抑郁病人——案例研究

优秀的人被诊断为抑郁人格障碍的描述;有普遍和持续抑郁的想法和行为。

的第一次治疗爱德华J。,男,51岁,被诊断为抑郁人格障碍

爱德华有一个笨拙的,麻木的存在。他走路好像在梦中,他的步态的机器人,他的眼睛朝下看。几分钟后,我非常清楚,他是悲观,沮丧、悲观,过于严重,缺乏幽默感,无精打采的,不高兴的,经常不开心。

他如何应对好消息吗?我问他,如果我刚刚告诉他,他在比赛中赢得了一百万美元的机会吗?他考虑这个意想不到的好运,然后耸了耸肩:“它不会产生很大的差别,医生。”A million bucks wouldn't make a difference in your life? - I am astounded. This time, he doesn't even bother to respond.

让我们试试另一个策略:用这些钱,你会怎么做?“可能将财富挥霍一空。”- - - - - -He laughs mirthlessly. I am no good with finances either, I confide in him. "I am not good at anything." - He counters. That's not what I hear from his wife and close friends whom I have interviewed, I try to reassure him. It seems that you are outstanding at your work, a loving husband, and a chess champion. "What do they know!" - He sneers - "I am a loser. The only thing I am really good at is disguising it."

不时失败不会使你失败,我试着引入角度每况愈下的谈话。他突然拍:“我一文不值,好吗?不足的,你明白了吗?我消耗稀缺资源,给很少的回报。我太懦弱的终结,就是一切。但不要给我这些假的,含糖的鼓舞人心的讲话,医生。”

我只是想了解,我安抚他。他能提供故障和失败的例子,有效地证明他的自我评估,证实吗?他陷入的沉思,然后勾起了:“我害怕失去我的工作。”Why is that? His boss praises him to high heaven! He dismisses this contrary information: "When he finds out ..." Finds out what? "The真正的我!”- - - - - -he blurts and averts his gaze.

他能描述这个隐形界限不明的实体,真正的他吗?

他感觉——不,他知道,他缺乏毅力,是虚伪的,顺从的,阻塞性,充满压抑的愤怒和暴力。担心他。他很别人的评头论足,权威或权力,sadistically惩罚性。他喜欢打滚痛苦当他批评或惩罚他们,但同时他讨厌和鄙视自己被这样一个来历不明的男人。他经常向他的虐待行为的受害者道歉,甚至哭泣。他真的对他的行为感到不好,因为他是真诚的,他们原谅他,给他一次机会。他还主张知识、技能和天赋,他不具备,所以,实际上,他是一个骗子,骗子。

这是一长串,我观察。“现在你明白了。”- - - - - -He concurs - "That's why I will likely end up unemployed." Can he try to imagine the day after he is sacked? He visibly shudders: "No way. Don't even go there, Doc." I point out that he has been leading the conversation inexorably to this topic. At which point he sulks and then rises from his chair and walks towards the door without a word.

“你要去哪里?”- - - - - -I am genuinely surprised.

“让自己真正的精神病医生。”- - - - - -He triumphantly calls out - "You are as much of a sham as I am, Doc. It's no use one fraudster trying to cure another." And he is gone.

这篇文章发表在我的书中,“恶性自恋自爱——重新审视”

---

---

下一个:偏执狂患者~回到to:案例研究:目录