论“区分”在精神医学临床诊疗中的意义

On the Significance of "Differentiation" in the Clinical Diagnosis and Treatment of Psychiatry

区分不只是探讨相同症状的不同疾病归属,也不只是探讨相同症状对不同患者、相同症状在同一患者不同疾病阶段中的意义,还要关注可改变的与不可改变的、需要治疗的与不需要治疗的。为了实现这种区分,临床工作者必须从症状出发,不断地超越症状,深入到患者的内心了解其整个生命历程,通过将症状置于个体的整个生命中,实现症状的再理解。在这一过程中,临床工作者不仅需要理解现象学意义上的精神病症状学,还需要了解精神分析取向的深层动力性心理治疗。

Differentiation should run through the clinical diagnosis and treatment of psychiatry. Differentiation is not only to explore the different disease attribution of the same symptom, to explore the significance of the same symptom to different patients and the same symptom in different disease stages of the same patient, but also to pay attention to the changeable and unchangeable factors and those in need of treatment and not need to be treated. In order to achieve this differentiation, clinical practitioners must proceed from symptoms and constantly transcend symptoms to understanding of the patient's whole life. In this way, re-understanding of symptoms can be achieved by placing symptoms in the whole life of individual. In this process, clinical practitioners not only need to understand the phenomenological meaning of psychiatry symptoms, but also need to understand the psychoanalytic orientation of deep dynamic psychotherapy.