臺灣博碩士論文加值系統

松德思想起心理治療中心在台灣精神醫療發展和台灣精神分析發展史上具有開創意義。這本論文書寫從筆者在思想起作為實習者／心理師/行動者各種角色轉換、精神分析／精神醫學越界 (border crossing)的田野筆記，紀錄筆者「我」穿梭其中所遭遇到的困境和成長。在此ㄧ過程中，「我」一方面對自身於其行動現場（實習田野）中的自我內部所發生的情感與思路所進行的反映，另一方面亦對機構環境的脈絡思索與辨析。透過行動研究和精神分析重視主體性知識崁卡於環境、社會結構此一知識論述的跨接，「我」將從田野紀錄進一步探究實習者遭遇看似個人化困境，擺放於精神分析傳輸入台灣的樣貌、精神醫學和精神分析合作的結構性層面下來思考解決路徑。
　　本論文試圖闡述精神分析治療如何將主體症狀擺放於社會歷史脈絡對人的影響，並從此反省當代精神「疾病」診斷和療癒可能路徑。同時將精神分析的理論反思具體落實於台灣精神分析知識和實務發展的機構脈絡背景，從此本土地氣尋找發展台灣更適切的心理療癒部署可能。當然，也在此脈絡下解構並重構機構場域中個人工作者與機構合作產生之具體異同、溝通，在精神分析知識脈絡下思考如何生成一名心理師所需具備「成為人」的傾聽耳朵和關係位置

This master thesis is based on the writer’s field study during her counseling psychology internship in Si-Xiang-Qi, Taipei Psychotherapy Center. Si-Xiang-Qi (transliteration of 思想起，and literal translation from Chinese characters is “when thinking about the past.”) has led the cutting-edge development of psychiatry and psychoanalysis in Taiwan. It is the first medical institution in Taiwan that provides not only medical-psychoanalytic cooperation in treatment of mental illnesses, but also psychoanalytic training for students majoring in counseling psychology. Thus, this master thesis pivots around the writer’s experience of border crossing between theories and praxis of counseling psychology, psychoanalysis and psychiatry. Different theoretical constructions and practical approaches of these helping professions can sometimes help workers establish a systematic cooperation, but can also cause barrier to communication. To try to face above problem, the writer implements the methodological framework of action research and psychoanalytic theory to argue that difficulties encountered by beginning therapists in clinical settings are actually entangled in the complex institutional and social structures, such as the transmission of psychoanalytic knowledge in Taiwan and the history of medical-psychoanalytic cooperation.
This thesis contends that psychoanalysis theories about subjectification and symptoms formation can shed light on the bottleneck of clinical setting. From psychoanalytic viewpoints, symptoms should be understood in the context of social -historical background. This understanding challenges contemporary mental illness diagnosis criteria as well as route for recovery. And, Si-Xiang-Qi is the place where the challenge and transformation are taking place. The writer intends to record how professional workers in Si-Xiang-Qi communicate and cooperate with each other to develop a better recovery dispositf in Taiwan; most important of all, with the training background, how a beginner psychologist learns to “become a person,”to listen to the other, and to be a relationship being.

目次

第一章　研究動機--------------------------------------------------1-16
1-1 前言
1-2　研究背景
1-2-1向精神病人學習－實習生初遇精神分析的困境和反思契機
1-2-2 「想」的空間- 松德思想起心理治療中心創立簡史
1-3　研究的行動脈絡
研究行動者的越界－發現研究工具-結果的活動

第二章　研究目的和方法----------------------------------------17-32
2-1 研究目的 :
2-1-1 精神分析動力取向實習心理師的實務養成歷程爬梳
2-1-2 精神分析在醫療機構中的面貌與發展
2-2 研究方法
2-2-1研究方法概述
2-2-2 研究步驟說明
2-2-3 研究方法論回顧

第三章 文獻回顧 ------------------------------------------------33-46
3-1 精神分析知識論概念簡述
3-1 精神分析病理學簡述
3-2 精神分析與精神醫療體系的歷史糾葛
3-3 精神分析在醫療機構的理論發展

第四章 研究內容--------------------------------------------------47-85
4-1 四則田野筆札
4-2實習者焦慮深鑿的自我痕跡和機構流變樣貌
4-3 焦慮的社會性
4-4 思想起心理治療中心作為涵容機構

第五章 結論---------------------------------------------------- 86-88

參考文獻---------------------------------------------------------89-93

參考文獻

丁允恭（民101）。暗影地帶下的龍發堂：體制外精神病院作為生活社區的法社
　　會學考察（碩士論文）。國立台灣大學科際整合法律學研究所，臺北市。
王浩威（民95）。總序：重返佛洛伊德。載於西格蒙•佛洛伊德（著），陳嘉新（譯），
　　狼人：孩童期精神官能症案例的病史（5-10頁）。臺北市：心靈工坊。
呂奕熹、吳皢萍、修慧蘭（民103）。諮商心理師在醫院中的角色、功能與貢獻。
社團法人中華民國諮商心理師公會全國聯合會電子通訊，18，1-3。
沈志中（民98）。瘖啞與傾聽：精神分析早期歷史研究。臺北市：行人出版社。
巫毓荃（民94）。「病態」的民族：日治晚期台灣的民族性精神疾病史（碩士論
文）。國立清華大學歷史研究所科技與社會組，新竹市。
林依璇（民102）。精神病「人」之於我－以會所和醫院實習為專業養成的省思。
　　（碩士論文）。私立天主教輔仁大學臨床心理系碩士班，臺北市。
林岱樺（民104）。廢墟裡的祕密花園：我在精神科慢性病房（碩士論文）。私立
　　天主教輔仁大學心理學研究所，臺北市。
林倩如（民104）。精神病個案觀察之經驗與省思—以精神分析取向為基礎。
　　輔導季刊，51(1)，75-77。
林婉卿（民89）。諮商心理師在醫療場域之心理服務經驗初探（碩士論文）。國　　
　　立新竹教育大學教育心理與諮商學系，新竹市。
林淳頤（民105)。長期諮商會談訓練對初入職場之專業認同與工作滿意度研究。
　　（碩士論文）。國立暨南國際大學諮商心理與人力資源發展學系輔導與諮
　　 商所，南投市。
林惠玲（譯）（民97）。黑太陽：抑鬱症與憂鬱。（原作者：Julia Kristeva）臺北
　　市：遠流出版公司。（原著出版年：1987）
洪雅琴、李維倫（民96）。精神分析取向心理治療與詮釋現象學的辯證關係：精
神分析臨床研究的困境與解決。中華輔導學報，22，157-183。
夏林清（譯）（民93）。反映的實踐者：專業工作者如何在行動中思考。（原作者：
Donald A. Schön）。臺北市：遠流出版公司。（原著出版年：1983）
--- (譯) （民89）。行動科學。（原作者：Chris Argyris, R. Putnam, and D. M.
Smith）。臺北市：遠流出版社。（原著出版年：1985）
--- （民101）。斗室星空：家的社會田野。台北市：財團法人導航基金會。
---、丁乃非（民104）。勁旅行腳- 地方斗室與星空共享的對話。應用心理研究，
63，3-49．
郭佩宜（民104）。八卦，不簡單。載於郭佩宜（主編），芭樂人類學（頁42-50）。
台北市：左岸文化。
徐復觀（民103）。中國人性論史（先秦篇）。台北市：台灣商務印書館。（原著
　　出版年：民68）
符裕、何珉（譯）（民101）。如何做田野筆記。（原作者：Robert M. Emerson, Rachel
I. Fretz, and Linda L, Shaw）。上海：上海藝文出版社。（原著出版年：民94）
曾仁杰（民97）。慢性精神病患安置於龍發堂的問題及相關因素之探討。（碩士
　　論文）。國立東海大學社會工作研究所，臺中市。
彭仁郁（民93）。臨床田野：遇見異己者、把「人」找回來。載於劉斐文、朱
　　瑞玲（主編），同理心、情感與互為主體：人類學與心理學的對話　　　
　　（頁69-110）。臺北市：中央研究院民族學研究所。
--- （民105）。反抗中建構的主體：三一八運動的象徵秩序傳承。載於吳叡人、
　　林秀幸（主編），照破：太陽花運動的振幅、縱深與視域（頁。台北市：左
　　岸文化。
黃珮玲、黃恩霖（譯）（民99）。傷心人類學：易受傷的觀察者。（原作者：Ruth
Behar）臺北市：群學。（原著出版年：1997）
萬心蕊、劉蓉台（民100）。後現代思潮中精神醫療社工發展的利類可能。社區
發展季刊，136，232-250。
劉佳昌（民99）。精神分析在台灣：理論與實務的多樣性。精神醫學通訊，29(10)，
12-15。
蔣興儀。紀傑克對敘事治療的批評（上）、（下） 評論摘自：https://goo.gl/gAfNXV
　　2017年1月1日。
樊雪梅。（民98）。精神分析與文化經驗。諮商與輔導，280，46-48。
簡美玲。（民98）。煩的人類學田野。人類學視界，3，31-33。
藍寬驊（民105）。新手諮商心理師個人經驗與理論取向整合歷程研究：以焦點
　　解決取向與精神分析取向心理師為例（碩士論文）。國立臺北護理健康大
　　學生死與健康心理諮商系，臺北市。
Aldridge, Dee, and C. Steveson. (2000). Social Poetics as Research and
Practice: Living in and Learning from the Process of Research. Nursing
Inquiry, 8, 19-27.
Alford, C. Fred. (2013). Winnicott and Trauma. Psychoanalysis, Culture and
Society, 18(3), 259-276.
Adelman, Clem. (1993). Kurt Lewin and the Origins of Action Research.
Educational Action Research, 1:1, 7-24.
Aisenstein, Marilia, and Claude Smadja. (2010). Conceptual Framework from the
Paris Psychosomatic School: A Clinical Psychoanalytic Approach to
Oncology. International Journal of Psychoanalysis, 91, 621-640.
Baratt, Barnaby B. (2015). Psychic Reality and Psychoanalytic Knowing. New
York: Routledge.
Bhabh, Homi K. Cultural Diversity and Cultural Differences. In B. Ashcroft, G.
Griffiths, & H. Tiffin (Eds.), The Post-Colonial Studies Reader (pp. 155-
157). New York: Routledge.
Birmingham, Nancy Kulish. (2002). The Psychoanalytic Method from an
Epistemological Viewpoint. International Journal of Psychoanalysis, 83,
491-494.
Brown, Kayleigh M., and Derek K. Tracy. Psychoanalytic Psychotherapy in
Contemporary Mental Health Services: Current Evidence, Future Role and
Challenges. British Journal of Psychotherapy, 30(2), 229-242.
Bruner, Jerome. (1991). The Narrative Construction of Reality. Critical
Inquiry, 18, 1-21.
Chiesa, Marco, Peter Fonagy and Jeremy Holmes. (2003). When less is more: An
Exploration of Psychoanalytically Oriented Hospital-Based Treatment for
Severe Personality Disorder. International Journal of Psychoanalysis, 84,
637-650.
Crossley, Michele L. (2000). Introducing Narrative Psychology: Self, Trauma,
and the Constuction of Meaning. Buckingham: Open University Press. .
Davidson, L. (1992). Developing an Empirical Phenomenological Approach to
Schizophrenia Research. Journal of Phenomenological Psychology, 23, 3-15.
De Bilbao, Fabienne, and Paola Bonavitacola. (2016). The Abuse of Certain
Knowledge. International Journal of Psychoanalysis, 97, 1677-1696.
De Vos, Jan. (2011). Psychologization or the Discontents of Psychoanalysis.
Psychoanalysis, Culture & Society, 16(4), 354-372.
Diamond, Michael A. (2007). Organizational Change and The Analytic Third:
Locating and Attending to Unconscious Organizational Psychodynamics.
Psychoanalysis, Culture & Society, 12, 142-164.
Eisold, Kenneth. (2005). Psychoanalysis and Psychotherapy: A Long and Troubled
Relationship. International Journal of Psychoanalysis, 86, 1175-1195.
Fink, Bruce. (1996). The Lacanian Subject: Between Language and Jouissance.
New Jersey, Princeton University Press.
Liu, Chia-Chang. (2013). The Formosa Model: An Emerging Tradition of
Developing Psychoanalysis in Taiwan. In Alf Gerlach, Maria Teresa Savio
Hooke, and Sverre Varvin (Eds.), Psychoanalysis in Asia (pp. 225-236).
London: Karnac Books.
Freud, Sigmund. (1917). Lecture xvi Psycho-analysis and Psychiatry. In
Introductory Lectures on Psycho-analysis, PartⅢ. (pp. 241-256) (The
Standard Edition of Complete Psychological Work of Sigmund Freud, Vol. XVI
) (Trans. James Strachey) London: Vintage, 2001.
Good, Byron J. (2012). Theorizing the ‘Subject’ of Medical and Psychiatric
Anthropology. Journal of the Royal Anthropological Institute, 18, 515-535.
Green, André. (1999). The Fabric of Affect in the Psychoanalytic Discourse.
London: Routledge.
Guasto, Gianni. (2014). Trauma and the Loss of Basic Trust. International
Forum of Psychoanalysis, 23(1), 44-49.
Hernandez, Max. (1998). Winnicott’s “Fear of Breakdown”: On and Beyond Trauma.
Trauma and Psychoanalysis, 28(4), 134-141.
Hinze, Eike. (2015). What do We Learn in Psychoanalytic Training? International
Journal of Psychoanalysis, 96, 755-771.
Hoffer, Peter T. (2014). Of Shadows and Realities in Psychoanalysis: A Historical
Commentary on Ferenczi’s Conception of Trauma. International Forum of
Psychoanalysis, 23(1), 18-22.
Hoffmann, Klaus. (2002). Psychoanalysis in Psychiatric Institutions:
Theoretical and Clinical Approaches. International Forum of
Psychoanalysis, 11, 237-243.
Holzman, Louis. (2009). Vygotsky at Work and Play. London: Routledge.
Kristeva, Julia. (2000). Sense and Non-sense Revolution: The Powers and Limits
of Psychoanalysis. (Trans. Jeanine Herman) New York: Columbia University
Press.
Lacan, Jacques. (1981). The Four Fundamental Concepts of Psychoanalysis. New
York: Norton.
---. (1993). Freud’s Papers on Technique: The Seminar of Jacques Lacan: Book Ⅰ.
Ed. Jacques-Alain Miller. Trans. Russell Grigg. New York : Norton
---. (1993). The Psychoses: The Seminar of Jacques Lacan, Book III (1955-
1956). Ed. Jacques-Alain Miller. Trans. Russell Grigg. New York :
Norton,Lewin, Kurt. (1948). Resolving Social Conflicts: Selected Papers on
Group Dynamics. New York: Harper.
Manfra, Meghan McGlinn. (2009). Action Research: Exploring the Theoretical
Divide between Practical and Critical Approaches. Journal of Curriculum
and Instruction, 3(1), 32-46.
Michaelsen, Scott, and David E. Johnson (ed.) (1997). Border Theory: The
Limits of Cultural Politics. Minneapolis: University of Minnesota Press.
Newman, Fred and Louis Holzman. (1996). Unscientific Psychology: A Cultural-
Performatory Approach to Understanding Human Life. Westport: Praeger
Publishers.
Penot, Bernard. (2005). Psychoanalytic Teamwork in a Day Hospital: Revisiting
some Preconditions for Patents’ Subjective Appropriation. International
Journal of Psychoanalysis, 86, 503-515.
Parker, Ian, Eugenie Georgaca, David Harper, Terence McLaughlin, and Mark
Stowell-Smith. (1995). Deconstructing Psychopathology. London: SAGE
Publications.
Reed, A. (1998). Manufacturing a Human Drama from a Psychiatric Crisis:
Crisis’ Intervention and the Work of R. D. Scott. Journal of Psychiatric
and Mental Health Nursing, 5, 387-392.
Reineman, Julia. (2011). Between the Imaginary and the Real: Photographic
Portraits of Mourning and of Melancholia in Argentina. International
Journal of Psychoanalysis, 92, 1241-1261.
Rosnow, Ralph L. (2005). Rumor and Gossip Research. Psychological Science Agenda, April 2005. Retrieved from: http://www.apa.org/science/about/psa/2005/04/gossip.aspx
Shotter, J. (1998). Social Construction as Social Poetics. In B.M. Bayer and
J. Shoter (eds.) Reconstructing the Psychological Subject: Bodies,
Practices and Technologies. (pp.33-51) London: Sage Publications.
Schafer, Roy. (1980). Narration in the Psychoanalytic Dialogue. Critical
Inquiry, 7(1), 29-53.
Schöter, Micheal. (2004). The Early History of Lay Analysis, especially in
Vienna, Berlin and London: Aspects of an Unfolding Controversy (1906-24).
International Journal of Psychoanalysis, 85, 159-178.
Scott, Maria. (2015). Deciphering the Gaze in Lacan's Of the gaze as objet
petit a. The DS Project: Image, Text, Space/Place, 1830-2015.
Retrieved from: http://thedsproject.com/ .
Shedler, Jonathan. (2010). The Efficacy of Psychodynamic Psychotherapy.
American Psychological Association, 65(2), 98-109.
Wallerstein, Robert S. (2011). Will Psychoanalysis Fulfill its Promise?
International Journal of Psychoanalysis, 93, 377-399.
Winnicott, Clare. (1980). Fear of Breakdown: A Clinical Example. International
Journal of Psychoanalysis, 61, 351-357.
Winnicott, D. W. (1971). Playing and Reality. London: Routledge.
World Health Organization. (2012). Health Education: Theoretical Concepts, Effective Strategies and Core Competencies. Retrieved from: http://applications.emro.who.int/dsaf/EMRPUB_2012_EN_1362.pdf