心理治疗并非专属于精神科医师,任何人都可以进行某种程度的心理治疗,最常见的是神父、牧师与信徒之间的告解(或忏悔,confession),或算命师(fortune teller)对顾客的铁口直断,指点迷津。
一年前到台北荣总妇产科rotation时,有一位怀了双胞胎之孕妇,因为早产迹象,因此住院接受安胎(tocolytic)的治疗,当时因该病人羊水过多(polyhydroamnio),压迫胸腔,病人感到很不适,不时愁眉苦脸,病奄奄地呻吟,进行超音波检查,某位资深的技术员,很好心地鼓励她,虽然有这么多的不适,但是一旦能将小孩平安的生下来,一手各抱一个,想想那种快乐甜蜜的情景,这一切辛苦的付出都是值得的!我一直很佩服该技术员深得认知治疗中影像想像(image visualization)的精髓!
认知治疗的过程,对于记忆中快乐的事情具体化,尽量想像成具体的影像,而悲伤痛苦的事情尽量的抽象化,升华为抽象的意念,减轻病人内心的煎熬和痛苦,书本上写的尽是高度抽象的原则,但是如何落实,每个治疗者,各凭高下。
When I was One-and-Twenty by A. E. Houseman
When I was one-and-twenty 当我二十一时,
I heard a wise man say, 我听到一个智者说:
“Give crowns and pounds and guineas 给别人铜元、银角、金币,
But not your heart away; 但不要把心给别人;
Give pearls away and rubies 给别人珍珠、红宝石,
But keep your fancy free 但要保留爱情。
But I was one-and-twenty 但我才二十一岁,
No use to talk to me. 对我说这些话没用。
When I was one-and-twenty 当我二十一时,
I heard him say again 我又听到这位智者说:
“The hearts out of bosom 心从胸怀送给别人从不会白费,
was never given in vain; 得到的是一大堆叹息,
‘Tis paid with sighs a-plenty 换来无尽悲叹。
And sold for endless rue.” 如今我是二十二岁,
And I am two-and-twenty, 哦,他的话真对,真对。
And Oh! ‘tis true, ‘tis true.
(‘tis 是it is的缩写,古典英诗经常会看到类似这样的缩写)
Crossing the Bar by Alfred Tennyson
Sunset and evening star 日落星见,
And one clear call for me! 我清晰听到一声呼唤,
And may there be no moaning of the bar, 当我扬帆远去,
When I put out to sea. 请勿为我的归去悲哀。
But such a tide as moving seems asleep, 潮水仿佛熟睡,
Too full for sound and foam, 满潮的时候海水平静,
When that which drew from out the boundless deep. 从无边海洋卷来的潮水,
Turns again home. 再回家去。
Twilight and evening bell, 薄暮晚钟声响,
And after that the dark! 夜幕低垂!
And may there be no sadness of farewell, 我将乘潮归去,
When I embark; 和我道别,请勿哀伤。
For tho’ from out our bourne of Time and Place 从这尘世的港口出海,
The flood may bear me far, 浩瀚的大水将我远载,
I hope to see my Pilot face to face 当我越过浅滩,
When I have crost the bar. 我盼亲见祂的容颜。
第一首”When I was One-and-Twenty”讲的是情人分手,第二首
“Crossing the Bar”描写一位老人已走完人生历程,隐约看到日落星见,朦胧听到晚钟声响,自己知道即将扬帆归去,内心不免泛起淡淡的哀愁,但却没有太多哀伤,他对死亡有超然的看法。
当我念完这两首小诗,再想到从前的种种,突然领悟具体化、抽象话的意义!