In psychological counseling, there is a part that needs to be on the lookout, which is the auxiliary treatment of schizophrenia. The reason why the auxiliary is not the dominant is that the sperm situation is relatively complicated, and the first choice for its treatment is medic

In psychological counseling, there is a part of us that needs to be on guard, that is, the auxiliary treatment of schizophrenia . The reason why

talks about assistiveness is not the dominant one because the situation of sperm is relatively complicated, and the first choice for its treatment is medicine.

Because only through drugs can the patient's degree of division be effectively controlled, excessive anxiety is reduced, and psychological counseling can be involved.

But even so, we will be very cautious.

Because The characteristic of schizophrenia is excessive fantasy, which makes spermatozoa often unable to distinguish between imagination and reality.

So the neurotic visitors who are relatively clear in consciousness and can deeply explore the inner heart, schizophrenia needs more considerations.

For example, it does not adopt a single treatment method, but flexibly adjusts the treatment method according to the patient's personal situation and proceed step by step.

So today, let’s talk about it in detail from a case.

A "little" girl who does not match her age

About May last year, my colleague referred me a special visitor. Her name is Qingqing (pseudonym), and she is a girl who is about to enter high school.

The reason why she is said to be special is that she was diagnosed with schizophrenia in March and was discharged in May after being treated with medication and hospitalized for a period of time.

Although his peers are also a school of psychodynamics, it is said that this girl would rather find a same-sex counselor, so after he thought about it over and over again, he recommended me to her.

When I first met, she left a deep impression on me.

This impression stems from two points.

One of them, although she is already 14 years old, she dresses more like a child of seven or eight years old. In addition, she is small and has two braids, which makes me dazed at the moment whether she has falsely claimed her age.

The second thing she did not come by herself, but by her mother. And her eyes dodged and timid, and she always looked at her mother when talking about her situation, as if she could not face me directly, but needed her mother as an intermediary.

Although we will understand her basic situation in advance for the referees, the text information is not richer than the information obtained from face-to-face contact.

For example, Qingqing's requirements for "youngering", "cowardice and hiding", and "wanting a homosexual counselor" are all in line with her information and have become my clues to further understand her.

So what does this clue point to in the end?

A pubertal girl who is overly dependent on her mother, symbiotic with her mother, and her psychological development stagnates in her early stages and cannot adapt to reality.

Supportive treatment is to establish a safety boundary

In psychodynamic-led psychological counseling, there are two treatment methods. One is expression therapy and the other is supportive therapy.

The former is what we often mention, which is equivalent to a method for clients to deeply explore their own subconscious with the assistance of a consultant. The latter promotes the improvement of clients' self-function through encouragement, psychological education, advice, etc.

Although relatively speaking, expressive treatment has more psychoanalytical connotations, in fact, supportive treatment is indispensable for some clients with serious psychological problems or temporary self-function caused by symptoms.

Because for this type of client, they are similar to children who retreat to their early years and cannot stand up through their own abilities, so before exploring themselves, they also need support from parents (the counselor will be projected as parents’ role). The clients who are diagnosed with schizophrenia are even more special.

In addition to insufficient ability, in their fantasy, this world is still extremely unsafe, so they must be on guard all the time to prevent danger from happening.

Even if a trust relationship has been established, they are not so reliable in their hearts. Once the situation is disturbed, they will doubt, such as Qingqing.

After we consulted for a while, Qingqing began to slowly trust me.

She became dependent on me just like she did to her mother. For example, accept my advice and change her lifestyle appropriately; be interested in psychology knowledge and want to know more about herself; most importantly, slowly change her obsession with academic performance, which was the trigger that stimulated her to suffer from schizophrenia.

But when everything is getting better, one day things change.

Because of the national legal holiday, we also take a vacation naturally.

But Qingqing did not come that week after the vacation, and she neither asked for leave in advance nor informed her temporarily, and disappeared directly.

At first I was a little worried and didn't know what happened to her. But after calling, she found that she was just staying at home. And according to her mother, everything was nothing, she just didn't want to come for consultation.

So I realized she was angry.

or furthermore, the vacation made her feel "abandoned".

Although vacation is completely understandable from a realistic level, in the eyes of a schizophrenia client who is prone to damage to security and strong delusions to be victimized, this is what others are not trustworthy, thinking that they will be left behind by the other party at any time, which is ruthless and cold.

And when I understand this, I know how to do it.

When I met next time, I said to her: "Although it is normal for a vacation, it was mentioned in the consultation agreement. But I know that your feelings are not good at all. You may feel that you have been left behind for no reason. If so, we can arrange a consultation in advance before the next vacation. Maybe this will make you feel better. What do you think?"

Originally, her expression was very restrained, but when she heard this, she slowly relaxed. Then he said to me embarrassedly: "Actually, I know it's normal to take a vacation, but I just don't feel happy. I originally thought you would scold me or not let me come, but it turns out that this is all my own imagination, thank you."

From this episode in our consultation, we can actually see the characteristics and functions of supportive treatment.

1 ① words need to be stated clearly. Only in this way can the visitor be "directly" taken away from the terrifying world in her fantasy, thereby establishing a security boundary.

② emphasize more on the sense of reality, such as "holidays are normal", in order to break the common obsession of "self-centered" among schizophrenia visitors.

"Explanation", expand the space of consciousness

For spermatorrheological patients, can we only use supportive treatment?

The answer is obviously no.

Because supportive treatment is often used in the early stages and inadequate self-function. When the sperm patients' condition improves and their fantasies fall back to normal levels, moderate expression therapy can be put on the agenda.

When talking about this, we need to first introduce a concept: explanation.

The so-called "explanation" is the core technology of psychoanalysis .

Its meaning is: to consciously realize the subconscious content.

For example, in the above consultation clip, I have this understanding: vacation made her feel abandoned. This understanding is an explanation, which is to make subconscious assumptions about Qingqing's rejection and anger.

When Qingqing felt relieved when she heard this assumption, it means that the assumption was confirmed.

means that at that time, part of her unspeakable subconsciousness was conscious, so her emotions were stable and her anxiety was reduced.

And that's why expression therapy is performed after supportive treatment.

Only by constantly consciously subconscious , increasing consciousness space, and reducing emotions in fantasy, can the client's psychological state be more stable and the symptoms will slowly disappear.

So in the next consultation with Qingqing, we discussed her symbiotic state with her mother, her knot of resentment for her mother, and her state of mind that she wants to be independent and fearful.

After consulting for a year, finally one day, she said to me: "I understand why I have become schizophrenia because of my academic performance. It is not just a pressure, it also represents my heart that I want to fight against my mother.

Since the grades are all for her, I have to completely destroy it to make her despair of me. It is not that I don't love her, but maybe only if I despair can she let me go, and I have the opportunity to find myself..."

After saying this, Qingqing breathed a long sigh of relief. I knew she was relieved because she understood herself from a deeper perspective and the love, hate and affection between herself and her mother.

What makes me even more gratified is that this is her own exploration, which means that her self-function has been greatly improved.

I think she will get better and better in the end.