亞洲輔導學報



Application of Cognitive Therapy to Hopelessness Depression

2007.第14卷第1及2期(Vol. 14 Nos. 1 & 2).pp. 125–140
 

Application of Cognitive Therapy to Hopelessness Depression

認知治療在無望抑鬱症的應用

Sau-Lan LI(李秀蘭)

Abstract

Hopelessness depression is a subtype of depression. Due to hopelessness, this subtype of depression has distinctive symptoms of retarded initiation of voluntary responses, apathy, and mood-exacerbated negative cognition. Hence, hopelessness depression patients have motivational defects and strong dysfunctional thinking. These are unfavorable factors for cognitive therapy because cognitive therapy requires patients’ participation in identifying and modifying their dysfunctional thinking and it has limitation for modifying strong dysfunctional thinking. This article shows that undermining hopelessness is a necessary preliminary step before cognitive work on their dysfunctional thinking when treating hopelessness depression patients, and it can be done by cognitive treatment focusing on self-esteem enhancement. A successful case experience of applying cognitive therapy to hopelessness depression is illustrated.

摘要

無望抑鬱症是抑鬱症的一種,無望感令患者有遲滯的自發反應、冷漠,且因低落情緒而出現嚴重的消極認知等獨特症狀。故此,無望抑鬱症的病人往往欠缺動機,並有強烈負面思想。這些問題不利於進行認知治療,因為認知治療要求病人參與識別和改變他們功能不良的思想;況且,認知治療對處理頑固功能不良的思想亦有其限制。本文引用一個個案,指出使用認知治療醫治無望抑鬱症病人時,首要工作是減輕病人的無望感,而這又可以透過重點提升病人自尊的認知治療來達成。