心理治疗中隐喻的使用、疗效检验及作用机制

doi:10.3724/SP.J.1042.2022.01546

摘要/Abstract

摘要：

隐喻是用一种具体、熟悉的概念去表达和理解一种抽象、不熟悉的概念的语言形式和认知方式,因其在心理治疗中可以有效传递治疗信息而被治疗师们广泛使用。早期的隐喻理论阐述了隐喻具有高创造性和增强长时记忆的认知加工优势,虽然不同心理治疗流派在治疗过程中对使用来访者还是治疗师产生的隐喻各有侧重,但它们都认为隐喻可以通过高创造性的内容、形成更优的长时记忆以及带来高度的认知卷入来帮助咨访双方有效加工、传递和保存治疗信息。精神分析流派强调治疗性隐喻在无意识水平上的意义交换产生的顿悟过程,认知行为疗法既强调隐喻可以促进认知图式的重构,也强调其组块性和形象性产生的记忆功能,接纳与承诺疗法认为隐喻传递信息时具有非评判、非分析、直觉经验的方式有利于促进个体发生改变,后现代疗法中强调让来访者重新叙述自己的人生故事或者发展出一种形象性或象征性表达,让来访者产生更具有功能的观点和看法。因此治疗性隐喻具备了跨越不同心理治疗理论取向的广泛认同基础。在实证研究上,大多数研究聚焦于探索在某种治疗方法中加入隐喻是否会有更佳的治疗效果,其中使用CBT作为框架的研究最为集中,有些研究发现隐喻干预在缓解心理症状方面优于常规干预,也有研究发现隐喻干预和非隐喻干预都可以有效缓解被试的心理痛苦,因此虽然没有获得十分一致的结论,但这些研究总体上证明了在心理治疗中使用隐喻是有效的。随着研究的深入,对治疗性隐喻起效的心理神经机制进行探索的实证研究也有效观测到了隐喻理论中提出的认知加工优势,包括隐喻的高创造性可以诱发顿悟（并伴随杏仁核、海马、梭状回等特异性神经网络的显著激活）、带来更佳的治疗效果,隐喻内容更容易被记住、有助于治疗持续发挥作用,以及隐喻可以增加来访者的认知卷入程度进而带来更大程度的认知改变。综上,无论从理论构建还是实证证据上,治疗性隐喻都是一种具有独特认知加工优势的认知工具和治疗信息传递途径。未来研究可以从更加科学的设置对照组、增加隐喻特异性的效果衡量指标以及探索其他可能的心理机制三个方面来进一步观察在治疗性隐喻的独特优势。最后,对在心理治疗实践中更好的使用隐喻以及研发嵌入隐喻的低成本高效益的社会心理健康服务方案提供了建议。

关键词: 隐喻, 心理治疗, 心理干预

Abstract:

Metaphor is a unique form of language and way of cognition, with which people use concrete or familiar concepts to express and understand abstract or unfamiliar ones. As metaphors usually work effectively in transmitting therapeutic information, they are extensively used in psychotherapy. Fundamental theories of linguistics and psychology state that metaphors possess cognitive processing superiority because they are high in creativity and has memory retention functions. Though different schools of psychotherapy have varied emphasis on using metaphors generated by either the client or the therapist, they all agree that metaphors can help with effectively processing, transmitting and preserving therapeutic information through highly creative content, better long-term memory and high cognitive involvement, with psychoanalysis focusing on unconscious meaning exchanges, CBT on schema restructuring, and ACT on intuition experiences. For empirical research, a majority of studies focused on whether adding metaphors to a certain therapy (mostly CBT) could improve the effects of treatment, and as a result, some studies found that therapies with metaphors have greater intervention effects compared with conventional ones, while some others found that the two kinds of therapies are equally efficient. These studies generally demonstrate that metaphor use in psychotherapy is overall efficient, as the potential mechanisms proposed in theories had also been observed. Studies have shown that metaphor-triggered creative insight (with significant activation of amygdala, hippocampus and fusiform gyrus), enhanced long-term memory, and greater cognitive involvement could play important roles between metaphor use and therapeutic effects. In conclusion, therapeutic metaphor is an effective tool with unique advantages in cognitive processing and transmitting therapeutic information on both theoretical empirical perspectives. Future research should examine the advantages of metaphor use by setting more rigorous control groups, using metaphor-related measurements of treatment effects and exploring mechanisms further. Finally, practical applications on applying metaphors in psychotherapy practices and developing cost-efficient public mental health service programs with therapeutic metaphors are suggested.

Key words: metaphor, psychotherapy, psychological intervention

中图分类号:

R395

于冠琳, 刘瑞璇, 张文彩. (2022). 心理治疗中隐喻的使用、疗效检验及作用机制. 心理科学进展 , 30(7), 1546-1560.

YU Guanlin, LIU Ruixuan, ZHANG Wencai. (2022). Therapeutic metaphors: Theories, empirical efficacy and underlying mechanisms. Advances in Psychological Science, 30(7), 1546-1560.

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