In modern society, with the explosion of new things, the world is changing with each passing day, and the temptation factors suddenly increase, which breeds a lot of desirable desires and produces a lot of pressure. Therefore, our generation is more prone to psychological problems than our parents and grandparents, so we should pay more attention to prevention and self-care from time to time.
Studying psychology is too deep, and people are somewhat professional, but it is also a special angle. For example, when people talk about a difficult person, they will directly say that this person is "morally wrong", "immoral" and "uneducated". As a psychology lover, you can't just give such irresponsible comments. Most people with interpersonal barriers have psychological barriers in one way or another. After all, few people are truly morally bankrupt. For example, a tenant with us, the couple, together with their sister and brother-in-law, always * * * four people crowded in a room all day, rarely went out, refused to communicate with everyone, never said hello to take other people's things, and took some public facilities for themselves. When meeting such a wonderful group of people, everyone can't help but mention personality problems. But I observed the things behind: paranoia, weakness, social fear, family environment.
But what we are going to talk about today is not minor problems such as paranoid personality disorder, depression and obsessive-compulsive disorder, but schizophrenia, which is called the most serious psychological problem (none of them). The protagonist of the story is my childhood playmate, so let's call him Mr. A (article 14 of the Code of Professional Ethics for Psychological Counselors). "Psychological counselors should strictly abide by the confidentiality principle, and have the responsibility to explain the confidentiality principle of psychological counselors to visitors and use this principle. Two months with Ah Jun, life is like a suspense movie, with ups and downs. People who haven't experienced it can't imagine it out of thin air, and people who have experienced it won't forget it.
First, I haven't seen you for many years, and you are like this (65438+1October 2? How are you? Yangzhou hometown)
Although I had learned about Mr. A's illness from my parents in advance, I was taken aback when I just got home-I sat motionless, my eyes were blank, my face was blank, my face was painful, and I didn't want to say hello. At the beginning of 20 14, I had a phone call with A. Although I didn't say anything about my life, the negative energy from the other end of the phone made me feel that I was talking to a cosmic black hole, and all my passion was taken away. After I fled and hung up the phone, the sensitivity of psychology lovers made me realize that A's situation was not optimistic, and he was likely to encounter psychological problems when he graduated in 20 15. But what I didn't expect was that his question would come so timely and intense. In addition, from the second half of 20 14 to the first half of 20 15, I was also entangled in various life events, and I couldn't get away from caring about him.
Until September this year, my family told me that A had a big problem-hearing someone talking in his ear all day, revealing privacy, lingering and unable to find it, feeling that he was being followed and teased by an unknown person, firmly believing that his parents and the unknown person conspired to persecute him, and because he missed more than half of the courses, he failed to get his diploma, and his relationship with his classmates and roommates was also chaotic. The most exaggerated thing is to go to the public security bureau to report the case. After his family took him to the hospital for psychiatric treatment, he still refused treatment and medication, insisting that he had no problem.
Although I haven't seen the diagnosis and treatment results of the hospital, I can completely confirm that Mr. A suffers from paranoid schizophrenia (the most common type of schizophrenia) through his performance and family description. For those who don't know about this disease, you can refer to johnf nash, the protagonist of the biopic A Beautiful Mind, who has made outstanding contributions to game theory. He also has exactly the same symptoms.
I have to feel sorry for this meeting with Mr. A for many years. I haven't seen you for many years. Why are you like this?
Second, relax and take you to climb the mountain (65438+ 10/month 10, sunny day, Suzhou Dayangshan)
A's problem is too difficult to be solved in a day or two-first of all, he is faced with the difficulty of finding a job, because he has no diploma, and the serious inertia caused by mental problems destroys his will to learn, resulting in a serious shortage of his professional skills; Second, because of his personality, A is emotionally numb and indifferent, living alone all the year round and extremely afraid of socializing. Even if he finds a job, it is difficult to integrate into it, which is also the most important factor leading to his illness. Third, fierce resistance to taking medicine, denial of symptoms and failure to cooperate with treatment have seriously hindered recovery, which is also the biggest problem. Because of these points, after discussing with A's family, we decided to take A to Suzhou for personal therapy and ability training after the National Day holiday.
A firmly believes that everyone around him wants to harm him (persecution delusion). Although he just wants to listen to me, he can't fully trust me for the time being because he hasn't seen me for many years. Therefore, treatment and ability training are also imminent. Therefore, I decided to take A out for the time being. First, I can release his extreme depression. Second, I can provide him with the friendship he lacks most in recent years. Third, I can enhance mutual trust and lay a good foundation for the follow-up treatment and training plan.
With enough dry food and drinking water, A and I embarked on a day trip to Dayang Mountain. The weather is fine, and the air in Dayangshan is very fresh. Mountaineering is a very healthy exercise, which consumes a lot of energy. Due to staying at home for several years and taking medicine recently, A's physical fitness is somewhat backward, and he wants to give up several times in the middle. This fear of difficulties and poor willpower are also highly consistent with the symptoms of schizophrenia, so I have to take pains to encourage him again and again. Although A didn't want to, she was more cooperative. On the way, I tried to talk to A many times, but A's willingness to speak was not high, his initiative was poor, and the atmosphere was a bit embarrassing. I told a dirty joke while drinking, and A couldn't help laughing. For the first time in so many days, I saw the second expression on A's numb face, and then the atmosphere gradually became harmonious.
At the end of the evening trip, I talked about some psychological problems (self-disclosure) I encountered before, and also talked about some topics that people are usually ashamed to talk about (such as love and masturbation). ), gradually unloaded A's psychological defense. A is also willing to ask her own questions. He told the story that he was severely isolated by his classmates and roommates because he was not good at communicating with others. He also told a story that one day in his second year of high school, he suddenly heard someone talking in his ear and followed him everywhere. In his junior year and senior year, he basically talked and even slept all day, and no matter what "that person" he was thinking about, he knew it and it was exposed. He felt that it was not an illusion at all. Although I have learned most of them in advance, it is absolutely meaningful in psychotherapy through A's own statement, because most of the problems that can be said are not hopeless.
Third, you see, society is like this (65438+ 10/7, cloudy day, Qingfeng Decoration Company, Suzhou Convention Center Hotel, Taihu Park? )
"Psychological problems are mostly caused by social relations rather than medical problems"-this is the feeling I got when I met a bottleneck in studying psychology last year and switched to studying sociology. Later, it was found that it coincided with what alfred adler, a giant one hundred years ago, called "the Big Three of Psychoanalysis" with Freud and Jung.
I laid the foundation of mutual trust, and then I want to start with the main source of Mr. A (social fear and social withdrawal). Due to years of loneliness, A is seriously lacking in social skills. More importantly, he seems to have no will to change the status quo. This is tricky because I can't whip him to communicate with others. So with the idea of giving it a try, I took A to Qingfeng Decoration Company and Suzhou Convention and Exhibition Center, and found two interior designers to discuss decoration cooperation. I let A watch the whole course, hoping that my speech and behavior can infect him and alleviate his fear of socializing, which is also a necessary skill for his upcoming job interview.
In the afternoon, I went to Taihu Park, took a walk by the water, and continued to chat with A for a long time. A is a little more open than when I first went out, and a little willing to initiate some topics with me, in order to further enhance trust.
Fourth, I know how heavy your heart is (10,21,rain, shelter).
After living with A for a while, I found that A's living habits are really different from ordinary people: serious procrastination tendency, a simple and clear thing takes a long time to finish; Getting up every day is like facing the Long March. It takes three reminders and six invitations to get up. There is no will to take the initiative. Don't explain his task, just watch TV or stare blankly. If you explain the task, you always give discounts. Many times he is expressionless, like he has depression (actually, a depressed person will take the initiative to seek medical treatment, but he will never); I seriously lack self-confidence and underestimate my ability, so I can't do many small things (such as online shopping, Baidu searching for needed information, making resumes, submitting resumes to find a job, etc.). The most common saying is "I can't do it, I really can't do it".
His behavior is considered lazy in the eyes of ordinary people (including his family). In fact, his illness has destroyed his willpower, so that he has repeatedly delayed and done nothing, and even the little thing of getting up has become a huge project for him. This is why he didn't even have the willpower to get up for class during his college years, which led to so many failed courses-this is hopeless for others.
Because there is no diploma, A refused to learn drawing software, refused to accept my induction training, and even refused to submit his resume. I can't help thinking that all this is in vain. I have to come up with some unconventional methods-help A forge a diploma that is exactly the same as the real one online. Although it is useless, because the authenticity can be checked online, with this encouragement, A finally moved.
Within a week, at my urging, A handled online banking and local calling cards, bought a useful mobile phone, registered an email address, applied for a QQ number, and installed drawing software Creo and Auto? CAD, made an unsatisfactory resume-this was unimaginable for Mr. A before, and finally, there was a substantial breakthrough.
5. Shout it out, there is nothing to be ashamed of (65438+1October 3 1, cloudy and sunny, Mudu ancient town, Lingyanshan, Tianpingshan and Baimajian)
I've been in Suzhou for almost a month. A's painting skills have been very solid, and her basic living ability has also improved. Judging from her last experience in Dayangshan, A really needs physical exercise. On this day, I want to take him out to relax and go hiking and training in Mudu Ancient Street and Lingyan Mountain.
In the morning, I trudged 35 kilometers to the old street of Mudu ancient town, taking him to feel the real old Suzhou and the flowing water of small bridges and eating some snacks. In the afternoon, I climbed the nearby Lingyan Mountain, visited the Lingyan Temple at the top of the mountain, and tasted the so-called "best vegetarian noodles in Suzhou" in the temple next door. Later, I went down the mountain along Houshan Road and accidentally climbed Tianping Mountain and Baimajian.
Especially in the mountainside of Tianping Mountain, facing the continuous mountains, I couldn't help roaring and feeling carefree. Then I patted Mr. A on the back and motioned for him to try. To my surprise, this time, Mr. A didn't hesitate too much, and shouted recklessly-such a depressed person could do such a move! Maybe the long-distance exercise has opened the hidden nature of A, maybe it is my demonstration effect, or maybe A has been depressed for too long and needs to be released.
But in any case, you can see two things-one is that A has completely stopped guarding against me; Second, exercise is really important to A.
After returning home, I felt that our mutual trust had a certain foundation, so I confidently introduced the knowledge about schizophrenia to A, convinced A that he was suffering from schizophrenia, and gave him several authoritative psychological tests, including the Minnesota Personality Questionnaire. The test results all prove my point, and A's reaction seems to be very obedient. I feel that it is not far away for him to take the initiative to take medicine and cooperate with treatment.
After that, I took him for a long run every few days. Although I don't like pure sports very much, things seem to get better every day with A joining me.
6. Don't be afraid, I'm your backing (165438+1October 9, Xiaoyu, residence)
Sleepwalking is mysterious and always seems to be seen in movies, but the following story will uncover the mystery of sleepwalking.
A has received interview notices from several companies after submitting her resume for a period of time. A is a little worried about the fact that she has no previous interview experience and failed to graduate because of her natural social fear. So I will definitely encourage him all the time, but because of A's suspicious and eccentric personality (typical characteristics of schizophrenia: suspicious, it is difficult to believe others' words), too much encouragement makes him feel that I am comforting him, making him more insecure and making me laugh and cry.
I can't help it, but let him experience what he is afraid of. After interviewing two companies, the situation is really unsatisfactory. In fact, I didn't expect him to succeed at the beginning of the interview, so I didn't worry. But what worries me is that although I am not satisfied with my performance and ability, and I am a little anxious, A can still escape from reality, stop studying as soon as he comes back, and even lazily submit his resume, just watching TV and staring blankly there.
I asked him, "What will you do if you still can't find a job after a while and the next fresh graduates are freshly baked?"
His answer annoyed me: "That's a big deal. I'll go home and look for it. " Then continue to watch TV in a daze.
Usually I am restrained, but this time I am really angry. I said with an expression, "Don't fucking deceive yourself here! If you can find it in your hometown, do you still have to follow me so far? ! Think about how much stronger Suzhou's industrial base is than its hometown. It would be better if you can't find your hometown here. ! ! "
This time, A's numb nerves were finally touched, perhaps because of my unexpected anger, or perhaps because he had to admit that he was deceiving himself, but in any case, A was moved again. After practicing painting seriously for a period of time, A is a little "hot". One night, he sat up inexplicably, his shadow stared at me and asked, "How do you draw this?" I fell asleep and exclaimed, "What did you say?" Then there was no reply from A, and he lay down to sleep again, and woke up completely unconscious the next day.
Sleepwalking occurs in deep sleep, so it is not a dream. 15% of children sleepwalk, which is normal, but the probability of adults is less than 1%, which is probably caused by schizophrenia. Through Freud's study of dreams and my own speculation, I can at least read the following points from the words of a sleepwalker: A is still not confident in his painting skills and still has a certain desire for work, but at the same time he has a serious dependence on me (this is a side effect of trust).
This time, his luck seems to be a little better. A few days later, several companies sent him an interview notice, and A was well prepared. Because of the more interviews, A is more or less sophisticated and less worried about the interview.
But the result is still not satisfactory. Later, these companies did not have the following. Maybe his false certificate was found out, or maybe it was for other reasons. Don't talk about him this time, even I was a little discouraged.
But it is unacceptable for me to give up so hard for so long. Besides, if I give up, who else around A can help him? I can't help it With the mentality of treating a dead horse as a living horse doctor, I no longer let the gang catch it all, but personally took him and his diploma to the talent market to try my luck. Fortunately, A still listens to me in this respect.
Luck is really not in vain. Two days after the investment, two companies in the talent market still said that he could interview without a diploma, so A took part in two interviews again and passed the initial test successfully.
7. How many secrets do you have in mind? (165438+1October 15, cloudy day, Yangcheng Lake Peninsula)
Later, one of the two companies hired A to have a physical examination. This time, A made a move that I didn't understand. I need to accompany him to the physical examination, otherwise it will be lonely. This makes me speechless. I didn't want him to rely too much on me, otherwise it would always be a time bomb in his life, so I flatly refused. But in fact, I am also a little worried about the physical examination, because the side effects of antipsychotics can cause abnormal heart rate.
After the results came out, the ECG was abnormal. Nevertheless, the company hired him. But what I didn't expect was that A refused! Yes, he thinks it's too far from here to go. Fuoco! I'm really angry this time! On the one hand, my efforts were in vain, on the other hand, I was shocked that I didn't know so much about A. A was also shocked by my anger, and the atmosphere was very bad.
But things have happened, and anger can't solve the problem. In the afternoon, I wanted to find a quiet place, have a full psychological talk with A, and deeply understand his thoughts, so I took him to the sparsely populated Yangcheng Lake Peninsula.
At the Yangcheng Peninsula Ecological Farm, I asked a penetrating question: "Do you still have hallucinations?"
"What illusion? ! I don't even admit that it was an illusion! And I don't feel sick! " A is very angry. I guess she was angry with me this morning, and the answer surprised me-she had realized that she was sick before, so how could she deny it? Compared with joy, anger is not a good emotion, but it is better than numbness. The sentence "Making a person angry is the most effective way to hear the truth" is really reasonable.
This unexpected answer made me wake up a lot at once-A's condition has not improved, but she pretended to obey in order to avoid disputes (A is the ninth personality among nine personality types, especially afraid of conflicts and disputes). So, I decided to patiently spy out how many secrets A's psychology has hidden.
After three hours of persuasion, I finally know that A really can't tell illusion from reality. On the one hand, he is very dependent on his mother, on the other hand, he is extremely suspicious that his mother will conspire with others to murder him, and he is also worried that his mother will drug him in his meal (because A strongly resists taking medicine, his mother did secretly put antipsychotics in his meal), and even for a while he suspected that I was the same. Actually, I was a little confused, but later I was convinced that I was helping him and ruled me out. He doesn't have any plans for the future, but he feels as if he is drifting in a dream.
Through this detailed intake conversation, I found that compared with the crazy behavior of hearing voices and reporting, A actually did not recover, but changed from obvious positive symptoms (hallucinations, delusions, confusion) to hidden and stubborn negative symptoms (apathy, lack of language and fading will)? . Although the positive symptoms look crazy, they are actually easily controlled by drugs. On the contrary, this mild negative symptom is hidden, the drug effect is not obvious, and it is extremely stubborn, so it is called "doctor killer"!
On the whole, the meeting was very successful, and I decided not to tell him the fact that I had been taking medicine without knowing it for the time being, so as not to affect the treatment.
Eight, don't get excited, let's sit down and talk (165438+1October 2 1, cloudy with light rain, Su Daxiangmen hou zhuang, Pingjiang Road, Suzhou Museum, residence).
A few days later, another company also hired Mr. A, and this physical examination barely passed. Although it is a happy event, it also brings another problem-after work, A's medication has become a problem, and his mother can no longer secretly mix drugs into A's meal. If the medication is stopped, A's condition is likely to turn for the better. The previous months of medication were all in vain, and she had to start over. Worst of all, once the symptoms recur, A is likely to lose his job, and once he loses his job now, A has little chance of re-entering the workplace in the future. In addition, the prejudice caused by the public's ignorance of schizophrenia will make them regard A as a monster, which will further deepen A's fear and retreat from the society at that time. But A has a bad feeling of illness. Tell him the truth, and he will probably stop taking the medicine at once. This is really a dilemma.
At first, I thought that A refused to admit that he was sick because he was afraid that he would be labeled as a "madman" if he admitted it, and then things such as work, marriage and life would leave him. Later, after a lot of literature review, it was found that this was not the case. He doesn't admit it because he has organic lesions in the frontal lobe of his brain, so he can't completely distinguish between reality and illusion, not because he can pretend not to admit it. Therefore, it is almost impossible for you to convince him that he is sick.
But I have no choice. This time, I decided to go against the norm and confront him head-on, trying my best to make him realize that he was ill. I firmly believe that conflict itself is also a kind of communication. So, I visited Suzhou Daxiangmen hou zhuang, Pingjiang Road and Suzhou Museum. On the way back to my apartment, I told him that he had been taking medicine.
A was shocked and hurt: "So you have been cheating on me with my mother, haven't you?" ! "
"Don't get excited. I won't argue with you. Think about it first. Does everything I do for you these days seem to hurt you? " Then silence all the way.
When I got back to my residence, I didn't rush to persuade him, but took a nap first, because I knew that the next persuasion work needed me to activate every cell of my body and play an extremely abundant role.
After dinner, A calmed down a lot, but still insisted that he was not ill. Those are not hallucinations. So, I turned on the computer, searched some information in front of A, and convinced him that although antipsychotic drugs have side effects, they will never make normal people mentally ill. Why do schizophrenics really not realize that they are sick? And patiently explain to him what will happen to his career after stopping taking the drug.
After nearly three hours of intense confrontation, A's attitude towards taking medicine gradually loosened, but he still refused to admit his illness: "I can't help it if you say so. The logic you explained makes sense, but my logic is fine! I'm not sick, you have a problem! " I have to admit that his ideas about his mother being bribed and conspiring with others to persecute him are crazy and grotesque, but they do make sense logically. So I decided to change my mind and convince him.
I searched the famous "incredible 60 psychological pictures" and convinced him that human senses are not as reliable as we thought (PS: Can you see that the colors of A and B in the picture are actually the same? )。 Then he said to him, "Maybe you are really normal, maybe we are all abnormal, but we abnormal people just want you to be as abnormal as we are." Do you think you can accept it? "
A thought carefully for a while: "that's actually ok." . . "
A is finally willing to take medicine.
Now, A has been successfully employed, and the treatment plan for nearly two months has come to an end. But for treatment, this is not the end, but the beginning. I wish a jun's life path leads to the light, and he is more and more stable.
Supplement: Popularization of knowledge about schizophrenia
The incidence of schizophrenia is 1%, which is slightly higher than our expectation. It can be divided into paranoid type, youthful type, neurotic type, simple type, residual type and amorphous type, among which paranoid type is the most common (both A Jun and johnf nash are like this).
The main symptoms of paranoid schizophrenia are hallucinations, auditory hallucinations, delusions, feelings of persecution and exposure, confusion of thinking, nervous behavior, emotional withdrawal, poor speech, fading willpower and refusal to treat. More than 60% patients are completely unaware of their illness. At present, the cause of treatment is not clear. Many diseases occur in young adults and generally exist in people with high IQ. The possible factors are mainly heredity, physiological diseases, personality and environment. Treatment: Most people can't recover by themselves. Mainly psychological counseling, supplemented by drug treatment. Exercise has a positive effect on treatment, and stable social relations support plays an important role in maintaining curative effect.
Most patients who recover after treatment will relapse at least once in their lives. People often don't have a detailed understanding of the disease, but are influenced by some unreal movies and TV series, which leads to prejudice and discrimination against patients. They think that patients are high-risk groups and easy to make harmful actions, but in fact, due to the lack of behavioral motivation, they are safer and more docile than ordinary people (schizophrenia and mania are completely irrelevant). The isolation caused by this prejudice and discrimination often makes it more difficult for patients to cure. Therefore, I call on everyone to have more understanding and support for patients and less prejudice and discrimination, and wish them to get out of the shadow of life as soon as possible.
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