爱不自觉的分析,所以这里面掺杂了好多我自己的分析,我认为是分析的我就用绿色奥!

(一)、显性灾难的开始

    症状最早出现在高一,感觉无助不自信,尤其在宿舍(高一开始住校),胆小,懦弱,窝囊,做事特别小心,怕人生气,甚至连碰一下都害怕人家生气,在宿舍的时候,都不知道什么时候坐着什么时候站着,反正特不自然,自己的所有行为几乎都是理性,几乎没有感性,当时自己还特敏感,多疑,爱嫉妒,所有这些感觉导致自己没有自信,甚至内心深处都看不起自己,高二高三情况加剧,恐惧,痛苦,毫无自信,生活甚至都不能自理,行尸走肉!

(二)、从小成长的环境,经历

    我是整个大家子里的第一个孩子,从小受到的爱特别多,老太爷,老太太,爷奶,爸妈,叔婶,姑,哥姐都特疼我,而我也好像特别乖,反正特别亲,但特怕我爸,他总骂我,只要他不高兴 ,怎么难听怎么骂,咬牙切齿,跟什么似的,总之很恐怖,有人时也不会顾及我的一点面子,(我还有一弟)。他好像认为我们是他生的,就是他的私有财产,他怎么对我们都是理所当然,天经地义,无可厚非的,还有如果10次我和他一块做事,就几乎10次他都会发脾气,特别凶,就是上面咬牙切齿的那种,所以无论哪次我和他一起做事心里都害怕,战战兢兢,结果更做不好,更挨骂,这种特性也延伸到了我和其他人的接触中,还有一个现象,就是别人让我找东西,我都特害怕,恐怕找不到,结果就是经常找不到,我想这和我爸让我找东西我找不到他会骂我是直接挂钩的,有时他在亲朋面前又把我夸上天,夸我踏实,做啥事都特认真,但当时我听了一点也不快乐,只是觉得别扭,尽管好像是事实,现在我觉得我之所以不快乐是因为那些虽然是优点,但他们根本就不是我真正的个性,所以我不会觉得舒服!小时候在家人面前脾气特大,一有点不顺我心的事我就发火跺脚,但在外人面前就发不出去,不敢,很胆小,懦弱,但特善良,对人特真诚,上小学自己没有伴儿一个人都不敢去上学,在学校也是胆小,老实的的角色,一点也不招人喜欢,只有三个发小,一块上学,一块放学,一块玩。

      插一句,就是我爸妈,尤其我妈特重视学习,因为她没上大学很遗憾,她希望我们能圆她的梦,所以从小对我期望特大。

    初中时成绩很优秀,被老师选为班长,特兴奋,所以特上心,特负责,特认真,给人感觉特正直,不徇私,但我现在好像感觉从那时起自己就特别在意别人对自己的看法,连上厕所都不自在,怎么说,连上厕所的一举一动都想让别人认为自己做的得体。对自己要求特别高,那时候,同学羡慕,老师宠爱,学习,体育,书法都很优秀,在学校班里很威风,当时感觉很有成就感,但我感觉在家不好,我爸依然那样,(现在感觉应该是没有被肯定,认可),当时就特担心我们班同学、老师知道我在家的状况。

    到了高中,我当了高一生活委员,高二高三班长,(高二高三被选班长并不是因为我的能力,应该是老师认为我太踏实了吧,又太负责了吧)其实这都是假象,当时我当班干部除了累,没什么好的感觉,只会让自己更自卑,这时对上厕所更觉得不得劲了,高三后半年不得不休学,当时自己都讨厌自己,看不起自己,就想改变现状,改变自己,当时我听到的最多的话就是“江山易改,本性难移”,当时自己坚定到了极点,如果改变不到我想要的感觉,我只有死,当时无论家人怎么规劝,我的决心从来都没有一丝一毫的动摇过,当时有一个感受,人最大的敌人是自己,其次就是亲人。随后的六年,自己时时刻刻每分每秒都在干这件事,我的世界只有这个。

(三)、以前的求治经历和结果

    高二自己实在撑不下去了,向父母求救,去了北京一家心理咨询机构看了一次,感觉不好,没再去,后来去了安定医院精神科,医生给我开药,说是安定情绪的,嘱咐我爸妈一定要让我吃,我看了说明,上面写着治疗精神分裂症的,我特抵触,我当时心里清楚我不是,坚决不吃,我妈都给我跪下了求我吃,我当时没感觉,没感觉,老师,您能体会这种感觉么,当时我感受到爱是一种能力,感受爱也是一种能力,我当时感觉我丧失了这两种能力,因为我妈怎么抱我,我心都是冷的,没感觉,又过了一段日子,我实在撑不下去了,我一天到晚都在屋子里,不敢出去,出不去,我怕见人,我跟我妈说我想去精神病医院住院,就去了,因为当时我走在马路上总感觉别人在看我,议论我,就根据这个,判定我是精分的妄想状态,接着就吃了4年的药,有副作用,一紧张害怕就吊眼,那种感觉特恐怖,就好像身体和精神分离了一样。这期间,我时时在跟自己斗争,因为实在撑不下去了,在中间我自己又去找了好几个心理医生,其中有两个咨询过一段时间,有两年的时间,那两个老师对我很负责任,但我感觉他们都没有能力解决我的问题,最后我选择了离开。

 三、问题诊断

    1、人格障碍,过分追求自我感觉和完美,不允许自己有一丝一毫的不舒服的感觉,以自我的感觉作为自己的行为指导原则;

    2躁狂抑郁,情绪波动极大,而且发作时很难自控;

    3、人际社交障碍,自我封闭,害怕与人接触

 四、心理咨询过程

第一次咨询的时候张佳颖是和她父母一起来的,现在我依然记得第一次见到张佳颖的情形。她身高166厘米左右,有些肥胖,那时候是深秋,上身褐色绒毛衣,蓝色外套,下穿黑色线裤,脚踏不过膝的靴子,双眼深埋在大檐毛线帽内。心理咨询开始前,我们之间有间断的对话,她问了很多我们机构的事情,我能感受得到,她一方面寄希望于在我们这里能解决她多年的心理问题,同时有带有细微的谨慎和深深的怀疑。咨询开始前5分钟美龄老师一走出心理咨询室,张佳颖就迎了上去问道:“美龄老师您看过我给你写的邮件了吧?我的问题您能解决吗?”美龄老师以其一贯的谨慎负责态度回答:“咱们这次咨询后我了解你具体情况后,再给你明确答复你看好吗?”这时候佳颖突然显得很不耐烦,说道:“如果这次咨询后,感到没有效果,那我就不再在您这儿做了”。不过当咨询结束后,佳颖脸上流露出了些许笑容,并预约第二天进行下次咨询。

五、咨询后反馈

    摘用张佳颖自己描述的话说:

    现在很自然,心思都放在具体的事情上,对感觉等虚渺的东西都想不起来去关注。现在心大了,对那些突然冒出来的不好的东西,心里能不去管它,不把它当回事,认为那些都是正常的,没什么。

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本文作者

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公益助人

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长程个案

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续单率

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咨询时
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