一个戒瘾咨询师的反思 |
2017/8/31 21:57:55 来源:一线希望 |
原创 2016-07-10 宋歌 歌子心理 歌子心理
歌子心理
SongGePsych
分享心理咨询理论,技术,咨询心理学相关研究,咨询师感悟,跨文化视角。
这是我代表机构在一个针对海洛因毒瘾的公益音乐会上演讲的讲稿。听众多为成瘾者家属,我通过分享自己的工作经历和反思,帮助家属了解成瘾者康复中所面对的挑战,成瘾的歧视和污名化对康复的影响,以及一些系统层面的局限。
音乐会现场出了点小状况,因为事先不知道有多少时间演讲,讲稿准备的是15分钟的,到了现场被告知只有3分钟,于是临时做了删减。视频里是删减版,文字版是完整的。
讲稿里所有的引用,都是我以一些共性的主题为蓝本,再次创造的,用引用的方式,增加现场的对话感,但并不是直接引用来访者的话。
英译中:宋歌
Good evening. My name is Song. I am currently an intern supervisor at xxx. I started with xx four years ago as a Master level intern. Prior to that, I was a practicum counselor at a partial hospital. There, I can still vividly visualize the facial expressions of my previous colleagues when they learned that I would pursue my Master-level internship at xxx. Their facial expression said, “Oh, that’s disgusting.” That was my first experience of addiction stigma.
晚上好。我的名字是Song。我是xxx的实习生督导。4年前,我以硕士实习生的身份加入了xxx。在那之前,我在一家日间精神病医院做实践。当我告诉当时的同事,我的硕士实习要在一家成瘾机构做时,他们的面部表情给我留下了深刻的印象。”Oh,好恐怖”,他们的面部表情似乎这么说。这是我第一次经历有关成瘾的歧视。 My internship started at xxx in 2012. The question in my mindwas “why do people choose to use drugs?” A semester later, I realized that Iasked the wrong question. I discovered that most individuals became addicted to opiates as a result of lack of choices. Many get hooked on opiates through pain medications prescribed by physicians. They take their painkillers diligently, as directed, without aclear knowledge of opiate dependence, until their doctors stop prescribing.
2012年,我开始了在xxx的实习。刚开始,我有一个疑问,“为什么人们会选择吸毒呢?”一学期后,我意识到,我问错了问题。我发现绝大多数染上海洛因瘾的人,是因为缺乏选择。很多人的海洛因瘾始于医生开的(阿片类)止痛药。他们非常遵循医嘱得服用这些止痛药,却对这些药的成瘾性缺乏了解,直到医生停止开药。
Others though seem to have had a choice. Unfortunately at some point in their lives, heroin was offered to them and they took it. But as I looked deeper into their stories, there are always reasons behind their heroin use. Everyone that I work with has mental health symptoms. A large number of them have trauma histories as well. Using drugs is their way to cope with their symptoms: Flashbacks, grief, unstable mood, panic attacks, depression, or lack of meaning in their lives. Most of them did not know that their symptoms can be treated or where to access treatment. Drugs are a more accessible though unfortunate intervention.
另一些人,看似好像自己选择吸毒的。在不幸的某一天,有人把海洛因递到了他们面前,他们接受了。但当我进一步了解他们的故事后,总能发现更深层的原因。我服务的每一个人,同时都被心理疾病困扰。他们中的很多人还经历过创伤。创伤记忆的闪现,哀伤,不稳定的情绪,惊恐发作,抑郁,找不到生活的意义:吸毒是他们应对这些症状的方式。很多人都不知道这些症状通过治疗可以缓解,也不知道去哪接受治疗。毒品变成了最易上手却也是最不幸的应对方式。So think, if what people with addiction really need is primarily mental health treatment, why are they treated differently than others who have mental or physical health issues. Why are they called addicts,junkies, dirty users?
所以,请想一想,如果有毒瘾的人真正需要的是心理健康方面的服务,他们为什么被区别对待?我们为什么叫他们瘾君子,垃圾,觉得他们脏? I always invite people I work with to share their experiences of stigma. This question has never failed me. No matter how quiet they are,this question always opens them up.
我总是请当事人分享他们遭遇的有关成瘾的歧视。这个问题极其灵验。即便是非常沉默的人,这个问题也能打开他们的话匣子。They feel shamed about their addiction. “I am so ashamed about this” “I feel terrible that I relapsed”, they say. Their shame comes from the belief that people who use drugs are inherently bad and immoral. They are afraid that once others find out about their addiction, they become less of a person but just an addict. “This is some dirty little/big secret that I need to hide,” “I will never tell my family abou-t this”, they say. Stigma makes it harder for them to seek treatment“It took me a lot to pick up the phone and make the call”, a person told me. Ironically, as much as we would like them to get help, receiving agonist therapy and counseling itself is something they need to hide as well. Many of the individuals I work with expressed their fear of being kicked out by their landlord, being fired at work if others find out that they are on Suboxone treatment. And more sadly, they feel they are being judged by healthcare professionals and are sometimes hiding their addiction treatment from other doctors.
他们为自己的毒瘾感到羞耻。“我感到十分羞愧”,“我的毒瘾复发了,我感觉糟透了”,他们说。他们的耻辱感来自于人们普遍认为吸毒的人是不道德的,本质是坏的。他们害怕一旦他人发现了他们的毒瘾,他们就不再是完整的人,而仅仅是个瘾君子。“这是我必须死守的肮脏的秘密”,“我绝不会让家人知道我吸毒”,他们说。而有关毒瘾的歧视也成了成瘾者求助的障碍。“我花了很大的勇气才播了你们的电话”,一位当事人这样说。更讽刺的是,接受成瘾治疗这件事,也得藏起来。很多人提到他们的担心:一旦别人发现他们在接受成瘾治疗,他们会被房东赶走,会丢掉工作。People I work with also talk about their family members’unrealistic expectations. Basically, they are expected to recover in a very short time and not allowed any relapses. Addiction is still considered as a moral issue - not a health issue. I too, initially held this expectation, untilI realized that recovery was far more than just stopping using drugs. Have you ever thought of what a Heroin user’s day looks like? If not, you can follow me.They wake up in withdrawal, desperately searching for drugs, if they are lucky,there are some leftovers. They prepare the drug and use it, get high for a bit but then withdrawal kicks in. They get hold of a drug dealer and figure out a time and place to meet. Then they need to figure out where they can get the money. Then they go, meet the drug dealer, get the drug and start the whole cycle again.
我服务的群体也会讲到家人不现实的期待。基本上,家人希望他们短时间内康复,且不能复发。毒瘾仍然被当做一个道德问题,而不是健康问题。其实我自己一开始也抱有这样的观点,直到我意识到,康复远不只停止吸毒这么简单。你们有没有想象过海洛因成瘾者的一天是什么样子的?如果没有的话,你可以跟着想象一下。他们在戒断反应中醒来,抓狂得寻找海洛因。如果幸运的话,能找到一些昨天剩下的。他们着手准备,接着吸食,享受短暂的“高”,然后戒断反应又袭来了。于是他们一边联系毒贩子,一边想办法搞钱。接着,他们出发,去和毒贩子会面,拿到毒品,再次开始整个过程。Imagine that one day, one of them starts on Suboxone treatment. All of the sudden he experiences no more withdrawal symptoms. But a new challenge occurs, how is he going to spend the whole day in a drug free way when using drug was the center of his everyday life? A huge void needs to be filled up. For people who use drugs to numb themselves from mental health or trauma symptoms, this is even worse. All of a sudden, they experience every bit of their symptoms. Without proper treatment, without alternative coping strategies, without solid social support, what can they do, when they keep in touch mostly with others who also use drugs and when the waiting list for treatment is at least a month-long?
想象一下,某一天,他们中的某一个人开始接受Suboxone治疗。突然,戒断反应消失了。但更大的问题出现了:之前每天的生活都是围绕着毒品展开的,现在不用吸毒了,需要如何打发一整天的时间?一个巨大的空白需要填补。对那些用毒品应对心理疾病,创伤症状的人,情况更糟。突然,他们能切肤得感到自己的每一点症状和痛苦。如果没有相应治疗,没有其他应对症状的方法,没有强有力的社会支持,他们能怎么办?尤其当他们的身边只剩下吸毒者,而想接受治疗又得排上一个月的队。
I also ask people I work with how they want to be treated by others. I heard this same message from almost every one of them. “We want to be valued as a whole person”, they say. They are fathers, mothers, daughters, sons,friends, and colleagues. They have dreams, strengths, and weaknesses like we do. They are one of us. It may be shocking to hear, “they are one of us”. But think more deeply. Are you not struggling with some life challenges? Are you also wanting to make changes but finding yourself relapse again and again? The difference may be that whatever you are struggling with, it’s considered more acceptable by our society.
我会问服务的对象,他们希望如何被对待。几乎每个人都这样回答:“我们希望被当做一个完整的人”,他们说。他们是母亲,父亲,女儿,儿子,朋友,同事。他们和我们一样,有梦想,有优点,有缺点。他们就是我们中的一员。听到“他们是我们中的一员”,你也许很吃惊。但请想想,你是否也在攻克生活的一些难关?你是否也想做出一些改变,但发现自己一次又一次回到原点?唯一的区别可能是,你们正在攻克的内容,更被社会接受。
Another message I frequently hear from people I work with is that they want their family and friends to be more patient and realistic about their recovery. As an
addiction counselor, I know that entering a treatment does not mean that a person will become clean right away. I see the limitations of the system. For example, after several months’ waiting, someone finally gets into a program, but she or he may need to wait for another month or so to be evaluated by a psychiatrist.
我服务的对象也经常提到,希望他们的家人和朋友更耐心和实际得看待他们康复的过程。作为成瘾咨询师,我知道从进入治疗到停止吸毒还有很长一段距离。我们目前的治疗系统有很大的局限。比如,某人排了好几个月的队,终于被一家机构收了,可能还得等上一个月,才轮到TA第一次与精神病医生会面。 In addition, we have all tried to make major changes in our lives. We all know how hard it is. How many of you have ever tried to have a healthier diet? Say eating more vegetables and less chips and soda? Where are you now? Have you ever relapsed? Then, why do we expect our loved ones to recover from addiction in one night, one week, or one month? Acknowledging how hard it is to stay clean, complimenting her or him on the, and encouraging her or him to go back for treatment when relapse happens.
我们每一个人都尝试过做重大的改变。我们知道这个过程的艰难。你们中多少人尝试过让饮食变得更健康?比如多吃蔬菜,少吃薯片少喝汽水?你们现在坚持得怎样呢?有复发过吗?所以,我们为什么要求我们的爱人一晚上,一周,一个月就完全从毒瘾中康复呢?承认康复之路的艰辛,肯定TA的每一点进步,复发时,鼓励TA回到治疗中。On the other hand, it is extremely hard to witness your loved ones struggling with addiction. You are dealing with the fear that their lives can be taken away any second. You do get burned out, just like caretakers ofpeople who have other chronic health issues. On top of everything, you experience the stigma of addiction as well. You, too, are ashamed. You feel that you have failed as a parent or a spouse. You, too, are trying your best to hide this addiction. As a counselor, I know the importance of taking care of myself before I can help others. Put your own oxygen mask on first. If you have flown in an airplane,you have heard about this phrase. This is exactly the same for family members of people who have addiction. Talking to a counselor, joining a support group, and gaining help from your personal support system. These are some ways that you don’t have to deal with this all by yourself.
但换一个角度,眼睁睁得看着你心爱的人在毒瘾中挣扎,确实很难。毒瘾随时能带走TA的生命,你时刻都在恐惧。在这个过程中,你感到耗竭,和那些照顾有其他慢性病的病人的家属一样。而你自己也深深得被有关毒瘾的歧视困扰。你,同样也感到羞辱。你觉得自己作为父母或伴侣很失败。你,同样也想方设法得隐藏这个毒瘾。作为咨询师,我知道必须把自己照顾好了,我才有能力帮助他人。“首先带上你自己的氧气面罩”,如果你搭过飞机,对这句话一定不陌生。这就是你需要做的。给你自己找一位咨询师,加入一个支持小组,向他人寻求支持。这些方法让你不再用孤立得面对爱人的毒瘾。 Nationwide, the number of heroin overdoses has experienced a 6-fold increase from about 2000 cases in 2001 to almost 12 thousand cases 2014.Last year, in the Lehigh valley, 117 heroin overdose deaths and 21 suspected overdose deaths happened. That’s 138 heartbroken families.
从2001年到2014年,美国因海洛因使用过量而丧生的人,从2000变成了12000,翻了整整六倍。去年,仅在理海地区,就有117人因海洛因使用过量而丧生,还有21人被怀疑因海洛因使用过量而丧生。这是138个心碎的家庭。Four years ago, I started with xxx thinking that I would never have become dependent on Heroin. Over those four years, my ideas have changed.I am no better than them. I just have the pure luck of not going through what they have gone through. So, if you are currently struggling with addiction, be patient with yourself and hang in in treatment. If your loved one is struggling with addiction and you wonder how youcan help them. The answer is in your heart. If you and they are really the same, how would you like to be helped? The answer is in your heart.
四年前,刚开始在xxx实习时,我想“我绝不可能染上毒瘾”。四年后,我的想法变了。不是我比他们好。我只是比他们幸运,不用去经历他们所经历的。所以,如果你正在和毒瘾搏斗,对自己耐心一些,并坚持接受治疗。如果你的爱人正在毒瘾中挣扎,你想知道自己如何能帮到TA。答案,其实就在你心里。如果你,和他,没有区别。你想如何被帮助?答案就在你心里。
Thank you!
谢谢大家!
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