由“闭户塞牖”“以从其意”论心理治疗的保密原则与治疗关系

Principle of Confidentiality and Therapeutic Relationship in Psychotherapy:A Discussion Based on Theory of "Closing Windows and Doors" and "Satisfying Patients' Wills"

《素问·移精变气论》中有"闭户塞牖,系之病者,数问其情,以从其意",大致含义为:临床诊治疾病时,应紧闭门窗,让患者处于安静、无外界干扰的环境中,详细询问其病情,顺从其意愿。由此可见,安静、保密的氛围与良好的医患关系在中国古代已受到足够重视,也是现代心理治疗顺利开展和进行的关键。

As a saying in Suwen： Yijingbianqi Lun （Plain Questions： The Theory of Transforming Es- sence and Qi） goes, ＂close the windows and doors for the patients, and inquire the patients many times to satisfy their wills＂. This expresses a fundamental principle in psychotherapy. A doctor ought to first close the windows and doors to make the patients in a quiet and undisturbed environment during clinical diagno- sis; then the doctor should inquire the patients about the illness conditions in detail to satisfy their wills when treating them. Therefore, it suggests that a quiet and private setting and harmonious doctor-patient relationship were given enough attention in ancient China. In addition, the principle of confidentiality and therapeutic relationship are the key to modern psychotherapy.