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Hayes及理论简介

在美国心理学界,斯蒂文·海耶斯(Steven Hayes)开创了一种治疗心理和精神疾病的新疗法——“接受与实现疗法”(acceptance and commitment therapy,简称ACT),成为继行为疗法、认知疗法后,美国兴起的第三波心理疗法。这种新疗法主张拥抱痛苦,接受“幸福不是人生的常态”这一现实,然后再建立和实现自己的价值观。ACT疗法在治疗抑郁症、上瘾症、癫痫病等精神类疾病方面都取得了不俗的成绩。目前,美国已有1.2万名心理专业人士接受了ACT疗法的培训,海斯的理论在18个国家都有追随者。

目录

从心理病人到心理医生

他的理论颠覆传统

创立“接受与实现疗法”(ACT)

疗法:挑战负面思维

1疗效:明显优于其它疗法疗效报道

1治疗癫痫

1治疗吸毒

1其他治疗

争议:“像个神秘主义者”

从心理病人到心理医生

斯蒂文·海斯博士是内华达大学基础心理学教授。在成为一名杰出的心理学家之前,斯蒂文·海斯也曾经患有心理疾病。1978年,他经历了第一次惊恐发作——在参加一次学术会议的争论中突然失声。他能够合上或者打开自己的嘴巴,但是一个字也说不出口。他当时以为自己是心脏病突发。那一年他才29岁。接下来,他饱受着痛苦的折磨。如今将年满57岁的海斯已经十多年没有经历过惊恐发作,而且成为其研究领域的领军人物。作为著名心理学机构——美国行为疗法推进协会的前主席,迄今为止,他已发表超过300篇学术论文,出版过22本学术著作。他最近跟一位心理学家合作出版了新书《学会接受你自己——全新的接受与实现疗法》(Get Out of Your Mind and Into Your Life),这本心理自助类书籍不仅在心理学界再次制造了争论的漩涡,而且跟一般的自助类书籍也有些背道而驰。

他的理论颠覆传统

《学会接受你自己——全新的接受与实现疗法》开篇就表示,书中的建议无法治愈读者的痛苦,其第一句话便是:“人总是会遭受痛苦”;其次,它建议那些痛苦的人不要跟负面情绪作斗争,而是将其作为生活的一部分来接受。这本书宣称的理念就是:幸福并不是人生的常态。如果海斯的理论是正确的,那么一般人对于心理学的看法就是错误的。就拿海斯第一次患病后那些年来说,一种被称作“认知疗法”的疗法开始被心理学界奉为主流,在结合或不结合药物的情况下,认知疗法能够对多种心理疾病进行治疗,包括抑郁症、精神创伤引起的压力紊乱的各种心理疾病。认知疗法所坚持的长期治疗策略就是攻击并且最终改变你的否定性思维,而不是接受它们。比如,当患者表达这样的想法:“我干活真是一团糟”,“每个人都在看着我的胖肚皮”时,认知疗法治疗师会质疑这些想法:你真的总是把工作搞得一团糟吗?真的是所有人都盯着你的肚皮吗?还是你自己太在乎别人看你的方式了?认知疗法的基本理念是帮助病人建立更为现实、更为积极的新理念。但是海斯的疗法并不注重如何操纵人们思考的内容,而是更注重如何改变病人的思维语境——矫正人们看待思维和情感的方式。你认为别人老是盯着你的肚子?也许事实是这样,也许你的肚子确实很大;也许不是这样,很多人对自己太过苛求罢了。认知疗法治疗师喜欢谈“认知错误”和“被扭曲的解释”,而海斯等人更愿意教病人像冥想般抽身事外,从一个有距离的角度,如同观察顺着小溪漂流而下的树叶般观察自己的思维。

创立“接受与实现疗法”(ACT)

海斯是第三波心理治疗浪潮中最有争议的心理学家。之所以称为第三波,是因为它脱胎于第二波疗法——认知疗法,而认知疗法则脱胎于第一波疗法——行为疗法。在行为疗法出现前,弗洛伊德的精神分析法是心理学界普遍认同的精神治疗方法。海斯所创立的疗法称作“接受与实现疗法”(acceptance and commitment therapy,简称ACT)。目前,美国已有1.2万名心理系学生和心理治疗师接受过这种专业的精神治疗训练。ACT疗法认为,我们应当承认否定性思维在人的一生中总是会重复出现;不要试图挑战这些负面的想法,而应当把精力集中在确立我们的价值观并竭力去实现它。海斯认为,一旦人们愿意接受消极的情绪,就会更容易找到生命的真正价值所在,并坚持向这个方向发展。虽然说来容易做来难,但是海斯的主要观点是:当人们竭力想控制自己的思维的时候,很难去考虑生命中真正的大事。

疗法:挑战负面思维

“日落”——当你看到这个词时,除了你的眼睛下移了一行,不会有其它事发生。但是你的思维或许跳到了别处。或许你脑中想起了一次美丽的夕阳,或许你会感到悲伤,因为你想到了某位亲人去世那一天美丽的夕阳。这个例子形象地说明了思维的这种不可靠性。海斯用这种练习来支持自己的观点:人的思维有着不可预料的后果。传统的认知疗法要求病人修正那些负面的想法,而ACT疗法试图化解这些想法的力量。它不会让病人说:“我很抑郁,”而是建议他们说:“我有一个想法,这个想

法就是我现在很抑郁。”“钟摆试验”——在1998年发表于《心理科学》杂志上的一个研究中,84名被试验者被要求握住一个钟摆,让它保持平衡。第一组被试验者被告知:要保持钟摆平衡。第二组被试验者被告知:不仅要保持平衡而且不要让钟摆倾斜。结果,第二组比第一组更容易犯错。海斯的解释是:“因为老是想着不要让它倾斜,反倒让控制这个动作的肌肉活跃起来。”认知疗法尽管没有要求人们去压制负面思维,但是的确要求人们去挑战和改变它们。这种疗法有时会像钟摆试验一样取得适得其反的结果。实践ACT疗法的心理治疗师喜欢用这个隐喻来解释其疗法中的“接受部分”:是用链子拖着重物拖曳前行还是干脆搬起重物随身携带前行更容易?当我们试图赶走痛苦时,反而会把它变成一种折磨我们的力量。认知疗法不让人有消极的心理,但反而可能会让人们更消极。而ACT做的,是削弱消极心理的力量!乍听起来,这套理论没什么作用。许多人罹患严重的抑郁症,或者极为孤独,疲于应付日常生活,根本就不清楚活着的价值所在。ACT治疗师利用一些技巧帮助你认识到自己的价值:例如钓鱼,让病人说出钓鱼的想法。治疗师的目的不是让你用钓鱼来打发时间,而是挖掘钓鱼背后的意义,让你意识到,你喜欢钓鱼是因为钓鱼意味着可以和家人待在一起,可以置身大自然……总之,找出所有有关钓鱼的一切让你认识到那些事情对于你的意义。

疗效:明显优于其它疗法

疗效报道

目前针对ACT疗法的科学研究取得了不凡的效果。在发表于科学期刊《行为研究和行为疗法》1月号的论文中,斯蒂文·海斯和其他四位合作者总结了1年中进行的13次关于ACT和其他疗法有效性对比的实验。有12次,ACT的效果优于其它疗法。在其中两个研究中,抑郁症患者被随机分派使用认知疗法或ACT疗法。两个月后,接受ACT疗法的病人在抑郁症量表上的病症表现平均下降了59%。

治疗癫痫

ACT疗法最引人注目的一个发现是2004年在癫痫病患者中所做的一个试验。27名来自南非的严重癫痫病患者仅仅接受了9个小时的ACT疗法,其癫痫发作的次数就明显减少,发作时间也短了。这让不知谦虚是何物的海斯本人也感到惊讶。

治疗吸毒

ACT疗法对治疗吸毒也有显著疗效。在一项实验中,吸毒者报告说ACT疗法让他们吸毒量减少。ACT疗法鼓励吸毒者接受治疗和由此带来的不吸毒的痛苦。

其他治疗

在参加世界各地的研讨会时,海斯用诗般的语言阐述他的理论。正是这种华丽的语言和表现使得ACT疗法在18个国家都有崇拜者。在美国,大多数州都有使用ACT 疗法的执业治疗师。在西班牙,一个ACT疗法心理治疗师治愈了一名30岁男子的勃

起功能障碍。而英国的一名治疗师则将ACT用于治疗一名性骚扰者。很明显的是,海斯自己也不确定ACT疗法是怎么在所有的病例中起作用的。但他相信,这种疗法让病人知道,面对痛苦的挣扎是生命内在和确凿的部分。

争议:“像个神秘主义者”

在许多心理学家眼里,海斯更“像是一个神秘主义者”,而不是科学家。他的教授方式也很古怪。他会要求参与的治疗师们,通常是一屋子博士一遍遍地重复某个词,比如“牛奶”,来显示如果一个词语说多了,这个词语就会变得毫无意义,而一遍遍地重复“我感到抑郁”也会产生这种效果。ACT疗法的另一个问题所在是,传统的行为疗法、认知疗法是在对某一种心理疾病的研究中非常有效才应用到其它疾病治疗领域的。但ACT疗法一开始就像是万金油,似乎什么精神类疾病都可以治疗。还有批评者认为,ACT要想进入主流,就不得不摒弃其令人讨厌的狂热行为,海斯本人也要收敛他的自大倾向。无法说哪种方法是对是错,只能说某种特定的方法对于一些人可能会更好一些。不管怎样,相信只要有所追求,有所付出,无论怎样的迷途,都是可以找到出路的——最后,说不定你就是下一个斯蒂文·海斯。

相关文章

接受与投入疗法和行为疗法

心理学空间

接受与投入疗法和行为疗法

中国自体心理学网刊於荷兰语行为疗法学报(摘录)Steven Hayes, Akihiko Masuda,2008-2-4 16:28:11

ACT and the 3rd wave of the Behavioural Therapy, Gedragstherapie (Dutch Journal of Behavioural Therapy) (Extract)

Co-author: Steven Hayes, Akihiko Masuda, and Hubert De Mey

摘录,整理及翻译:马信诚

接受与投入疗法(Acceptance and Commitment Therapy, ACT)) 不是革命性创举,

而当被视为行为疗法传统的第三期衍变中的一个代表。行为疗法的第一期发展,可以用经典条件反射论(Classical Conditioning) 和操作性条件反射论(Operant Conditioning) 为依据的早期纯行为疗法为代表。第二期则为引入思想因素的各家知行疗法(Cognitive Behavioural Therapy)。接受与投入疗法与诸如辨证行为疗法(Dialectic Behavioural Therapy) 等加强了对价值观(Value),接受事实的程度(Acceptance),对追求人生目标所耍作出的改变的投入程度(Commitment) ,和观照(Mindfulness)等因素的处理之新疗法,可算是这传统的第三期发展。

接受与投入疗法以功能依景说(Functional Contextualism) 为其哲学思想,以关系框架论(Relational Frame Theory) 为理论基础,有核心内容八,易犯毛病二。简介如下:

哲学思想: 功能依景说

一切事物的功用,需以其所出现的情景参照才能了解。

理论基础: 关系框架论

人不是孤立地去理解和记忆一事一物,而是以事物之间的相互关系去理解记忆。相互关系一旦在思想中形成,则无法消除。越想消除,越易勾起。故尝试改变一思一念每多徒劳。欲变,当从改变思想背後的情景框架著手。

核心内容八:

令求助者对不可行的方法死心(Creative Hopelessness)

在详细了解过求助者的问题和以往无功的应对方法後,如发现其法本身就不可能解决问题的话,可设法令求助者自己体味一下成效,然後让其退後一步审视己往所用之法,是否本身就不可能解决问题。

具体操作上,接受与投入疗法师喜用喻引导。因此派深刻体会到因积习之故,人们定对某些字眼有牢不可破的观念和相关情绪。一旦提到这些字眼,势必牵动该相关情绪而极易产生抗拒和引来争拗。故此派喜用喻引导求助者去接受其思想,从而避开与那些可能勾起根深蒂固之念的言词之争。

此阶对应的比喻为:人在洞中喻(Man in Hole Metaphor)(为简单易记计,我以为大可意译为:以铲除洞喻)。

此喻为:有人失陷地洞中,无法出走。手中仅有铲子一袋。其人苦苦掘地,遍用袋中各铲,然越陷越深,不得出离。其之困,用功不勤乎?其器不适乎?

藉此喻,引导求助者从根本解决问题的大方向上重新审视问题为何。

使其体会想掌控自身思想本身才是问题(Control is the problem)

人们对各界常加控制,故误以为内在思想感受亦能随心掌控。事实不然。往往越叫自己不要想便越想得多。故当体会想掌控自身思想本身才是问题所在。

此阶对应喻为:多度仪喻(Polygraph Metaphor) (意译:以惊致静喻)

此喻为:一人因忧恐难安求医。医栓之於能记恐慌程度之多度仪。以枪指其头曰:此疾需致极静而不起一丝惧意方可,吾今助汝。一旦仪器表汝有一丝惧意,吾则枪击汝。以死生大事警之,汝必尽力,疾除必矣。问其能静否?

藉此喻,引导求助者明白在某些情况下,想完全掌控自身思想而不生负面情绪是不可能的。而这跟其人的能力付出无关。

提供接受自身一切好与坏的想法(Acceptance as an alternative)

在上述基础上,以天秤两端喻为求助者提供与负面思想对抗之外的选择---去接受身上发生的一切好与坏。

此喻为:人心中有一天秤。秤有二端,一者忧虑,二耆接受。忧虑易知而接受难察。人徒欲减忧而不知接受。不知接受则一端永为零。为零则无论其忧轻重,亦势必失重不能平。故求平不在减忧,而在忧虑接受二耆相符。无论其忧多重,若能完全接受之,则亦能致平。

藉此喻,引导求助者发开接受自身感受。

尝试以自身为景,提升对自己的看法(Self as context: transcending sense of self)

既能开始接受,则进而改变其思想背景,引导其重审其处景。

此阶对应喻为:棋盘之喻(Chess Board Metaphor)。

此喻为:人欲以己正向之力压下自身负面情绪,犹如执棋之一方与敌对叠。既执一方,则必求所执方胜。然何为胜,何为负?正者出於吾身,然负者亦未尝不出於吾身也。故以正胜负,或负胜正,皆是以已伤己,虽胜亦损。求助者或问,吾当若何?反问之:以正负双方之一为已,则必有伤。如汝为棋盘若何?

末後一句,引求助者自思自为棋盘之景况,则其思想背景随思而转矣。

放松思想和观照(Cognitive defusion and mindfulness)

思想背景既转,可进而学习接受感受而不为所困。其要有三:

一:仍需避免因言语而勾起抗拒争论,固宜少用否定式字眼,如:但是(But);而多用肯定式字眼,如:还有(And)。(以中文的表述而言,But一类的表述还可包括:虽然;而And则可说成:同时,而且等。大家当考虑中文比英文更多样的表达方式,而不要单注意but 和and的直译而勿略其他。)

二:牛奶牛奶牛奶法(Milk, Milk, Milk)

(译者未能完全确定此法的用意和具体操作法。以我理解,此法意在为某些关键言词脱敏,削弱其与相连的情绪和思想的牵连。其法为先选一词,论尽其所有含意及属性(如以牛奶为例,则包括滑,白,液体等)。然後不停重覆此词几分钟,使求助者对之除本身的含意及属性外不作他想。)

三:观照

观照意识如叶浮河上,随水而去。能如此,则可以之观一切感受而不为所执。(译者注:至此,对负面感受的接受已成,而开始向投入新生下功夫。)

助其找出所重之事(Value)

挽歌或墓铭志法:请求助者细想自己百年後,希望自己的挽歌或墓铭志会写些什么,以此助其找出所重之事。既知所重之事,再订出想达到的具体目标,和执行方案,并找出潜在障碍和应对之法。

发愿和投入到要达成所重之事而耍作出的相应行动中去(Willingness and commitment to valued actions)

为坚其心,可以此问之:你的内在体验与你的期望有落差已是事实,你愿意毫不抗拒,完全接受这些感受,并不受困於其思想内容,以此来使你在如今的处境中向自己选择的目标前进吗?

从此起,接受与投入疗法便转入指导求助者学习具体方法(Skills building),使其能处理障碍,达成目标上去。

治疗关糸(Therapeutic relationship)

最後,作者特别强调此法的治疗师,除了要有关爱外,还需要使求助耆能作出反思(Be Challenging)。

易犯毛病二:

解人之苦:

治疗师往往急人之难,想尽辨法舒缓或使求助者避开令其伤痛之经历。但作为接受与投入疗法的治疗师,则不应令求助者避开伤痛经历。而是要令求助者自己去细味属於他自己的一切,包括人生中的甜酸苦棘,然後才能不抵抗、不逃避地接受自已的一切。

落入两边:

治疗师容易陷进求助者的思想内容中,或而认同,或而有异。认同则易陷求助者的困局中,而难以洞悉出路;有异则易陷争辩中,而易栓於言词,不能出境外。故此派治疗师当谨守让求助者自己去细味属於他自己的一切感受此一原则,而不陷落到对其具体思想言语上的认同与否去。

相关书籍

正念与接受:认知—行为疗法第三浪潮

正念与接受:认知行为疗法第三浪潮》不仅有助于提高专业心理治疗师处理疑难个案的能力与信心,而且也有助于提高非专业人士对自身内心体验的觉察与接受,进而发展更灵活、更多样的与自身内在价值观相一致的适应行为。

《正念与接受:认知—行为疗法第三浪潮》

作者:史蒂文?C?海斯维多利亚·M·福利特玛莎·M·莱恩汉等编

译者:叶红萍等译李鸣审校

出版社:东方出版中心2010/10

ISBN:9787547302262

丛书:佛法与心理治疗译丛

定价:30.00元

原书名:mindfulness and acceptance:expanding the cognitive-behavioral tradition

简介

认知-行为疗法第三浪潮超越了传统认知-行为主义的范畴,创造性地运用正念、接受、冥想、认知离解等

技术。它与传统认知-行为治疗最大的不同在于:强调聚焦当下并全盘接受当下体验;鼓励来访者采取积极灵活的行动,改变生活中可以改变的领域;帮助来访者澄清自己的价值观,并过一种与自身内在价值观相一致的生活。这种行为接受与改变之间平衡的理念不仅有助于我们的来访者缓解其心理痛苦,而且更适合我们所有生活在这个时代的个体解决自身的心理难题。

作者简介

斯蒂文·海耶斯(Steven Hayes)开创了一种治疗心理和精神疾病的新疗法——“接受与实现疗法”(acceptance and commitment therapy,简称ACT),成为继行为疗法、认知疗法后,美国兴起的第三波心理疗法。这种新疗法主张拥抱痛苦,接受“幸福不是人生的常态”这一现实,然后再建立和实现自己的价值观。

史蒂文·c.海斯史蒂文·C.海斯博士(Steven C.Hayes,PhD)是美国内华达大学心理学系教授,公开发表著作20余部、论文325篇,研究方向为人类语言和认知特征分析,以及语言和认知在理解和缓解人类痛苦方面的应用。海斯博士目前是美国心理协会第二十五分会、美国应用和预防心理协会以及美国行为治疗发展协会的主席,美国国立卫生研究院国家药物滥用咨询委员会顾问。他还曾担任过由其协助创建的美国心理学会的第一任财务主管。

维多利亚·M.福利特,是内华达大学心理学系主任、教授,内华达创伤研究机构负责人,致力于运用情景行为法了解创伤过程。研究领域包括将科学引入临床治疗,以及在治疗中综合运用正念和接受。

玛莎·M.莱恩汉,是华盛顿大学心理学教授、精神病学和行为科学系兼职教授及行为研究和治疗门诊部主任,该机构针对为严重心理障碍和多重障碍患者开发新的治疗方法并评估其疗效的研究项目而设立。莱恩汉博士的主要研究方向为行为治疗在自杀行为、药物滥用以及边缘性人格障碍中的应用。她曾担任过美国行为治疗发展协会的主席。目前为美国心理协会、美国心理病理学协会会员,美国行为心理委员会专科医生。莱恩汉博士出版过两本治疗学专著,分别是《边缘性人格障碍的认知一行为治疗》(Cognitive-Behavioral Treatmentt of Borderline Pevsonality Disordeer,1993,The Guilford Press)和《边缘性人格障碍治疗技术辅导手册》(Skills Training Manual for Treating Borderline Personality Disordet,1993,The Guilford Press);她还在科学杂志上发表过多篇专业论文,同时担任多家专业杂志的编委。

序言

最早和心理学结缘,是在20世纪80年代中期。因为讲授唯识的关系,翻阅了一些心理学相关著述。当时就感到,佛法与心理学有不少相通之处,适当运用心理学的概念,有助于现代人更好地理解并接受唯识思想,同时,还可作为教外人士接触佛法的方便之道。尤其在那个年代,人们对佛教暌违已久,误解重重。在多数人心目中,佛教所代表的无非是迷信,是古老而不合时宜的;而心理学所代表的则是科学,是崭新而契合潮流的。在这样的认识背景下,以心理学作为桥梁,可使佛法具有时代感与亲和力。

从另一个角度来说,若是由心理学走入佛门,往往更关注对佛法的实际运用,关注怎样以此解决自身问题,这恰与佛陀说法设教的本怀相应。佛陀从修行到证道,从说法到度众,并不是为了创立某种学说或理论,他所关注的核心始终是人生的大事,是为了帮助人们认识自己,明心见性,最终离苦得乐。所以,佛教与心理学的结合,比之哲学、文学、艺术等其他学科有更多的共同点,可以说,这是一项从理论到实践的全面结合。

佛法为心性之学,和心理学一样,是以解决心理问题为目标。当然,两者对心理问题的定义并不一致。心理学所解决的,主要是异常的心理问题。换言之,只是对某些异于常人的言行和病态心理进行纠正。所以,治愈标准只是成为一个正常的人,一个为社会大众所接受的人。至于人类共有的无明、我执、贪嗔痴等心理隐患,并不在其解决之列。事实上,在我们的观念中,早已将这些问题赋予了合法地位。

目录

总序一

总序二

译序

1 接受与投入治疗和新行为治疗:正念、接受及其关系

2 辩证行为治疗:全盘接受与善巧的整合

3 基于正念的认知治疗:理论依据和实证支持.

4 接受、正念和认知一行为治疗:对照、比较和应用抗焦虑治疗

5 功能分析心理治疗、认知治疗与接受

6接受和投入治疗中的价值观工作:确定行为治疗的前进方向

7发现行为激活治疗中的行动:有关干预和改变机制的实证研究

8 正念、接受、认可和婚姻中的“个体”心理障碍

9接受、正念和创伤

10广泛性焦虑障碍:在认知一行为治疗中引入当下的概念

11 进食障碍治疗中的接受和改变:基于手册的认知一行为治疗的发展

学会接受你自己——全新的接受与实现疗法

接受与实现疗法(ACT)是一种全新的、有科学基础的心理疗法,从全新的视角来审视为什么我们会感觉到痛苦,什么是心理健康。要是痛苦本来就是人生不可避免的一部分·而逃避或是忍受痛苦会使你备受折磨。甚至还会毁了你生活的质量,你该怎么办?在书中,你会学会:了解为何人类语言的本质就会产生折磨;逃离回避的陷阱;培养积极的心态来接受痛苦;使用正念,活在当下;找到人生的真正意义;过上有活力的;有意义的人生。

在哪儿买《学会接受你自己——全新的接受与实现疗法》.....

卓越网:26.80节省5.20

当当网:26.80节省5.20

作者:(美国)史蒂夫·C.海耶斯(Steven C.Hayes) (美国)斯宾塞·史密斯(Spencer Smith)

译者:曾早垒

出版社:重庆大学出版社2010-1-1

ISBN:9787562452546

丛书:鹿鸣心理心理自助系列

定价:32.00元

原版链接:Get Out of Your Mind and Into Your Life

作者简介

史蒂夫·C.海耶斯,博士、心理学教授、接受与实现疗法创始人。曾被评为20世纪末世界上最有影响力的心理学家,美国行为治疗进展协会、美国应用与预防心理学会前主席,著有《接受与实现疗法》和《关系框架理论》。

斯宾塞·史密斯,自由作家和编辑。现居美国加利福尼亚圣罗莎者。

相关案例

ACT疗法:案例对话

心理学空间

ACT疗法:案例对话

朱松2008-2-9 11:19:03

下面是一个ACT治疗师在评估一个慢性忧虑者的改变日程:

Therapist: What else have you tried to do?

治疗师(下简称“T”):你还做过什么?

Client: Well,sometimes I try to talk myself out of it. I say, "This is silly, you are making a mountain out of a molehill."

来访者(下简称“C”):嗯,有时我试图劝阻自己。我说:“太蠢了,你这是小题大做。”

T:In other words, criticize and chastise yourself. And the purpose of this criticism...? 也就是说,你责备和惩罚自己。你的目的是……?

C: To get me to stop it.

让自己停下来。

T: To get yourself to change-to stop worrying.

让自己有所改变——停止担心。

C: Yeah... The things I worry about are silly. I mean some of the things that come into my mind are just nuts.

是的……我的担心很愚蠢。我的意思是,我脑袋里冒出来的有些东西简直就是胡说八道。

T: And the idea is that if you could get rid of those worries-those thoughts-then the anxiety would be less and you'd be able to face your daily situation better.

你是说,如果你能去除那些担心——那些想法——那么焦虑就减少,你就能够更好的面对日常情况。

C: Right, but it is pretty hard to convince myself to stop it, so sometimes it works but sometimes it doesn't.

对,但是说服自己停下来相当困难,因此有时有用,有时没用。

T: So if you could just convince yourself that you don't need to worry, then it would work and things would start moving ahead. OK. So far we've got criticism, chastising, and attempts to convince yourself to stop. What else have you tried?

如果你能说服自己,你就无需担心了,那就有用了,事情就会向前发展。好。到目前为止,你受到了责备、惩罚,还试图说服自己停下来。你还做过什么?【94】

T: And this. Coming in here. Is it part of that effort to change how bad you feel as well?

……这也是你改善坏感觉的努力当中的一部分吗?

C: Of course. I'm not sure what I will get out of this really, but if I could feel even a little better about myself, it would be worth it.

当然。我不确定真能从中得到什么,但是如果自我感觉哪怕能好一点,也值得。

T: So you're hoping to remove some of the bad feelings and get more good feelings because then you would be able to move on.

你希望少一些坏感觉,多一些好感觉,这样你就解脱了。

C: (Pause) I guess so.

(犹豫片刻)我猜是的。

T: So this is another thing to try. Good. So let's add this therapy to the list. It is another thing you've done to feel better.

这是你的另一个尝试。好,我们把这个治疗加到列表中。这是你为了感觉更好已经做过的另一件事。

C: I've tried almost everything I know to feel better.

为了感觉好点,我几乎尝试了所知的所有事情。

T: I'm sure you have. You have indeed. And this-therapy-is yet another attempt.

我确信你做过。你真的做过。这个治疗是又一次尝试。

C: You say it as though there is an alternative.

听你的意思好像有选择的余地。

T: Well. I don't know. Right now I just want to be clear about what you have tried and how it has worked.

哦。我不知道。现在我只想弄清你已经尝试过什么,以及效果如何。【95】

下面的来访者就是前面提到那个慢性忧虑者,我们来看看如何评估规则系统的起效方式:

C: Right, but it is pretty hard to convince myself of it, so sometimes it works but sometiems it doesn't.

是的,但说服自己相当困难,所以有时有用,有时没用。

T: So if you could just convince yourself, then it would work. OK. Let me ask you this. Your mind says that when you convince yourself that your concerns are silly, you will stop having those concerns, you will become less anxious, and then you will do better. Right?

你是说如果能说服自己,就有用。好。我来问你。你的想法是,当你说服自己相信,你所关心的是愚蠢的时候,你就不再关心了,焦虑就会轻些,你就会好些。

对吗?

C: Right.

是的。

T: OK. And dose that work? What does your experience tell you?

好。有用吗?凭你的经验?

C: Sometimes. But I can't always talk myself out of them.

有时有。但我不是总能劝阻自己。

T: And even when it does work, if we expand the time frame a bit, would you say that over time, as you've followed the rules your mind has laid out for you, that your concerns overall are less or more?

就算是有用,如果我们把时限延长一点,或者说随着时间的发展,如果你遵循头脑里的规则,总体来看,你所关心的会多还是会少?

C: ...Overall it is more.

……总的来说会更多。

T: That seems like a paradox, doesn't it? I mean, you do what your mind says, sometimes it even seems to work, and then somehow it seems as though the concerns and worries are getting bigger, no smaller. They are more important, not less.

这像是个悖论,对吧?我的意思是,你做的正是你想的,有时似乎是有用的,而有时不知道又是怎么搞的,好像关心和担心变得更多了,而不是更少了,更重要了,而不是不那么重要了。

C: So what should I do?

那么我应该怎么办?

T: What does your mind tell you to do?

你的心里是怎么说的?

C: Try harder.

再努力。

T: Interesting. And have you tried harder?

有意思。你有努力吗?

C: And harder and harder.

越来越努力。

T: And how has that worked? Has it paid off in a long-term or fundamental way, so that by doing it you have transformed the situation and it is no longer a problem? Or are you, unbelievably enough, sinking in deeper as you try harder and harder?

效果如何?是起到了长期的本质的作用,情况得到了改变,问题不存在了呢?还是陷得更深了?

C: ... I'm sinking in deeper.

……我陷得更深了。

T: If we had an investment advisor with that track record, we would have fired him long ago, but here your mind keeps leading you into efforts that don't really, fundamentally, pay off, but it keeps following you around with its "blah, blah,blah," and it is hard not to give it one more try. I mean what else can you do but what your mind tells you to do? But maybe we are coming to a point in which the question will be, "Which will you go with? Your mind or your experience?" Up to now, the answer has been "your mind," but I want you just to notice also what yor experience tells you about how well that has worked.

如果是一名有记录的投资顾问,我们早就解雇他了。而你的想法带着你不懈的做着无谓的努力,一直在你边上巴拉巴拉的说废话,你想不再试试都很难。除了心里的声音让你做的而外,你还能些做什么呢?也许我们正逼近问题的所在,“你将和谁在一起?是想法还是经验?”现在,答案是“想法”,但我想让你也注意到经验告诉你怎样能起作用。【97】

下面的对话演示了创造性无望(creative hopeless)的介绍。

T: You have told me a lot of things you have tried to do, and it seems to me that you have tried to do just about everything that is logically there to be done. You've done all the obvious and reasonable things. You've thought hard, you've worked hard. You've looked for the angles. And now here you are in therapy...still trying. But

you've hired me. I work for you. So it is my obligation to point something out:"This isn't working, right?"

你讲了你试过的很多事情,在我看来,你做的正是逻辑上该做的事情。你做了所有明显的合理的事情。你努力思考,努力做事。

你寻找问题的各个方面。

现在你来治疗……还是尝试。但你已经雇用了我。我为你工作。所以我有责任指出:“这没什么用,对吧?”

C: I haven't figured it out yet.

我还是没明白。

T: Here is another way to say what you just said: Even trying to figure it out isn't working so far.

你的这句话也可以这么说:即使设法弄明白了也没用。

C: Not yet.

还是没有。

T: Not yet. What if it won't? What if this whole thing is a setup?

还是没有。如果还将没有呢?

如果整件事就是个局呢?

C: A setup?

局?

T: Well, in other areas if you had worked this hard, you'd have a lot of good things to show for it. Isn't it true in your experience, although it doesn't seem that it should be this way, that the more you've struggled with emotional discomfort and disturbing thoughts-the more you have tried to get rid of them-the more difficult it has becaome? They don't seem to respond to conscious control. These feared reactions haven't gotten smaller, they have gotten bigger.

嗯,在其它方面,如果你这么努力,你已经有很多好东西可以炫耀了。以你的经验来看,难道不是这样的吗?虽然好像不是这样的。你越是与坏情绪和烦人的想法奋争,你越想除掉它们,就变得越是困难。它们似乎不像是对有意控制作出的反应。这些害怕的反应不是变小,而是变大了。

C: I don't know how to get rid of them. I'm hoping you can help. How should I get rid

of them? What am I doing wrong?

我不知道怎么去除它们。我希望你能。我应该如何去掉他们?我做错了什么?

T: Those are important questions because they show very cleraly what has been going on, but let's not get off on that issue quite yet. Let's start with what you know directly. You feel stuck.

这些问题很重要,因为这显示发生了什么,但我们先不要开始这个问题。让我们直接从你所知道的开始。你感到进退维谷。

C: Big time.

一流。

T: It is not clear what to do next, but it doesn't seem as though there is a way out.

下面要做什么并不清楚,但是好像没有出路。

C: Exactly.

没错。

T: So I'm here to say something:"You are stuck. There is no wa

C:So why am I coming in to see you? It sounds as if you are saying I will never be successful.

听你这么说,我再也好不起来了。那我干嘛来看你?

T: My purpose is not to help you win this struggle. That does not mean that you are hopeless or you can't be successful. In fact, my goal is to help you have your life work, and I 100% think I can help you do that if you are willing to face these monsters your have been running from.

我的目标不是帮你赢得挣扎。但那并不意味你没有希望了,也不意味你好不起来了。事实上,我的目标在于帮你把生活运转起来。如果你愿意面对你一直在逃离的这些怪物,那我100%地相信能帮到你。

C: If it is easy to have your life work, why haven't I done it?

如果运转生活那么容易,为什么我做不到呢?

T: I neve said it was easy. It is hard. Not hard effortful-it is hard tricky. This is a very tricky trap-one that catches us all. Look, it is absolutely clear to me that if you knew what to do, you would have done it. I don't believe for a minute that you are broken, weird, perverse, or self-destructive. You have done the absolute best you can. You have everything you need to move ahead from here to live a vital, committed, meaningful life. It is just that we have to start from here-here is where you are. So you look and you see whether your experience doesn't tell you that you are caught in a struggle you seemingly can't win. Are you willing to trust that experience, allow it to influence you, and then to move from here? That is what your life is asking of you right now.

我从没说过容易。这很难。不是难在需要努力上——而是很难处理。

这是个危险的陷阱——能逮住我们所有人.

看,事情对我来说很清楚,如果你知道要做什么,早就做了。我根本不相信你有问题,不相信你是离奇的、反常的,不相信你在自我破坏。你已经做的绝对是最好的了。你拥有所需要的一切,这能让你离开这里,去过充满活力的、具有责任感的、有意义的生活。我们要做的正是从这里开始——从你这里开始。你看看,你会发现你的经验是否没有告诉你,你被似乎不可能赢得的挣扎给困住了。你愿意信任经验吗?让其影响你?然后离开这里?那是你的生活在邀请你。(107】

下面的来访者诊断为惊恐障碍,治疗师试图阐明来访者的无效控制策略的本质:T: What else did you observe?

你还注意到了什么?

C: Well, when I was about to go into the department meeting, I noticed I checked several times to see whether I still had my bottle of Valium in my purse. I kenw it was in there-I alsways carry it anyway-but I checked it maybe four times within 5 minutes right before the meeting.

嗯,当我打算进去会议室时,我发现自己检查了好几次钱包中是否有安定药瓶。我知道有——我总是带着它——但是在开会前的5分钟之内我大概检查了4次。T: What do you think the checking was in the service of[1]?

你认为检查的作用是什么?

C: I guess reassuring myself that it was there.[2]

我想,如果在,我就放心了。

T: So that you could...

这样你就能……

C: Well, so that I could always quick sneak a pill if things got too bad. I have learned to open the bottle with one hand and sort of[3] tuck a pill in the knuckle joint. Like a magician does. Then I cough or something, and I get it in my mouth. It tastes pretty bad, but actually if I just let it dissolve it works faster anyway, so I don't need water or anything.

是的,这样,如果情况不对,我就能迅速偷吃一片。我已经学会用一只手打开瓶子,藏一片药在膝关节里。就像魔术师那样。然后咳嗽什么的,将药送进嘴里。味道很不好,但如果让其在嘴里溶解,实际上起效更快,所以我也不需要水什么的。

T: So one thing you observed is that before you go into the department meeting you make sure you have a way of dealing with your anxiety. And you check for the bottle to reassure yourself that you have that way out even if you can't just leave the room. 所以你注意到的一件事是,在进入会议室之前,你证实自己有处理焦虑的方法。你检查药瓶让自己安心,即使你不能离开房间,你也有办法处理。

C: Yeah.

是的。

T: And that is in the service of keeping the anxiety away.

作用是,远离焦虑。

C: For sure.

没错。

T: Can I say it this way?: Access to tranquilizers is probably one way you dig.[4]

我能这样说吗?:镇静剂的使用也许就是你寻找的方法。【119】

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U2 Reading Home alone Act one 1.Mom and Dad arrive back from vacation a day earlier than expected. The curtain s are closed and the living room is dark when Mom and Dad enter. Dad: It’s so nice to be home! Mom: Yes, 2.I can’t wait to surprise the boys! Suddenly a door opens and a soccer ball flies through the room. 3.Eric runs in after it, followed by a big dog, walking very slowly. Eric: Mom! Dad! You’re back early! (looking around room, sounding frightened) But, but---4. you weren’t supposed to come home until tomorrow! The dog slowly walks to Mom and Dad. Mom: (bend ing to touch dog) Eric, he’s so tired and hungry! (looking at table) 5.The money for dog food is gone, but Spot looks like he is starving! What did you do with the cash we left? Dad: And look at this room—garbage all over the place! Where is your brother? (shouting angrily) Daniel! Daniel: (running into room) Mom, Dad, I can explain--- Dad opens the curtains and light comes into the room. 6.The room is in a mess, with pizza boxes on the floor and dirty dishes in the sink. In the corner, there is a garbage can around which are pieces of garbage and waste paper. Mom and Dad both turn towards Daniel. Dad: (sounding very angry) listen to me, young man--7.we left you in charge? We thought you could act like an adult, but look at the mess!8. I don’t know the reason why the house is so dirty--- Mom: Daniel, we thought you were an adult, a person who could make good decisions... Dad: How can we trust you any more? 9.We won’t tolerate such behavior in our family! Daniel: ( shouting) Stop shouting at me. I’m still a teenager! Why is everything always my fault? Daniel runs into his bedroom and shuts the door angrily. 10.Mom and Dad look at each other as lights go out. Act two, scene one Daniel and Eric’s be droom. Eric sits on his bed. 11.Daniel has his arms crossed and looks upset. Daniel: 12.They never even gave me a chance to defend myself. I hate them! Eric: You don’t hate them. I can tell them we had an emergency. Then they won’t be mad any more. Daniel: No, don’t tell them anything. 13.Anyhow they didn’t trust me. 14.They don’t deserve an explanation. Let them think what they want. Eric: But Daniel, if they knew that Spot was sick and we used the money to take him to the clinic--- Daniel: And that we spent all of yesterday waiting there for him and that is why we had no time to clean the house -- but no, Eric, why didn’t they ask me what happened instead of shouting at me? Act two, scene two Mom:Do you think we were too hard on Daniel? Perhaps there is a reason why the house is a mess Dad: Maybe, but 15.now that he has been so rude to us, I feel like we have to punish him or he won’t respect us. Mom: Oh, why does this have to be so difficult? End of act two.

M1U2 课文原文

M1U2 Reading---- Home Alone Act one Mom and Dad arrive back from vacation a day earlier than expected. The curtains are closed and the living room is dark when Mom and Dad enter. Dad: It’s so nice to be home! Mom: Yes, I can’t wait to surprise the boys! Suddenly a door opens and a soccer ball flies through the room. Eric runs in after it, followed by a big dog, walking very slowly. Eric: Mom! Dad! You’re back early! (looking around room, sounding frightened) But, but--- you weren’t supposed to c ome home until tomorrow! The dog slowly walks to Mom and Dad. Mom: (bending to touch dog) Eric, he’s so tired and hungry! (looking at table) The money with which you were to buy dog food is gone, but Spot looks so hungry! What did you do with the money we left? Dad: And look at the room --- garbage all over the place! Where is your brother? (shouting angrily) Daniel! Daniel: (running into room) Mom, Dad, I can explain--- Dad opens the curtains and light comes into the room. The room is in a mess, with pizza boxes on the floor and dirty dishes in the sink. In the corner, there is a garbage can around which are pieces of garbage and waste paper. Mom and Dad both turn towards Daniel. Dad: (sounding very angry) Listen to me, young man---- we left you in charge! We thought you could act like an adult, but look at the mess. I don’t know why the house is so dirty--- Mom: Daniel, we thought you were an adult, a person who would make good decisions……. Dad: How can we trust you any more?We won’t tole rate such behavior in our house! Daniel: ( shouting) Stop shouting at me. I’m still a teenager! Why is everything always my fault? Daniel runs into his bedroom and shuts the door angrily. Mom and Dad look at each other as lights go out. Act two, scene one Daniel and Eric’s bedroom. Eric sits on his bed. Daniel has his arms crossed and looks upset. Daniel: They never even gave me a chance to defend myself. I hate them! Eric: You don’t hate them. I can tell them we had an emergency. Then they won’t be mad anymore. Daniel: No, don’t tell them anything. Anyhow,t hey didn’t trust me. They don’t deserve an explanation . Let them think what they want. Eric: But Daniel, if they knew that Spot was sick and we used the money to take him to the clinic--- Daniel: And that we spent all of yesterday waiting there for him and that is why we had no time to clean the house --- but no Eric, why didn’t they ask me what happened instead of shouting at me?

走遍美国课文

Episode13 Act I 1.Theree’s nothing more joyrou than the arrival of a new baby. 2.I am so excited,Mother!Just imagine-Marilyn and Richard must be thrilled!Oh,a new baby 3.Mae,Mae,Mae.Oh,it’s a sweet-sounding name for a sweet boy.My fisrst grandchild. 4.And my first nephew.Isn’t he just adorable?He looks a lot like you,Mo.He does. 5.Do you think so?Well,I guess.He does look a lot like Richard,and I guess he looks a lot like me.Oh,he’s got Richard’s eyes,though. 6.I really want Harry and Michelle to see Max. 7.When are they coming? 8.Tomorrow. Harry has account to work on today.Yes,he does have Richard’s eyes.Big blue eyes.The baby even look at you like Richard does. 9.Well,children usually resemble their parents. 10.It’ true..Michelle is a lot like Harry in so many ways.And she’s shy with new people,just like he is. 11.You really like Michelle,don’t you? 12.Yes,I’m very fond of her. 13.And Harry,too? 14.Well… 15.Uh,It’s….four-thirty.Oh my!Marilyn and Richard will be home from the hospital any minute,and we must prepare this room. 16.Where will we put all the presents? 17.Well,let’s take everything to the living room,Marilyn and Richard and the baby need the space.It’s crowded in here. 18.The welcome sign is up.”Welcome home,Max.” 19.Isn’t it exciting,Grandpa? 20.Your first great-grandchild. 21.Yes.Yes,sir.a great-grandchild.A great-grandchild.Antoer generation to carry on the Stweart name. 22.I love you,Grandpa.You make me feel so pround to be part ofour family. 23.And one day.you’ll have your own family,and I’ll be proud to be part of it. 24.Now you understand my feeling,Susan.I’m Grandpa’s daughter-in-law,but I feel like a Stewart.He’s always made me feel like his own daughter. 25.Well,that’s because you’re so much like us-wonderful! 26.Mo,got it.This will makes a nice gift for Marilyn and Richard.They can keep a record of all of the important dates and information about Max’s life

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