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研究生: 陸怡安
Lu, Yi-An
論文名稱: 關係創傷之療癒-EMDR運用於解離反應之個案研究
The Healing of Relational Trauma-EMDR Case Study of Dissociation
指導教授: 鄔佩麗
Wu, Pei-Li
學位類別: 碩士
Master
系所名稱: 教育心理與輔導學系
Department of Educational Psychology and Counseling
論文出版年: 2016
畢業學年度: 104
語文別: 中文
論文頁數: 285
中文關鍵詞: EMDR關係創傷解離
英文關鍵詞: EMDR Therapy, Relational Trauma, Dissociation
DOI URL: https://doi.org/10.6345/NTNU202203611
論文種類: 學術論文
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  • 本研究目的在探討EMDR運用於關係創傷之解離當事人之治療成效,採質性方法之多個案研究設計,研究對象為兩位出現解離人格部分,呈現情緒、行為和特質轉變並有控制困難之當事人。本研究之治療介入由一位EMDR治療師進行,依循EMDR標準治療程序,依相關研究建議做調整。研究者蒐集治療師之晤談紀錄、研究者觀察紀錄、訪談紀錄及當事人提供之相關文件等質性資料,進行當事人之生命故事、治療歷程與改變分析。
      研究發現,研究參與者於EMDR治療後,解離部分皆有所融合與統整,過往創傷記憶帶來的情緒困擾已大幅降低,對自己有較正向觀點,於治療中找到自我安撫的能力,面對挫折的能力提升,並轉化創傷帶來之衝擊成為自我成長的養分,對未來生活更有信心與他人的互動關係亦獲得改善。六個月後的追蹤訪談顯示結果仍持續。最後對未來研究及實務提出進一步建議,以供參考。

    關鍵字:EMDR、關係創傷、解離

    The purpose of the study was to explore the applicability and efficacy of EMDR with relational trauma and dissociation. Subjects were two clients who shows signs of dissociative part, having compulsive behavior and sudden shift of emotion, behavior and attitude. It’s a multiple case study expanding the current study of EMDR through the use of qualitative approach. The treatment was administered by an EMDR therapist following the adaptive EMDR standard protocol. Description of the life story, related treatment procedures and changes were analyzed from clinical records, observer’s records, interview of the clients, and the documents provided by the clients during and after the treatment.
    The results show the impact of significant improvement on the clients, such as the integration of dissociative parts, the decreasing of emotional and compulsive behaviors, the disappearance of the disturbance, the self-concept turned more positive from negative, more easily to sooth themselves when feeling frustrated, more energy to release from the overwhelming past experience, standing firmer toward future life, and getting along well with other. Results maintained after 6 months follow-up. Based on the results and discussions, further clinical and academic suggestions are proposed.

    Keywords: EMDR Therapy, Relational Trauma, Dissociation.

    致謝詞 i 中文摘要 v 英文摘要 vii 目次 ix 表次 xi 圖次 xiii 第一章 緒論 1 第一節 研究動機與目的 1 第二節 研究問題 6 第三節 名詞釋義 6 第二章 文獻探討 9 第一節 關係創傷 9 第二節 解離現象 23 第三節 EMDR治療的理論與應用 34 第四節 EMDR運用於關係創傷之解離反應 43 第三章 研究方法 53 第一節 研究取向與設計 53 第二節 研究參與者 55 第三節 研究工具 59 第四節 研究程序 60 第五節 資料分析策略與步驟 65 第六節 研究之信效度考量 72 第七節 研究倫理 74 第四章 研究結果 77 第一節 白龍的面具 77 第二節 龍族的守護 145 第三節 綜合分析與討論 228 第五章 結論與建議 251 第一節 結論 251 第二節 研究限制與建議 252 參考文獻 259 中文部分 259 英文部分 260 附錄 267 附錄一 研究邀請函 267 附錄二 研究同意書 268 附錄三 治療紀錄引用同意書 269 附錄四 訪談大綱 270 附錄五 「心理診斷初次會談」紀錄表 272 附錄六 「建構並促進平靜與安全的場所」練習單 274 附錄七 EMDR練習作業單 276 附錄八 正負向認知範例 280 附錄九 DES量表 282

    中文部分
    王豐彬譯(2007):人際關係與大腦的奧秘(原作者:Siegel, D. J.)台北:洪葉。(原出版年:2002)
    朱品潔(2011):個人失落與EMDR之介入:個案研究(未出版之碩士論文)。國立臺灣師範大學,台北。
    周海濤、李永賢、張蘅譯(2009):個案研究:設計與方法(原作者:Yin, R. K.)。(原出版年:2003)
    尚榮安譯(2001):個案研究法法(原作者:Yin, R. K.)。新北市:弘智。(原出版年:1994)
    林佩璇(2000):個案研究及其在教育研究上的應用。載於中正大學教育學研究所主編,質的研究方法(239-259)。高雄:麗文。
    施宏達、陳文琪譯(2004)。從創傷到復原(原作者:Herman, J.)。台北:遠流。(原出版年:1992)
    胡嘉琪(2014):從聽故事開始療癒:創傷後的身心整合之旅。台北:張老師。
    張芬芬譯(2006)。質性研究資料分析(原作者:Miles, M. B., & Huberman, A. M.)。台北:雙葉。(原出版年:1994)
    張美惠譯(2004)。鏡子裡的陌生人(原作者:Steinberg, M., & Schnall, M.)。台北:張老師。(原出版年:2001)
    莊玉玫譯(2000):晚安,愛蜜莉:給女兒的枕邊詩(原作者:Straus, C.)。台北:方智。(原出版年:1998)
    陳品皓、羅愔愔、曾孟頤、蔡佳縈譯(2014):認知治療:基礎與進階(原作者:Beck, J. S., Beck, A. T., Jordan, J. V., & Carroll, A.)。台北:揚智。(原出版年:2011)
    陳麗英、胡甄容、陳美秀、朱品潔譯(2013)。EMDR應用於兒童心理治療之藝術(原作者:Adler-Tapia, R., & Settle, C.)。台北:心理。(原出版年:2008)
    楊淑智譯(2003):我想安心長大:如何讓孩子有安全感(原作者:Greespan, S. I.)。台北:張老師。(原出版年:2002)
    鄔佩麗(2005):輔導與諮商心理學。台北:東華。
    鄔佩麗(2008):危機處理與創傷治療。台北:學富。
    翟宗悌等譯(2011)。EMDR:基本原理、範本及程序。台北:學富(原作者:Shapiro, F.)。(原出版年:2001)
    謝馨儀(2011):EMDR介入PTSD治療歷程與效果之個案研究(未出版之碩士論文)。國立臺灣師範大學,台北。

    英文部分
    Ainsworth, M. D. S. (1973). The development of infant-mother attachment. In B. Cardwell & H. Ricciuti (Eds.). Review of child development research (pp. 1-94). Chicago, IL: University of Chicago Press.
    Alexander, P. C. (2013). Relational trauma and disorganized attachment. In J. Ford & C. Courtois (Eds.), Treating complex traumatic stress disorders in adolescents and children (pp. 39-61). NY: Guilford Press.
    Allen, J. G. (2001). Traumatic relationships and serious mental disorders. United Kingdom: Wiley, John & Sons.
    American Psychiatric Association. (2000). Quick reference to the diagnostic criteria from DSM-IV-TR (4th ed.). Washington, D.C: American Psychiatric Association.
    American Psychiatric Association. (2013). Desk reference to the diagnostic criteria from DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.
    Bowen, M. (1978). Family therapy in clinical practice. New York, NY: Jason Aronson.
    Bowlby J. (1969). Attachment and loss: Vol. 1. loss. New York, NY: Basic Books.
    Bowlby, J. (1982). Attachment and loss (2nd ed.). New York, NY: Basic Books.
    Braun, B. G. (1988). The BASK model of dissociation. Dissociation, 1(1), 4-23.
    Cook, A., Blaustein, M., Spinazzola, J., & Van der kolk, B. (2003). Complex trauma in children and adolescents: White paper from the National Child Traumatic Stress Network Complex Trauma Task Force. Retrieved from National Child Traumatic Stress Network: retrived from 2016.2.1 http://www.nctsn.org/products/complex-trauma-children-and-adolescents-2003
    Courtois, C. A., & Ford, J. D. (2013). Treatment of complex trauma: A sequenced, relationship-based approach. New York: The Guilford Press.
    Cozolino, L. J. (2006). The neuroscience of human relationships: Attachment and the developing social brain. NY: Norton, W. W. & Company.
    Croitoru, T. (2014). The Emdr revolution: Change your life One memory at a time (the client’s guide). United States: Morgan James Publishing.
    Ebrinc, S., Semiz, U. B., Basoglu, C., Cetin, M., Agargun, M. Y., Algul, A., & Ates, A. (2008). Self-mutilating behavior in patients with dissociative disorders: the role of innate hypnotic capacity. The Israel journal of psychiatry and related sciences, 45(1), 39–48.
    Evans, T. (2015). Counselling skills for becoming a wiser practitioner: Tools, techniques and reflections for building practice wisdom. United Kingdom: Jessica Kingsley Publishers.
    Fine, C. G., & Berkowitz, A. S. (2001). The Wreathing protocol: The Imbrication of hypnosis and EMDR in the treatment of Dissociative identity disorder and other Dissociative responses. American Journal of Clinical Hypnosis, 43(3-4), 275–290.
    Fishbain, D. A. (1994). Secondary gain concept. APS Journal, 3(4), 264–273.
    Fishman. D. B. (2013). The pragmatic case study method for creating rigorous and systematic, practitioner-friendly research. Pragmatic Case Studies in Psychotherapy. 9(4).2. Retrieved from 2016. 4.30. http://pcsp.libraries.rutgers.edu
    Fonagy, P., & Target, M. (1997). Attachment and reflective function: Their role in self-organization. Development and Psychopathology, 9(04), 679-700 .
    Ford, J. D., & Courtois, C. A. (Eds.). (2013). In Treating complex traumatic stress disorders in children and adolescents: Scientific foundations and therapeutic models. United States: Guilford Publications.
    Forgash, C., & Copeley, M. (Eds.). (2008). Healing the heart of trauma and dissociation with EMDR and EGO state therapy. United States: Springer Publishing Company.
    Gold, S. N. (2000). Not trauma alone: Therapy for child abuse survivors in family and social context. Philadelphia, PA: Brunner-Routledge.
    Gomez-Perales, N. (2015). Attachment-focused trauma treatment for children and adolescents: Phase-oriented strategies for addressing complex trauma disorders. United Kingdom: Routledge.
    Gonzalez, A., & Mosquera, D. (2012). EMDR and dissociation: The progressive approach. SC: A. I.
    Grant, R. (2013). The dissociation handbook. manuscript submitted for publication, Oakland, California.
    Hari, J. (2016). Chasing the scream: The First and last days of the war on drugs. United Kingdom: Bloomsbury Publishing PLC.
    International Society for the Study of Trauma and Dissociation (2005a). Child/Adolescent FAQ's. Retrieved July 14, 2016, from http://www.isst-d.org/default.asp?contentID=100
    International Society for the Study of Trauma and Dissociation (2005b). Dissociation FAQ’s. Retrieved May 7, 2016, from http://www.isst-d.org/default.asp?contentID=76
    International Society for the Study of Trauma and Dissociation (2011). Guidelines for treating Dissociative identity disorder in adults, Third revision: Summary version. Journal of Trauma & Dissociation, 12(2), 188–212.
    James, B. (1994). Handbook for treatment of attachment-trauma problems in children. NY: Simon & Schuster.
    Kluft, R. P. (1994). . In R. M. Klein & B. K. Doane (Eds.), Psychological concepts and Dissociative disorders: Symposium: Papers. Hillsdale, NJ: Erlbaum.
    Leeds, A. M. (2009). Resources in EMDR and other trauma-focused psychotherapy: A review. Journal of EMDR Practice and Research, 3(3), 152–160.
    Liotti, G. (2006). A model of dissociation based on attachment theory and research. Journal of Trauma & Dissociation, 7(4), 55–73.
    Luxenberg, T., Spinazzola, J., & Van der Kolk (2001) . Complex trauma and disorders of extreme stress (DESNOS) diagnosis, Part One: Assessment. Directions in Psychiatry, 21(25),373-394.Hobart, NY: The Hatherleigh Company.
    McLeod, J. (2010). Case study research: In counseling and psychotherapy. Thousand Oaks, CA: Sage Publications.
    Mollon, P. (1996). Multiple selves, multiple voices: Working with trauma, violation, and dissociation. New York: Wiley, John & Sons.
    O’neil, D. (2008). Dissociation and the dissociative disorders: DSM-V and beyond. London: Routledge.
    Oyebode, F. (2008). Sim’s Symptoms in the mind: An introduction to descriptive psychopathology (2nd ed.). London: W.B. Saunders Company.
    Parnell, L. (2013). Attachment-focused EMDR: Healing relational trauma. New York: NY: W. W. & Company.
    Paulsen, S. (1995). Eye movement desensitization and reprocessing: Its cautious use in the dissociative disorders. Dissociation, 7(1), 32-44.
    Paulsen, S. (2009). Looking through the eyes of trauma and dissociation: An illustrated guide for Emdr therapists and clients. Charlston, SC: Booksurge Publishing.
    Putnam, F. (1985). Dissociation as a response to extreme trauma. In R. P. Kluft (Ed.), Childhood antecedents of multiple personality disorders (2nd ed; pp. 66-97). Washington, D.C.: American Psychiatric Publishing.
    Rosenbloom, D., Williams, M. B., & Watkins, B. E. (2010). Life after trauma: A workbook for healing. New York, NY: Guilford Publications.
    Ross, C. A., & Halpern, N. (2009). Trauma model therapy: A treatment approach for trauma, dissociation and complex Comorbidity. Richardson, TX: Manitou Communications.
    Sanderson. C. (2010). Introduction to counselling survivors of interpersonal trauma. London, England: Jessica Kingsley Publishers.
    Schore, A. N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1-2), 201–269.
    Schore, A. N. (2010). Relational trauma and the developing right brain. In B. Tessa (Ed.), Relational trauma in infancy: Psychoanalytic, attachment and neuropsychological contributions to parent-Infant psychotherapy (pp. 19-47). NY: Routledge.
    Schore, A. N. (2013). Relational trauma, brain development, and dissociation. In J. Ford & C. Courtois (Eds.), Treating complex traumatic stress disorders in adolescents and children (pp. 3-23). NY: Guilford Press.
    Shapiro, R. (2009). Attachment-based depression: Healing the “hunkered-down”. In Shapiro, R. (Eds.). EMDR Solutions Ⅱ: For depression, eating disorders, performances, and more (pp. 90-105). New York, NY: Norton & Company.
    Stosny, S. (1995). Treating attachment abuse: A compassionate approach. NY: Springer Publishing Company.
    Turkus, J. A. (1992). The Spectrum of Dissociative Disorders: An Overview of Diagnosis and Treatment. Retrieved January 17, 2016 from http://www.fortea.us/english/psiquiatria/spectrum.htm
    Vaillant, G. E. (2012). Triumphs of experience: The men of the Harvard Grant Study. MA: Harvard University Press.
    Van der Hart, O., Groenendijk, M., Gonzalez, A., Mosquera, D., & Solomon, R. (2013). Dissociation of the personality and EMDR therapy in complex trauma-related disorders: Applications in the stabilization phase. Journal of EMDR Practice and Research, 7(2), 81–94.
    Van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. New York: Norton, W. W. & Company.
    Van der Kolk, B. (2005). Developmental trauma disorder: Towards a rational diagnosis for children with complex trauma histories. Retrieved from http://www.traumacenter.org/products/pdf_files/preprint_dev_trauma_disorder.pdf
    Van Der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. NY: Viking Books.
    Van Der Kolk, B. A., & Fisler, R. (1995). Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study. Journal of Traumatic Stress, 8(4), 505–525.

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