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合理情绪疗法治疗偏执型人格咨询案例-给力心理
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合理情绪疗法治疗偏执型人格咨询案例

合理情绪疗法治疗偏执型人格咨询案例
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发表时间:2015-02-06 14:37:49 277 0 0

基本情况:葛红,女,18岁,是农村某重点高中的一位三年级学生,由母亲陪同来心理咨询室就诊。她低着头坐了好久,才慢慢地叙说了最近在宿舍里发生的一件不愉快的事。 上周六的晚上,外面下着毛毛雨,同学们都没去教室看书。有的织毛衣,有的聊天,她躺在床上看小说。寝室内不停地回荡着收音机里传出的《涛声依旧》的歌声……大家都沉浸在紧张学习之余的轻松气氛中。 忽然,她猛地从床上爬起,跳到地上,声嘶力竭地对坐在她下床正在谈话的两个同学说:"你们凭什么在议论我?今天非把这件事情搞清楚不可!"这话说得那两个同学丈二和尚摸不着头脑,其他同学也都跟着紧张起来。 寝室长急中生智,建议把说话和听话的三个当事人分成三组,各设一名同学记录,分别到三个寝室,临时搞个"三堂会审"。然后再回到本寝室来,当众公布三组的记录。结果两组说话人的记录内容基本相似,她们说毕业后要报考医学院校,家长也希望自己能当个大夫。听话人的记录内容与此不同,她听到的是:"大夫说她有些神经质"。原来,前些天她们去县医院进行高考体检,在化验室采血时,她和护士发生了口角,主任医师说了她一句"神经质"。为此,她和那位主任医师吵了一架。今晚,她只听到下床两个同学说到"大夫"二字,就以为是议论她在医院里的那件事,于是便质问了那两个同学。 经过"三堂会审"真相大白了,寝室里的风波平静了,可同学们都感到很委屈,她也觉得自己太多疑了,就到心理咨询室来求助。 她母亲又接着说:这孩子小时候就过于敏感、多疑。在小学读书时,一天放午学回家吃饭,她和姐姐的面条碗里各放一个荷包蛋。可她硬说姐姐碗里是两个鸡蛋。妈妈怎么解释她都哭闹不停,后来,到底还是把姐姐的那碗面条又倒在锅里,她用筷子翻腾半天,直到发现有两个半拉鸡蛋时才罢休。 她母亲还说,她从小就不合群,无论在家里,还是在外边,总爱和别人发生矛盾,人际关系很紧张。现在长大了,自己意识到了这个问题,也担心是否精神上有毛病,请老师好好给看看。

【治疗】: 第一次,采用了合理情绪疗法(简称RET)。 治疗者:你认为是什么原因使你经常处于这种情绪状态? 来访者:主要是和同学没处好关系,因为一些琐事就和同学发生矛盾,搞得同学关系很紧张。 治疗者:这些事情我们称为生活事件或诱发事件,但它们并不是引起你负性情绪的直接原因。 来访者:那么什么是引起我脾气发作的原因呢? 治疗者:是你对那些诱发事件的认识。一个人对他生活中发生的大大小小的事件都会有些看法,有的是合理的,有的是不合理的,不同的认识会导致不同的情绪状态。如果你能认识到自己现在的情绪状态是一些不合理的认知所造成的,你才能控制自己的情绪。 来访者:真会这样吗? 治疗者:我们来举个例子。假若一个星期天,你在学校附近的饭店里吃早点,这时走进来一个人坐到了你的旁边,不小心把你的稀饭碰洒了,你会怎样? 来访者:我一定会很生气,这个人怎么这样没礼貌。 治疗者:如果我告诉你他是个盲人,你又会怎样呢? 来访者:那我会谅解他,就不会生气了。 治疗者:你看,同一件事,由于有不同的认识,就会产生不同的情绪。所以,对事物的认知,才是引起情绪的真正原因。 来访者:你说得很有道理。 治疗者:你在学习生活中遇到的那些事,别的同学也可能遇到,但别的同学不一定都像你现在这样子,你说这是怎么回事? 来访者:难道是我和他们的认知不一样吗?可我还没看出我对那些事件的认识有哪些不合理的地方。 治疗者:这正是我们下一步要讨论的问题。冷静地想一下,你和同学的关系为什么很紧张? 来访者:有些人总爱挑我的毛病。 治疗者:你有什么理由不让人家挑你的毛病呢? 来访者:老师,你好像在为他们辩护,难道他们那样对我就有道理吗? 治疗者:这不是为谁辩护的问题。你可以希望人家不挑你的毛病,但你无法要求人家不挑你毛病。因为你总想要求别人如何,但别人又做不到,所以你才像现在这个样子。 来访者:对别人不能提出要求吗? 治疗者:和人相处有个黄金规则,就是"像你希望别人如何对待你那样去对待别人"。你对待同学们的观点符合这个规则吗? 来访者:好像不是一回事。 治疗者:其实你把这个规则用反了,一般称为"反黄金规则",即我如何对待别人,别人就应如何对待我。这是对他人一种不合理的信念,一种绝对化的要求,因为我们无法要求别人必须为我们做什么。如果我们把对别人的"要求"变成"希望",当我们不希望的事情发生时,最多是一种失望,不会过分地怨恨别人,自己也就不会烦恼了。 来访者:老师,你讲得很对,但我担心自己做不到这点。 治疗者:你的这种人格障碍是长期形成的,要想很快改变它是很困难的。但是只要坚持在实践中不断改变,从一点一滴做起,出现反复不要灰心,贵在坚持,一定会达到理想效果的。 来访者:谢谢老师,我决心改变自己的不良人格,以后出现什么问题,还请老师多指教。 第二次,采用的是音乐疗法。 一个月后,她又来到心理门诊室,说自己的认知改变了,情绪好多了,和同学相处也开始出现了新的局面。我们又建议她每天利用休息时间听10--15分钟音乐,在情绪低沉时也要听一会儿音乐,使自己经常保持合理的情绪,这样有助于正确处理人际关系问题。 半年后,她从某大学来封信,说自己的毛病好多了,在大学里生活得很快活。自己看了不少有关心理治疗方面的书,并表示决心坚持矫治自己的人格障碍。

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本文作者

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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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