依恋理论能帮助解释童年逆境和精神病之间的关系吗?

J. Read, A. Gumley
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引用次数: 37

摘要

几十年来,我们理解人类痛苦、绝望和困惑的原因的努力一直受到一种主要或只对基因和神经递质感兴趣的简单化、还原论范式的阻碍(Bentall, 2003;Read, Mosher, & Bentall, 2004)。这种“医疗模式”得到了制药行业的热烈支持,制药行业从传播一种最小化心理社会原因的意识形态中获益良多(Mosher, Gosden, & Beder, 2004;读,2008)。尽管这种模式的主导地位遍及所有类型的精神病学诊断,但它在精神病领域表现得最为强烈或更具破坏性。自从一个世纪前发明了所谓的“精神分裂症”以来(Bentall, 2003;Read, 2004a),全世界数以百万计的人被谴责为悲观、自我实现和污名化的信念,认为他们患有某种不可逆转的脑部疾病。这种疾病被错误地认为主要是由基因决定的,据说与一个人的生活史或环境几乎没有关系。重要的是要认识到,世界各地的公众从来没有接受过一般精神健康问题的疾病模型,特别是“精神分裂症”。在几乎所有进行过调查的国家,公众都认为疯狂主要是对发生在人们身上的坏事的反应,而不是基于生物基因的疾病(Angermeyer & Dietrich, 2006;读,2007)。在任何地方,公众(包括患者和家庭成员)都认为“精神分裂症”是由贫困、孤立、家庭问题、虐待儿童和忽视引起的,而不是由基因或大脑缺陷引起的。尽管有数百万美元,通常是由制药公司捐赠的,
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Can attachment theory help explain the relationship between childhood adversity and psychosis?
For several decades our efforts to understand the causes of human distress, despair, and confusion have been impeded by the dominance of a simplistic, reductionist paradigm interested primarily or exclusively in genes and neurotransmitters (Bentall, 2003; Read, Mosher, & Bentall, 2004). This ‘medical model’ has been enthusiastically supported by the pharmaceutical industry, which has much to gain from promulgating an ideology that minimizes psycho-social causes (Mosher, Gosden, & Beder, 2004; Read, 2008). Although the dominance of this model pervades all categories of psychiatric diagnoses, nowhere has it been stronger or more damaging than in the field of psychosis. Since the invention of the supposed illness ‘schizophrenia’ a century ago (Bentall, 2003; Read, 2004a), millions of people worldwide have been condemned to the pessimistic, self-fulfilling, and stigmatizing belief that they are suffering from some kind of irreversible brain disease. This disease, which has wrongly been presented as largely genetically determined, supposedly has little or nothing to do with one’s life history or circumstances. It is important to realize that the public, all over the world, have never accepted the illness model of mental health problems in general, or of ‘schizophrenia’ in particular. In virtually every country where surveys have been conducted, the public believes that madness is primarily a reaction to bad things happening to people rather than bio-genetically based illnesses (Angermeyer & Dietrich, 2006; Read, 2007). Everywhere ‘schizophrenia’ is seen by the public (including patients and family members) to be caused by poverty, isolation, family problems, child abuse and neglect more than by faulty genes or brains. This is despite millions of dollars, often donated by drug companies,
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Interprofessional collaboration: Achieving integrated care in mental health services Never let the truth get in the way of a good story A brief history of psychosis, its politics and why genetics is a cop-out In bits: Hearing the fragmented narratives of people who experience psychosis Truth is stranger than fiction—what happens to the story when no-one wants to know
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