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心理咨询师学习笔记28:神经症的咨询重点

  • 2026-02-07 07:16:05
心理咨询师学习笔记28:神经症的咨询重点
目的：了解各种神经症背后蕴藏的内在动力是什么。
1、焦虑障碍
焦虑——对还没有发生的事情的恐惧。
常见焦虑障碍：
1）睡眠障碍
两种——入睡障碍（睡不着，入睡困难），属于原发焦虑：“个体存在”的焦虑（个体的存在是否感到安全）；——动力起源：我这个主体，够不够强大，能不能支撑。
      ——惊醒，早醒，浅睡眠（睡着之后容易醒），属于继发焦虑：“关系安全性”的焦虑。——动力起源：我和别人的关系能否很好地维持下去。
2）疑病症——患者对自身的健康状况或身体的某一部位、某部分功能过分关注，怀疑患了某种躯体或精神方面的疾病，不因为客观现实的证据，而打消心中对患病的恐惧。——动力起源：早期养育环境中主要抚养人缺位、消失、过度情绪化，导致孩子的情感得不到恰当回应，无法确定自己的感受和存在，故而成年后对自己不能接受的部分凝聚在某个器官上。是一种原发焦虑。
3）惊恐发作——是种急性焦虑发作。患者突然发生强烈不适，可有胸闷、气透不过来的感觉、心悸、出汗、胃不适、颤抖、手足发麻、濒死感、要发疯或失去控制感，每次发作约一刻钟左右。——动力起源：对于未来的恐惧，没有办法完成自我内在的整合。
4）考试（演讲）焦虑——指因考试压力过大而引发的异常生理心理现象，包括考前焦虑、临场焦虑（晕考）及考后焦虑紧张。——动力起源：害怕爱的关系对象的丧失（我成功我优秀才能获得爱）
5）性功能障碍——动力起源：对男性，与父母的关系中是否有被虐待的创伤？母亲是否过度强势或控制？  对女性，对于父母的忠诚，导致她无法完成自己作为成年人与父母的分化，对于离开父母过自己的快乐生活充满羞耻感。
2、抑郁障碍
动力起源：攻击性向内的投射；自恋水平的不健康（自恋不够，不相信自己，不敢完成合理的攻击性表达，我只有完美才能获得别人的喜欢）；无法去爱与他们有联系的人，对自己的愤怒感到恐惧和内疚。
3、强迫障碍
强迫——通过完美的行为（仪式化）来远离内心的情感体验或者冲动（力比多），比如洗手、清洁等。（洗的是心中对欲望的肮脏感）
动力起源：完美主义；用行为隔离情感。
强迫症：固定的仪式不能够更改，不做心里就接受不了。强迫在反强迫中会不断壮大。要对背后的动力进行工作，而不是在行为层面。
4、恐惧障碍
所有恐惧的背后，都隐藏着一个特别强烈的渴望。恐惧物在象征层面上表达着和情感的关系，或者和欲望的关系。
5、进食障碍
两种——厌食，暴食。
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  133. /yingpanguazai/ssd/ssd1/www/no.67808.cn/vendor/topthink/framework/src/think/Cookie.php ( 6.06 KB )
  134. /yingpanguazai/ssd/ssd1/www/no.67808.cn/vendor/topthink/think-view/src/Think.php ( 8.38 KB )
  135. /yingpanguazai/ssd/ssd1/www/no.67808.cn/vendor/topthink/framework/src/think/contract/TemplateHandlerInterface.php ( 1.60 KB )
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  137. /yingpanguazai/ssd/ssd1/www/no.67808.cn/vendor/topthink/think-template/src/template/driver/File.php ( 2.41 KB )
  138. /yingpanguazai/ssd/ssd1/www/no.67808.cn/vendor/topthink/think-template/src/template/contract/DriverInterface.php ( 0.86 KB )
  139. /yingpanguazai/ssd/ssd1/www/no.67808.cn/runtime/temp/6df755f970a38e704c5414acbc6e8bcd.php ( 12.06 KB )
  140. /yingpanguazai/ssd/ssd1/www/no.67808.cn/vendor/topthink/think-trace/src/Html.php ( 4.42 KB )
  1. CONNECT:[ UseTime:0.000715s ] mysql:host=127.0.0.1;port=3306;dbname=no_67808;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000874s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000505s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000882s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000538s ]
  6. SELECT * FROM `set` [ RunTime:0.000210s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000686s ]
  8. SELECT * FROM `article` WHERE `id` = 464082 LIMIT 1 [ RunTime:0.004244s ]
  9. UPDATE `article` SET `lasttime` = 1770428052 WHERE `id` = 464082 [ RunTime:0.000750s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.000305s ]
  11. SELECT * FROM `article` WHERE `id` < 464082 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.003163s ]
  12. SELECT * FROM `article` WHERE `id` > 464082 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.002655s ]
  13. SELECT * FROM `article` WHERE `id` < 464082 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.004518s ]
  14. SELECT * FROM `article` WHERE `id` < 464082 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.021674s ]
  15. SELECT * FROM `article` WHERE `id` < 464082 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.011526s ]
0.124423s