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严重抑郁症的治疗-给力心理
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严重抑郁症的治疗

严重抑郁症的治疗
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发表时间:2015-02-06 13:51:35 325 0 2

一、收集资料:

(一)、基本资料:女性、55岁、事业单位退休会计、一个儿子已经成家,和退休的丈夫一起生活。

(二)、我的观察:情绪低落、表情焦虑、局促不安。

(三)、患者主述:有个人在指挥她,让她干这干那,不听他的就会报复她家人,让她孙子尿绿色的尿,还说她的行为都是他安排的,她身体哪里不舒服,都是他弄的,有时说是仙家,有时说是狐。这个声音加上身体的不舒服折磨的她什么都干不了,茶饭不思,睡眠障碍。

这个案例有些棘手,因为她出现了明显的幻觉,按常规的诊断就应该考虑“精神分裂”了,我经过认真的询问,慎重的分析最终诊断为严重的抑郁性神经症。当时我的助手劝我不要接这个案例了,我也犹豫了,后来我经过了一番心理斗争还是接下了这个案例。我的理由是如果我不接,在当地其它咨询机构不可能有人接。她就得去精神医院就诊,精神医生的环境和精神医院的治疗方式真的会把她脆弱的心灵摧残成精神分裂。

我介绍了我机构的基本情况、我的咨询设置、工作性质、保密原则以及收费标准。双方协商同意开始治疗。

 二、摄入性会谈:

我:你的症状发现多久了。

求助者:最近一个多月了。(她又把主述的症状复述了一遍)。

我:在什么样的情况下最严重。

求助者:越静的时候越严重,有一个声音出现时,我就会不由自主的和他对话;当我在做什么事的时候,他总说是他安排我做的,我不做时他又说会惩罚我的家人;当我一起心动念时,他就批评我,你修的是什么佛呀。

我:你修佛多久了。

求助者:我修了很多年,可是越修越觉得离佛越远,越修越困惑。

 三、心理测量:

我的助手为她做了mmpi明尼苏达正常与异常人格测试、sds抑郁症测量,都符合我的诊断。

 四、正式治疗:

(一)、采用认知疗法

和她聊她的生活、工作,从中找到她思维模式和认知的局限。

1、她做会计期间,工作非常认真,就怕出错,每天晚上回家都要回顾一天的工作,就怕出现错误。

2、后来开始信佛,认师傅,她的信佛信的非常虔诚,也非常曲折,认了几位师傅,但几位师傅的观点不一致,使她更加迷茫,每日提心吊胆,就怕哪儿修的不对了,哪儿犯错误了。

3、在她儿子高考时,她的情绪异常的焦虑,担心这儿,担心那儿,都快撑不下去了,好在儿子考的不错,才慢慢的缓解了情绪。

根据她以上的三点叙述我做出了如下的判断:

1、她的性格是焦虑性人格,追求完美、缺乏安全感、缺少自信。

2、她信佛信的有些偏执了。

有了治疗的目标,我们就开始研究治疗方法。

1、我和她聊她的童年,她在家排行老二,有一个姐姐,一个弟弟。爸爸脾气很暴躁,姐几个都很怕他,姐姐、弟弟和爸爸关系不好,他 们不听爸爸话,经常受到打骂,我小的时候很乖,会来事儿,看到爸爸时我就主动找活干,学习还比他们好,所以我基本不挨打。妈妈很和 蔼。我给她讲,这样的环境、这样的生活经历会形成什么样的性格,她非常的赞同,确实符合她的性格。她的性格中过分谨慎,又力求完美,非常害怕出错,所以她这么多年来一直生活得很紧张。她知道了自己的问题主要是出在了她的人格上了,愿意修正自己的人格,我们开始用艾利斯的理论来破解她的思维模式,凡事都不能做到极致,也不能要求自己完美,打破非黑即白的思维模式,追求自己想要的,不如珍惜眼前拥有的。

2、和她讨论如何修佛,讨论是否有佛、是否有鬼神。一点点的瓦解她多年来形成的神鬼、祸福理论。她最后的焦虑就是在这方面产生的她就怕自己信的不够好,得罪了鬼神,受到惩罚,甚至起心动念都觉得是罪过,长期的神经紧张,产生了幻觉。

(二)、运用行为疗法

1、立即停止以前的佛事活动,不再相信外在的事物能够救赎自己。
2、每天都做一些家务,帮儿子看孩子,让自己的退休生活越来越有价值感。

3、每天要安排一定的时间休闲、健身、多参与社会活动,别让自己身体闲下来。

4、抛弃自己的不良认知,弱化自我,什么事都尽量听老伴的,听儿子的,装糊涂。

5、放下自我,把老伴、儿子、孙子放在心上,在为他们服务的过程中享受幸福快乐。

(三)、使用意象技术

在每次的治疗中我都要使用意象技术。

1、破除她潜意识中的旧有信念、记忆、感知。

2、帮她去感知新的事物、新的内心体验。

3、把她潜意识中的不良情结又重新的做个解释,用她自己的合理化接受。

(四)、使用冲击疗法

在我的指导下她去尝试过去从来不敢做的事,(比如:吃点肉、和老伴亲近、接受别人的爱、穿一些时尚的服装等等),在不断的尝试、不断的突破当中,她找到了自信,找到了乐趣。

经过了三个月的治疗,她的情绪基本稳定了,社会功能也基本恢复了,家庭气氛也和谐了,笑容多了,人也胖了,她的儿子 非常感激。我把她转到了我的个人成长课堂来学习了,她还能用自己的成长经验去帮助别人了,看到了她的喜悦与成就感了。

 

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本文作者

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0岁
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公益助人

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收费助人

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长程个案

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续单率

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咨询时
0 性价比

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