Chitsanzo chabwino cha thanzi labwino: Kuwunika komanso kutengera chitsanzo cha chithandizo cha anthu omwe ali ndi matenda opatsirana pogonana (2018)

J Behav Addict. 2018 Dec 23: 1-13. pitani: 10.1556 / 2006.7.2018.127.

Blycker GR^1,2, Potenza MN^3,4,5.

1 College of Nursing, University of Rhode Island, Kingston, RI, USA.

2 Hälsosam Therapy, Jamestown, RI, USA.

Dipatimenti ya Psychiatry ndi Neuroscience ya 3 ndi Child Child Center, Sukulu ya Zamankhwala, Yunivesite ya Yale, New Haven, CT, USA.

4 Connecticut Council pa Vuto la Kutchova njuga, Wethersfield, CT, USA.

5 Connecticut Mental Health Center, New Haven, CT, USA.

Kudalirika

ZOKHUDZA NDI ZOTHANDIZA:

Njira zowonongeka, zomwe zachokera zaka mazana ambiri za kum'mawa kwa filosofi ndi machitidwe, zakhala zikuwonjezeredwa ku madera akumadzulo. Mwachitsanzo, chithandizo cha deta ndicho chithandizo cha mankhwala othandizira kulingalira kuti achepetse nkhawa ndi kulimbikitsa thanzi labwino.

ZITSANZO:

Mu phunziro lino, timapenda mwachidule zitsanzo ndi njira zogonana zokhudzana ndi kugonana, kufotokozera zovuta zokhudzana ndi kugonana, kufotokozera njira zowonongeka, kuledzera, ndi zizoloŵezi zakugonana, ndikupereka chitsanzo chabwino cha kugonana (MMSH) limaphatikizapo zinthu zina za kummawa ndi kumadzulo kwa filosofi. Timafotokozeranso kuti ntchito ya MMSH ikugwiritsidwa ntchito panthawiyo.

ZOKHUDZA:

Tikupangira MMSH ngati njira yonse komanso yophatikizira yomwe imalemekeza ndi kuvomereza kusiyana kwake komanso kupereka zida ndi machitidwe othandizira anthu kuthandiza mothandizirana, kuwongolera, komanso kulimbikitsa kugonana ndi malingaliro. MMSH itha kugwiritsidwa ntchito ngati njira yopangira chidziwitso chokhudza thupi, malingaliro, malingaliro, zogonana, komanso ubale, komanso mapu olingalira opereka maluso oyenda kuti athe kulumikizana ndi chidziwitso mkati mwa malingaliro / thupi lanu kuti apange chisankho chanzeru chokweza moyo wabwino okhudza kukhutitsidwa ndi kugonana M'magulu ake, MMSH imagawika m'magawo asanu ndi atatu omwe amagwirizana ndi zochitika zachilengedwe ndipo angagwiritsidwe ntchito kuzindikira ndi kuthana ndi zotchinga zokhudzana ndi kugonana mwakufunsira mwanzeru pamachitidwe azachipatala kapena makonda aphunziro.

ZOKAMBIRANA NDI ZOMALIZA:

Popeza kuti cholinga chake ndi kuzindikira za njira zamaganizo kudzera mu malingaliro / kugwirizana kwa thupi, MMSH ikhoza kuyambanso ndi anthu osiyanasiyana, kuphatikizapo omwe ali ndi vuto la chilakolako chogonana.

ZINTHU ZOFUNIKA ZINTHU: Kusokoneza maganizo kwa chiwerewere; chiwerewere; maphunziro okhudzana ndi chikhalidwe chogonana; zochizira; malingaliro okhudzana ndi kugonana; zogonana

PMID: 30580543

DOI: 10.1556/2006.7.2018.127

Introduction

Kulimbikitsa kugonana ndi ntchito yofunikira. Anthu ambiri amakumana ndi nkhawa zokhudzana ndi kugonana kuphatikizapo kuchita nawo chizolowezi chogonana,Maltz, 2001; Ogden, Minton, Ululu, Siegel, & van der Kolk, 2006; Tekin et al., 2016; Van der Kolk, 2015; van der Kolk et al., 1996), ndikuchita zolaula zomwe zingadzipange okha kapena ena omwe ali pachiopsezo chotenga matenda opatsirana pogonana kapena mavuto ena.Erez, Pilver, & Potenza, 2014; Kraus et al., 2018). Nkhawa zokhudzana ndi khalidwe lachiwerewere zosayenerera zingakhale zikuwonjezeka pakukula kwa zolaula za pa Intaneti ndi kuchuluka kwa zinthu zolaula (Kor et al., 2014; Kraus, Martino, & Potenza, 2016), kugwiritsa ntchito matekinoloje a digito kuti azichita zogonana ndi zofanana zokhudzana ndi thanzi labwino ndi zakuthupi (Turban, Potenza, Hoff, Martino, & Kraus, 2017), ndikuphatikizidwa ndi chisokonezo cha khalidwe la kugonana m'ndandanda wa 11th wa International Classification of Diseases (ICD-11) ndi World Health Organization (WHO; Kraus et al., 2018). M'machitidwe amasiku ano, kukhala ndi zitsanzo zotsitsimula za umoyo wathanzi kumakhudza kwambiri thanzi labwino.

WHO (2006) limapereka tanthawuzo lathunthu komanso lachidziwitso la thanzi labwino monga "mkhalidwe wa umoyo, wamaganizo, wamaganizo ndi umoyo wabwino pokhudzana ndi kugonana; Sikuti kungokhala kupezeka kwa matenda, kufooka kapena kufooka. Kukhala ndi chiwerewere kumafuna njira yabwino komanso yolemekezeka yogonana ndi kugonana, komanso mwayi wokhala ndi zosangalatsa zokondweretsa kugonana, mosasunthika, kusankhana, ndi chiwawa. Kuti umoyo wa kugonana upeze ndi kusungidwa, ufulu wa kugonana wa anthu onse uyenera kulemekezedwa, kutetezedwa ndi kukwaniritsidwa"Ma bungwe ena, monga US Center for Disease Control and Prevention, amalimbikitsa kutanthauzira kofanana ndikuphatikizapo gawo lauzimu (Douglas & Fenton, 2013). Popeza kuti kugonana, malingaliro, ndi thanzi labwino zimagwirizana, pangakhale phindu lenileni la kulingalira kwakukulu. Kuti akwaniritse chitukuko chokhudza kugonana, nkofunika kuzindikira zolepheretsa thanzi, ulemu, chitetezo, ndi zosangalatsa komanso kukhala ndi luso komanso luso la momwe mungalimbikitsire zochitika zokhudzana ndi kugonana.

M'nkhani ino, timapenda zitsanzo za kugonana pofuna kuti tipeze mbiri yatsopano yokhudzana ndi kugonana pogwiritsa ntchito kafukufuku wochulukirapo omwe amachititsa kuti anthu azidziwika bwino ndi maiko ena (Mehling et al., 2012) ndi opindulitsa popititsa patsogolo kugonana (Brotto, 2013; Brotto, Basson, & Luria, 2008; Brotto, Chivers, Millman, & Albert, 2016; Mize, 2015; Silverstein, Brown, Roth, & Britton, 2011; Stephenson & Kerth, 2017). Chifukwa cha zochitika zachitsanzo, tidzalongosolanso momwe njira zowonetsera zokha zakhala zikugwiritsidwira ntchito kuchipatala chakumadzulo, zomwe zimadetsa nkhaŵa, kupsinjika maganizo, ndi kuledzera. Kusamala mosamalitsa kungatanthauzidwe kukhala wosadziweruza, kuleza mtima, ndi kudzilemekeza (Kornfield, 2009). Maziko anayi amalingaliro amaphatikizaponso kuzindikira mozama kuti mufufuze thupi, malingaliro, malingaliro (mwachitsanzo, malingaliro, zithunzi, nkhani, ziweruzo, zikhulupiriro, ndi zina zambiri), ndi dharma [ie, chowonadi, zinthu zomwe zimathandizira kuzokumana nazo, ndi mfundo ndi malamulo omwe akugwira ntchito (Kornfield, 2009)]. Dharma imachokera ku Sanskrit ndipo imatanthawuza "malamulo a cosmic ndi dongosolo" ndipo imaphatikizapo ziphunzitso zomwe zimalimbikitsa kupatsa, ubwino, ndi kukoma mtima. Ngakhale kuti poyamba adalingalira mkati mwa chikhalidwe cha Buddhist / achipembedzo, kulingalira kwatengedwa ndipo kunasinthidwa mkati mwa madera akumadzulo. Kusamala kungagwiritsidwe ntchito polimbikitsa ubwino wa maganizo kupyolera mu mfundo zinayi za kusinthidwa zomwe zimaphunzitsidwa pogwiritsa ntchito mawu akuti "RAIN"; kuzindikira chomwe chiri, kuvomereza, kufufuza ndi kusamala ndi zochitika za thupi, malingaliro, malingaliro, ndi zenizeni, ndi zosadziwika (Kornfield, 2009).

Njira zowonongeka zakhala zikupangidwa ndipo zasonyeza mphamvu zothetsera nkhawa (Kabat-Zinn & Hanh, 1990), kuchiza matenda okhudzana ndi ululu (Astin, Shapiro, Eisenberg, & Forys, 2003), kuchepetsa kuvutika maganizo (Brewer, Bowen, Smith, Marlatt, & Potenza, 2010), komanso kulimbikitsa kudziletsa kapena zotsatira zina zabwino zowonongeka (Hendershot, Witkiewitz, George, & Marlatt, 2011; Mtengo & Smith-DiJulio, 2016; Mtengo, Wells, Donovan, & Rue, 2012). Potsatira mankhwala osokoneza bongo, kuganizira mozama kubwezeretsa matenda opatsirana pogwiritsa ntchito SOBER (kuima, kuona, kupumira kwa mpweya, kukulitsa kuzindikira, ndi kuyankha mosamala) kusinkhasinkha kupuma ndikukakamiza kuyesa kungachepetse kuchitapo kanthu kuchitapo kanthu, kulakalaka, ndi kukhumudwitsa (Bowen & Marlatt, 2009; Brewer et al., 2010; Hendershot et al., 2011; Witkiewitz et al., 2014). Ngakhale kuti njirazi zimamvetsetsanso, kulingalira kwabwino kungaphunzitse anthu omwe akulimbikitsana ndi zolakalaka ndizochitika zochepa zomwe zimasintha pakapita nthawi, ndipo kudzera mukumvetsetsa ndi kuvomereza kwabwino, akhoza kusintha makhalidwe osokoneza bongo (Bowen et al., 2009). Kafufuzidwe ka zochitika za m'maganizo zokhudzana ndi kusamala (mwachitsanzo, kusinkhasinkha) zawonetsa kusiyanasiyana pakuchita nawo chidwi komanso kusasintha kwa ma netiweki (Brewer et al., 2011, Garrison, Zeffiro, Scheinost, Constable, & Brewer, 2015). Kukonza ndi maluso oganiza bwino awonetsedwa kuti achepetse kuyesera kuchita zolakalaka komanso zovuta mwa kupeŵa kapena kufunafuna kuthawa ku zosafuna kapena zochitika za mkati mwa kuwonjezeranso kuzindikira ndi kumveka za zizolowezi zomwe zingayambitse ululu ndi kuvutika kwa nthawi yaitali (Bowen, Chawla, & Marlatt, 2011; Brewer, Davis, & Goldstein, 2013). Ngakhale nkhani yokhudza chidziwitso chodziwitsa anthu kuti azisokoneza chiwerewere amachititsa kuti pakhale kusintha kwakukulu (Van Gordon, Shonin, & Griffiths, 2016), ndondomeko ya kulingalira zochiritsira zokhudzana ndi kugonana ikusowa. Makhalidwe abwino omwe aperekedwa pofuna kulimbikitsa thanzi la kugonana sangagwiritsidwe ntchito pochiza anthu omwe ali ndi vuto la chilakolako chogonana. Mwachitsanzo, kuganizira mozama zachipatala chomwe chimagwira ntchito pophunzitsa anthu zokhudzana ndi kugonana kwagwiritsidwa ntchito pothandiza anthu kubwezeretsa kuchitidwa chiwerewere, kusokoneza bongo, ndi mavuto a kugonana komanso kuphatikizapo zinthu zakuthupi zomwe zingakhale zosayenera m'makonzedwe a kachipatala powathandiza anthu omwe ali ndi vuto la chilakolako chogonana (Carvalheira, Mtengo, & Neves, 2017; Mtengo, 2005; Mtengo & Smith-DiJulio, 2016; Mtengo & Hooven, 2018; Mtengo, Thompson, & Cheng, 2017; Mtengo et al., 2012). Choncho, zitsanzo zina ndizofunika.

Pofuna kuthetsa zosowazi, timapereka chitsanzo chabwino cha kugonana kwabwino (MMSH; Blycker, 2018). Pogwiritsa ntchito chitsanzo, mafunso owonjezera omwe amachititsa kuti anthu azikhala ndi chidwi chokhala ndi maganizo amtunduwu akhoza kulimbikitsidwa kuti adziŵe zam'tsogolo za thupi lawo ndi malingaliro awo pazochitika zaumwini komanso zaumwini. Zomwezo zingapangitse zisankho zokhudzana ndi kugonana pogwiritsa ntchito luntha la kugonana komanso mwaluso kuukitsa kugonana ndi kuzindikira. M'nkhaniyi, wina akhoza kuthandizira kwambiri zinthu zomwe zimayambitsa mavuto osiyanasiyana okhudzana ndi kugonana ndi chiwonongeko.

MMSH imalimbikitsa kulimbikitsa zomwe zilipo panopa m'malo mochita zokhudzana ndi kugonana komwe kuli njira yowonongeka osati njira zamakono. Kuphatikizana uku ndi kuunika kwa chidziwitso kupyolera mu chidziwitso cha thupi ndi kusankhana pakati kungathandize kusintha ndi kukula kwa kugonana ndi chitukuko cha maganizo ndi kukula kwaumwini. Kusiyanitsa ndi kusokonezeka kungayambitse kusokonezeka kwa kugonana ndi matenda opatsirana pogonana komanso njirazi zingakhale zowunikira ndi kuziwerengera pakuwonjezeka kwadzidzidzi pa nthawi ya chiwerewere (Carvalheira et al., 2017; Mtengo & Thompson, 2007).

Zomwe anthu ena a ku yunivesite omwe adapeza (zomwe adazipeza pophunzitsa maphunziro a kugonana kwa anthu khumi kwazaka khumi zapitazi) adanena kuti akufuna ndi chikhumbo chawo chokhala ndi maphunziro a zaumoyo omwe akuphatikizirapo komanso kutengera zitsanzo zamakono za matenda opatsirana pogonana komanso matenda opatsirana pogonana. Mwachindunji, chitsanzo chomwe chimaphatikizapo kudzifufuza kwa "kudziona nokha kwa kugonana," kufufuza mozama za njira zopangira zisankho zodziwa bwino komanso zogwira mtima, komanso luso loyankhulana bwino lomwe limakhala lothandiza komanso lothandiza. MMSH ikufuna kuthetsa nkhanizi pofuna kulimbikitsa thanzi labwino ndi kuchepetsa mavuto kapena zovuta zokhudzana ndi kugonana ndi zotsatira zake zoipa. Chifukwa cha zovuta poyendetsa zochitika zokhudzana ndi kugonana mudziko ladijito ndi mauthenga akunja ogonana, palifunika kuphunzitsidwa bwino zokhudzana ndi kulimbikitsa maganizo, malingaliro, komanso kugonana. Kuwerengera komanso kugwiritsidwa ntchito mosavuta pazinthu zogonana zowonongeka kungapangitse anthu, ndipo makamaka achinyamata, pa chiopsezo chokwanira chotsogoleredwa ndi zolaula, zomwe zingalowetse machitidwe a khalidwe ndi kutsogolera zochitika zogonana (Dzuwa, Bridges, Johnson, & Ezzell, 2016). Zithunzi zolaula zowononga nthawi zambiri zimaphatikizapo kukakamiza kugonana, kuwonongeka kwa akazi, ndi chiwawa kwa akazi (Mabwalo, Wosnitzer, Scharrer, Sun, & Liberman, 2010; Gorman, Monk-Turner, & Fish, 2010). Ngakhale kuti deta imasonyeza kuti akazi saona zolaula kuposa amuna, akazi omwe amaonera zolaula amakhala ndi zolaula (Milatho, Dzuwa, Ezzell, & Johnson, 2016). Chibwenzi chochuluka chanenedwa pakati pa zolaula za amuna ndi kugwiritsira ntchito malemba oonetsa zolaula pofuna kukhala ndi chilakolako chogonana, komanso kugwiritsira ntchito zolaula zowonongeka zokhudzana ndi kuchepetsa kukondana ndi khalidwe lachikondi monga kukupsompsonana ndi kukhumudwitsa (Sun et al., 2016).

M'zaka za digitoyi, ndikofunika kukhala ndi moyo wathanzi wopititsa patsogolo maphunziro a kugonana omwe angapangitse kugwirizana ndi zotsatira zolakwika za zovuta zogonana komanso zomwe zimagwira ntchito pofuna kupewa chitukuko cha makhalidwe ogonana. MMSH imafuna kulimbikitsa kudzidziwitsa, kudzidzimva, ndi luso kuti afotokoze mfundo zamkati kuti ziwoneke bwino ndi chidaliro pakupanga zosankha zomwe zimalimbikitsa thanzi. Chikhumbo, mphamvu za kugonana, malingaliro, kukhudzidwa, kugonana, kukhutira kugonana, kudzilemekeza, ndi chiyanjano chaukwati zimakhudzidwa ndi zifukwa zingapo. MMSH ikufuna kupereka ndondomeko yokonza, kuyesa, ndi kuyendetsa zinthu zambiri zomwe zingakhudze thanzi labwino ndi umoyo.

Zochitika zaumoyo ndi Zochitika Zogwirira Ntchito

Mitundu yambiri yopititsira patsogolo kugonana kwaperekedwa, ndipo ndemanga yangwiro silingathe kufanana ndi zolembedwera. Zitsanzo zina zoyambirira zinkafuna kuonetsetsa makhalidwe omwe poyamba ankatsutsa, monga maliseche (Ellis, 1911) ndi zochitika zosiyanasiyana za kugonana (Kinsey, Pomeroy, & Martin, 1948; Kinsey, Pomeroy, Martin, & Gebhard, 1953), ndikutsutsa mfundo zomwe zanenedwa kale zokhudzana ndi malingaliro ochepa komanso ovuta a kugonana kwa anthu, monga chiwerewere chachiwiri chokhudzana ndi chikhalidwe chokhudzana ndi kugonana kapena zosangalatsa za amuna ndi akazi (Crawford & Popp, 2003). Chitsanzo chokhala ndi magawo anayi ogwiritsira ntchito kugonana chinayambitsa kuganizira, njira yomwe imagwiritsidwanso ntchito pothandizira anthu awiri (Masters, Johnson, & Kolodny, 1982). Gwiritsani ntchito magalimoto otsogolera kuti azipereka ndi kulandira thupi lachikondi lachikondi panthawi yeniyeni ndi yodziwika bwino, kuti adziwe zomwe akukumana nazo panthawi yomwe akukumana nazo, zomwe zimatha kuphatikizana ndi zochitika zowonongeka pambuyo pochita "kuyang'ana" ndi kukhala Zogwira ntchito zikuchepa. Kulingalira mozama kungaoneke ngati njira yowonongeka yomwe ikufufuzidwa kwambiri lero. Njira zowonongeka zomwe zimaphatikizapo kuphunzitsanso njira zowonjezereka pofuna kuonjezera kudziwitsa thupi ndi kugwirizana kwa thupi kungakhale koyenera pa chithandizo cha zochitika za kugonana (Brotto, Krychman, & Jacobson, 2008; Brotto, Mehak, & Kit, 2009; Brotto, Chisindikizo, & Rellini, 2012; Carvalheira et al., 2017; Mehling et al., 2012; Mize, 2015; Silverstein et al., 2011).

Zolingalira zakhala zikufotokozedwa kuti ziganizire kusiyana pakati pa kugonana mu kukwatira, kugwira ntchito, zolimbikitsa, ndi zosangalatsa. Zitsanzo zafotokozedwa kuti ziwonekere kufunikira kwa amayi pa ntchito zoganizira komanso zokhudzana ndi zochitika zokhudzana ndi kugonana zomwe zingapangitse kukhala ndi zolimbikitsa zokhudzana ndi kugonana pakati pawo komanso zomwe zingaphatikizepo kuphatikizapo mfundo zochokera ku malingaliro, thupi, ndi chiyanjano kudzera m'maganizo ndi biological processing (Basson, 2002, 2005). Cholinga chopangidwa ndi biobehavioral (Diamond, 2003) amasiyanitsa chikondi chachikondi ndi kukondana kuchokera ku chilakolako cha kugonana, akufotokozera ubale wawo, ndikufotokozera momwe izi zingakhudzire kugonana kwa amuna ndi akazi (Diamond, 2003). Wolemba yemweyo ananena kuti kugonana, kumatanthawuza kuti kukhala wodalirika wokhudzana ndi kugonana, ndikofunika kwambiri mu njira izi (Diamond, 2008). Chitsanzo china chokhazikitsa mfundo zokopa pamagwiridwe abwino a kugonana (Maltz, 1995). Chitsanzo ichi, chomwe chinapangidwa kuti chigwiritsidwe ntchito pa mankhwala ndi maphunziro opatsirana pogonana, mphamvu zogonana zokhudzana ndi kugonana monga chirengedwe ndi mphamvu zamphamvu zomwe, malinga ndi zinthu zomwe zimalongosola komanso zochitika, zimakhala zogwirizana ndi zomwe zimachitika kapena zomwe zimawonetsedwa kuti zisawonongeke. Mawu akuti mphamvu yogonana anagwiritsidwa ntchito muchitsanzo ndipo akhoza kuyambiranso ndi kummawa kwa dongosolo la chakra. Kumadzulo kumidzi, mphamvu zoterozo zingaganizidwe monga malingaliro, malingaliro, zolimbikitsa, zoyendetsa, kapena zofuna. M'makonzedwe ka pachipatala, anthu enieni angakhale ndi malingaliro apadera kapena a chikhalidwe cha anthu komanso anthu omwe ali pamsonkhano wawo, ndipo kuvomereza zochitika zawo zingathandize kulumikizana kwachidziwitso ndi kulimbikitsa zotsatira zabwino zachipatala. Mu zochitika zamakono, chitsanzocho chimalongosola kufunika koyankhulana momveka bwino pakati pa okondedwa, kukhazikitsidwa kwa chitetezo ndi chidaliro, ndi kufunika kwa "Kugonana kwachidziwitso monga chidziwitso chokwanira pazogonana"(Maltz, 1995). Chitsanzo choyanjana ndi chibwenzi chokhudzana ndi kugonana,Kugonana Kwabwino Kwambiri,"Zimaimika kusintha kwa chikhalidwe cha zochitika zogonana komanso kufunika kokhala ndi ziyembekezo zomveka zomwe zingathandize kuti anthu azigonana mosiyana ndi tanthauzo la kugonana (McCarthy & Wald, 2013). Zowonjezerapo zina zimaphatikizapo kugwiritsa ntchito njira zamagwiridwe odziwa zachipatala kwa anthu payekha komanso maanja kuti agwiritse ntchito malingaliro omwe akugwiritsidwa ntchito panopa kuti athetse vuto la kugonana, kuphatikizapo kuzindikira momwe angagwiritsire ntchito kugonana, kugwiritsira ntchito zosiyana za chilakolako, kusokonekera kwa erectile, ndi kukwera msanga pamtengowu.McCarthy, 2004). Zitsanzo zina zomwe zikuwongolera kuchita chiwerewere kapena chizoloŵezi chogonana muzochita zogonana zakhala zikudziwika pozindikira ndi kuthetsa mavuto othawa (Zolemba & Adams, 2013). Chitsanzo chaposachedwapa chokhudzana ndi kugonana pakati pa anthu ogonana ndi amuna amalingalira ntchito zokhudzana ndi kugonana, makhalidwe ndi chiwerewere, komanso kugonana kwachiwerewere pambuyo pake (Walton, Cantor, Bhullar, & Lykins, 2017). Ngakhale kuti pali mafunso ambiri okhudza momwe angagwiritsire ntchito mchitidwe wamakono womwe umachokera ku zokhudzana ndi kugonana kwaumunthu komanso njira zowonongeka kapena zovuta zogonana, kufunika kwa kafukufuku wowonjezera kumawunikira makamaka kuwonjezeka kwa chisokonezo cha khalidwe la kugonana mu ICD-11 (Gola & Potenza, 2018; Kingston, 2017).

Chitsanzo Chabwino cha Umoyo Wogonana

Kupititsa patsogolo kwa MMSH kunakhudzidwa ndi machitidwe a kummawa ndi kumadzulo, mafilosofi, ndi magwero omwe akuphatikizapo kulingalira, chifundo, kuyanjana pakati, kuganizira za maganizo ndi kugwirizana, mphamvu za thupi, zomangamanga, komanso maganizo abwino. Mapulogalamu omwe adziwa zambiri za MMSH ndi awa omwe amaphatikizapo kuphunzitsidwa kwa thupi ndi kuyanjana; Maphunziro a zachipatala kuchipatala pogwiritsa ntchito njira zoganizira za njira ya Hakomi (Kurtz, 1997); Maphunziro a zachipatala kuti athetse mavuto okhudza kugonana; Maphunziro a yoga aphunzitsi omwe amagwirizanitsa njira zamaganizo; ndi maphunziro a ophunzira a koleji mu chiwerewere chaumunthu, pogwiritsa ntchito machitidwe okhudza kulingalira za kugonana, maganizo, ndi zochitika.

Mu bungwe lake, MMSH imagwiritsa ntchito thupi lodziwika bwino, kapena dongosolo la chakra ku Indian yoga, lomwe laperekedwa kuti liphatikizidwe ku mbali zamkati za mitsempha yamagetsi ntchito (Loizzo, 2014, 2016). Thupi lomangika limapereka malingaliro okhudza kugonana ndi chikhumbo. Mavuto a chilakolako cha kugonana ndi omwe amawoneka kuti ndizovuta kwambiri zokhudzana ndi kugonana (Leiblum, 2006). Mafotokozedwe opita kumadzulo a chilakolako cha kugonana akuphatikizapo kukhala ndi malingaliro okhudzana ndi kugonana ndi malingaliro ofuna kugonana (Meston, Goldstein, Davis, & Traish, 2005). Kuchokera ku lingaliro la a Buddhist la maganizo, izi zikhoza kuwonedwa ngati zotsutsana ndi njira zakummawa za kulingalira ndipo mmalo mwake zimayandikira kuonekera kwa kugonana mwa njira yomwe ili yosiyana ndi chidziwitso chodziwika bwino komanso kumatsata kapena kuyesa chilakolako cha kugonana ndi malingaliro ndi malingaliro. Kafufuzidwe kafukufuku amafunikanso kuti aone ngati kumanga kumeneku kungapangitse zoyembekeza, zikhulupiliro, ndi zochitika zomwe zimachitika kuti chilakolako chogonana chikhudze chilakolako ndi kuganizira zofuna kunja kwadzidzidzi kuti zithetse chilakolako chogonana ndi kuganizira. MMSH imaphatikizapo malingaliro ndi mayendedwe a kummawa kuti azikulitsa luso kuti adziwe kuzindikira ndi kuvomereza kusintha kwa mkati mwazochitikira mu thupi, malingaliro, zolimbikitsa, mphamvu, ndi mphamvu. Kugonana, mphamvu, ndi / kapena chilakolako amavomereza kuti ndi mbali ya mphamvu ya moyo yowonongeka, ndipo imadzutsa mphamvu za kundalini zatsimikiziridwa kuti zitha kuthandiza kuyanjanitsa ndi kulumikiza malo a chakra mu thupi lopanda nzeru (Dowman, 1996; Paswaran, 2007). Kuphunzitsa chidwi pa kusintha kwa maganizo, kumapangitsa kukhala ndi malingaliro okhudzana ndi kugonana / zolinga / chilakolako cha kugonana kuti muthandizidwe ndi thanzi, umoyo, chisangalalo, ndi moyo wabwino, m'malo momangothamanga, kumamatira, kapena kulumikiza kunja kwa nokha. Izi zikhonza kukhala ndi zifukwa zosiyanasiyana m'magulu ambiri okhudzana ndi kugonana komanso kugwira ntchito kuchokera ku zovuta zokhudzana ndi chilakolako chokhudzana ndi kugonana komanso zovuta zogonana.

Mfundo za bungwe la MMSH zikuphatikizapo izi:

MMSH ili ndi madera asanu ndi atatu a moyo wabwino omwe amagwirizana. Kukhala ndi thanzi komanso kulingalira kumaphatikizapo kuwonetsetsa ndikugwirizanitsa madera onse asanu ndi atatu omwe akuphatikizapo thanzi labwino, kugonana, kukhudzana ndi maganizo, kudzikonda, kuyanjana, kuyankhulana, kudzidziŵa, kuuzimu, ndi kulingalira. M'madera onsewa, pali mbali zina zokhudzana ndi kuwonetsetsa bwino komanso zowonongeka, zotheka kuwonongera thanzi komanso kuchepetsa, zotsatira zake, zoopsa, kapena zovulaza zokhudzana ndi zolepheretsazi, komanso zofunikira zoyambira pofunsa mafunso odziyendera okha. Njira yowonjezera yogwiritsira ntchito malingaliro omwe amaganizira za thupi, ndi mpweya ndikusuntha kugwirizana ikufotokozedwa mu Table 1. M'madera onse a MMSH, kufunsa mafunso angapangidwe pofuna kulimbikitsa thanzi labwino. Chitsanzo cha chitsanzo chikufotokozedwa momwe chitsanzochi chikhonza kugwiritsidwa ntchito pochita chithandizo kuti athe kuthandiza munthu yemwe akufuna chithandizo cha chilakolako chogonana. 2).

Gulu 1. Zikugwirizana ndi ndondomeko yofunsira nzeru muchitsanzo choganizira za kugonana

Gulu 2. Kugwiritsa ntchito MMSH kuti chizolowezi chogonana chisokonezeko matenda: Kugwirizana ku chitsanzo chachitsanzo

Zomwe zimaphatikizapo zaumoyo zimaphatikizapo chidziwitso cha sayansi zokhudzana ndi umoyo ndipo zimaphatikizapo kutenga udindo wothandizira thanzi ndi mankhwala Izi zikuphatikizapo kugwiritsa ntchito njira zabwino kuti athetse mavuto ndi kuchepetsa kuyankha kwapanikizika m'thupi. Zizolowezi zodzikonda zimaphatikizapo zizoloŵezi za moyo wathanzi ndi kugona, zakudya, ndi maseŵera olimbitsa thupi. Kulumikizana kwabwino ndi thupi limodzi kumaphatikizapo kusangalala ndi zosangalatsa zakuthupi.

Udindo wokhudzana ndi kugonana-maganizo umaphatikizapo kuyendetsa thanzi ndi kusintha kwa kusintha kwakukulu kwa zokhudzana ndi zochitika zamkati m'maganizo komanso kugonana ndi chidziwitso cha amuna ndi akazi. Kukulitsa ubale ndi kudzigonana kwathunthu kumaphatikizapo kulimbikitsa kugonana kwabwino (Potki, Ziaei, Faramarzi, Moosazadeh, & Shahhosseini, 2017) komanso kuwonetseratu kwasintha kwa template yanu, kapena tanthauzo lake lokhalokha lokhudzana ndi chikhalidwe cha mayankho ogonana. Kuphatikizana kwabwino, kudzidziwitsa nokha, kumvetsetsa, ndi kuvomereza kumakhala njira zofunikira kwambiri. Muzoyanjana za kugonana, kufotokozera zidziwitso ndi zikhumbo pazokha zenizeni zogonana zingakhale zofunikira pa thanzi ndi kumvetsetsa. Maluso othandizira malingaliro angagwiritsidwe ntchito poyang'anira mphamvu zogonana, pokhala ndi zochitika zowonongeka, ndikukulitsa chidziwitso chodzikonda. Kukulitsa kugwirizana kotereku kungalole kuti munthu akhale ndi mphamvu yowonjezeretsa mphamvu, zosangalatsa, kapena zolinga. Kulumikizana mwaluso kungathandizenso kufotokozera moona za kugonana, kugonana, komanso kufotokozera.

Udindo wodziwika paokha umakhudza kudzidalira, kudzilemekeza, kudzilemekeza nokha, kudalira, ndi kukonza malire. Kuwonetsera chifuniro chaumwini, kudzilamulira, kugwiritsa ntchito mphamvu moyenera, kudziletsa, kugonana, komanso kusankha kungakhale mbali ya kuwonetsera bwino kwaumwini.

Kukhala ndi thanzi labwino mu gawo la chiyanjano kungaphatikizepo zochitika za kugwirizana, kudzivomereza nokha, ndi kutentha ndi chikondi payekha. Kuchita chifundo payekha (umunthu) ndi umunthu (ponseponse) zikuyimira miyezo yapamwamba ndi yakuya ya kulima ukhondo mu dera ili. Kusamalira zokhuzana ndi zochitika za mkati mwa mnzanu ndikukula mukumverera ndi kumvetsetsa kugonana ndi zitsanzo za ubwenzi wabwino. Kugwiritsa ntchito malingaliro ozindikira pakudziwitsa malire omwe amalimbikitsa chitetezo ndi kudalirika ndikofunikira pakudziwitsa zakuya kwa kugawidwa kwa maganizo ndi / kapena kugonana ndi anthu odalirika. Makhalidwe apamtima a chiyanjano angapangitse zowonjezereka zogwirizana.

Kuyankhulana kungaphatikizepo chidziwitso chodzidziwitsa nokha pakupeza chidziwitso mkati mwazokha. Kulankhulana ndi chidziwitso ichi ndi wokondedwa nthawi zambiri kumafuna kugawana mwaluso ndi kutsegula, kumvetsera mwachidwi pofuna kumvetsetsa kumvetsetsa. Kulankhulana mwaluso kumaphatikizapo kukhala ndi thanzi labwino osati kulankhulana koopsa (Garanzini et al., 2017) komanso zingaphatikizepo zokambirana zokhudzana ndi kuchuluka kwa mphamvu ndi kuthetsa mikangano.

Dera lodzidziwitsa lokha limaphatikizapo kulima luso lomwe limagwiritsa ntchito kusinthasintha ndi luntha kuti mukhalepo ndi maganizo anu, malingaliro, ndi zosowa zanu, pamene mukulola malo, kuwona, kuzindikira, kuvomereza, ndi kumvetsa malingaliro a wina, malingaliro ake, ndi zosowa zawo . Kutsogola ndi chidwi chofuna kumvetsetsa kumvetsetsa kumathandiza popititsa kumvetsetsa. Kuphatikiza pa kuwonera maonekedwe osiyanasiyana, kufotokoza momveka bwino ndi kudzipereka pa kudzidziwitsa nokha ndikofunika kwambiri pakuzindikiritsa zosokoneza zamaganizo, zomwe zimasokoneza zochitika ndi maganizo. Zolinga, zifukwa, ndi kukana zonse zimalepheretsa kuwona choonadi ndikuwona chowonadi ndi kulemekeza nokha, ena, machitidwe, kapena mikhalidwe. Kuchita mwakhama kudzizindikira, kuganizira mofulumira, ndi kuzindikira choonadi kuchokera ku chinyengo kapena kupotoza ndi njira yopitilirapo.

Mzinda wauzimu umaphatikizapo kumvetsetsa kwa mgwirizano ndi wamkulu kuposa wina aliyense, kuphatikizapo koma osakwanira; mphamvu ya moyo, chiwalo, mulungu kapena mulungu wamkazi, nzeru zakuya, mphamvu zakuthambo, kapena chilengedwe (Miller et al., 2018). Zauzimu zimaphatikizapo kumveka, kukhala omasuka, ndi kugwirizana. Kuphatikizana kwa kugonana ndi uzimu kwatchulidwa kofunikira pakulima malingaliro ounikiridwa (Epstein, 2013). Kuzindikira mmalo amenewa kungaphatikizepo kupumula ndikukhalitsa mukumangika komwe kumapangidwa kuchokera ku zenizeni za chilengedwe chonse ndi zochitika za munthu. Kuvomereza kukanika kungapangitse nthawi yodzivomereza zosadziwika zokwanira kudzipereka kuti zilowerere kusintha. Kukhala ndi thanzi labwino m'dera limeneli kungaphatikize kuunika ndi kusamalira chitetezo ndi malire abwino pamene akupereka kudzipereka kwakukulu komanso kovuta. Zolepheretsa mayiko auzimu zingaphatikizepo kugwiritsira ntchito malingaliro ndi malingaliro kuti asokoneze zowonekera mwachindunji, kuchititsa chikhulupiriro chonyenga kuti kupulumuka kupyolera mu kuyendetsa malingaliro kapena chidziwitso kudzitetezera wekha kuchokera pa chosadziwika ndi kusatsimikizika kwa kukhala pachiopsezo. Kubweretsa luso loganizira malingaliro kuti azidziwe kuti akudziwongolera kapena kuwathamangitsa zochitika ngati kuti munthu akhoza kukhala ndi mphamvu, kukhala ndi chilakolako, kulamulira ena, ndi kulepheretsa kusintha kwa ena angayimire zinthu zovuta zomwe zimawoneka moledzeretsa ndi zizoloŵezi zakugonana.

Kuika maganizo kumagwirizanitsidwa ndi madera onse asanu ndi awiri apitalo. Izi zimalimbikitsa mphindi zokhalapo, zomwe Pema Chödrön wanena kuti, "mkhalidwe wogalamuka kumene maganizo anu ali otseguka"(Haas, 2013). Kuganizira mwachidwi m'magulu onse aumwini ndi pakati paokha ndi ena, ndi chidwi chodziwika ndi chosaganizira, ndizofunika kwambiri pophatikiza mfundo kuti zitsogolere njira zopangira zisankho. Kulingalira ndi kuzindikira njira zopezera, kuyesa, ndi kuyesa zizindikiro za thupi, zozizwitsa, ndi zochitika za thupi zimaphatikizapo kudziŵa zamaganizo, ndipo zanenedwa kuti ndi njira yeniyeni yothetsera kulingalira kwa mankhwala (Mtengo et al., 2017).

Kugwiritsa ntchito MMSH

MMSH ikhoza kugwiritsidwa ntchito popanga ndondomeko yodzikonda yokha yapadera / yaumwini ndikupereka njira zomwe zingalimbikitse uchembe wabwino wa kugonana. Zitsanzo za zolepheretsa zomwe MMSH zingakuthandizeni kugonjetsa zikuphatikizapo zoopsa za kugonana, kugonana monga kuthandizira kuthana ndi mavuto, kugonana ndi kukakamiza, kudzipatula, zovuta zogonana zokhudzana ndi kugwiritsidwa ntchito kapena kukhumudwa, kugonana, zolaula, kugwiritsa ntchito zolaula, malire, kudzichepetsa kapena kudzidalira, kapena manyazi. Chimene chingakhale chofunika mu njira zochiritsira kapena kukonza malire zingakhale zosiyana kwa munthu aliyense.

Kufufuza kwaumwini za kugonana kungapezeke mwa kufufuza mderalo uliwonse wa MMSH kupyolera m'malingaliro akufunsanso molimbikitsidwa ndi machitidwe a Hakomi (Kurtz, 1997). Mu ndondomeko ya Hakomi, dziko lalingaliro limagwiritsidwa ntchito kufufuza ndi odwala ndikuwonjezeranso kudzidzimva kwa malingaliro omwe angakhale okhudzana ndi mavuto, zopinga kapena zina zomwe zikuwongolera kuchipatala. Kuzindikiritsa mphamvu za kudzikonda nokha ndi zovuta kapena zovuta zowonetsera bwino kapena kulingalira bwino ndizotheka kudzera mwa njira yothandizira yolumikizana ndi mfundo zenizeni ndi zapadera zomwe zimabwera mukamagwiritsa ntchito mosamala machitidwe a mkati. Kufunsa mwachidwi kungagwiritse ntchito ngati mukugwiritsidwa ntchito popanga chikhalidwe, chotseguka, chokhudzidwa, chosakondera, chapano, ndi chokhudza thupi. Izi zimaphatikizapo kuzindikira chosankha kuti uchitire umboni kapena kuzindikira zomwe mwachibadwidwe kapena zomwe zimachitika mthupi mwathu. Uthenga ukhoza kuwululidwa kudzera m'maganizo, zikhumbo, zithunzi, mitundu, zifaniziro, zikumbukiro, mawu, kapena mauthenga ena. Kuchita izi kungalimbikitse khalidwe losiyana lomwe limakhala ndi chidwi pozindikira / kusiyanitsa zosiyana ndi zomwe anthu amaganiza komanso m'malo mwake zimalimbikitsa kukhala otseguka kuti alole chinthu chosadziwika kapena chosadziwika. Kudziwa izi kumaphatikizapo kukumana mwachindunji ndikukhala ndi khalidwe lachikondi ndi lachifundo lomwe limakula ndikudzidalira nokha komanso kumalimbikitsa zochitika zomwe zimakhala zosiyana siyana (Trungpa, 2015).

Pali madalitso angapo ophatikizira chidwi ndi kugwirizana ndi kugonana. Kafukufuku wam'tsogolo akuwonetsa kuti njira zokhudzana ndi malingaliro zomwe zimaphatikizapo kuphunzitsanso njira zowonjezereka pofuna kukulitsa kuzindikira za thupi ndi kugwirizana kwa thupi ndizochiza chithandizo cha kugonana (Brotto, 2013; Brotto, Basson, et al., 2008; Carvalheira et al., 2017; Mehling et al., 2012; Mize, 2015; Silverstein et al., 2011). Deta yomwe imaphatikizapo kuti kugonana kosagwiritsidwe ntchito kungabwere kuchokera ku zolaula zomwe zimakhala zovuta, njira zokhudzana ndi malingaliro zingagwiritsidwe ntchito kumbali zambiri za zizolowezi zamakhalidwe. Kuphatikiza pa kuzindikira thupi ndi kugwirizana kwa thupi kuli kofunikira pa kuchiza kugonana kosayenera ndi kuonjezera chisangalalo cha kugonana ndi kukhutira, amafunikanso kupeza mwayi wolunjika mwachindunji kuchokera muzochitikira zamkati zomwe zingakhale zofunikira kuti mutengepo mbali pa zokambirana zomwe zikuchitika zokhudzana ndi kugonana kugonana. Mu MMSH, kukhala ndi chidziwitso komanso kuphunzitsidwa za chitonthozo chamkati, malire, zosangalatsa, chitetezo, zowawa, ndi mayankho ndi maonekedwe enieni ndizofunikira pakukulitsa kuyankhulana muzochitika zogonana zomwe zimakhala zolimba komanso kusintha kuchokera pakanthawi pang'ono.

Kuchiza kwa Zovuta Kugonana

Kuphatikiza maganizo (Chawla et al., 2010), kuzindikira zamkati (Mehling, 2016), komanso chifundo (Germer & Neff, 2013) muzochita zothandizira, kudziletsa, komanso kubwezeretsa kwa anthu omwe akulimbana ndi makhalidwe okhudzana ndi kugonana ali ndi kafukufuku wowonjezera omwe amasonyeza kuti ntchitoyo ndi yothandiza. Kuphunzitsa mwachidziwitso ndi chifundo kungapatse anthu mphamvu kuti agwire ntchito ndi maiko awo kuti azilimbikitsa machiritso, kukula, ndi kusintha kwabwino.

Kwa anthu omwe akulimbana ndi zovuta zokhudzana ndi kugonana, kugonana "kuchita" kugonana kungayimire njira yothetsera vutoli komanso "njira" yothetsera kusungulumwa, manyazi, kapena zina zolakwika. Choncho, kuphunzitsa malingaliro kungalimbikitse chitukuko cha umoyo kumaphatikizapo kumvetsera maganizo ndi maganizo, pamene akulekerera zochitika zamakono ndi chidwi, kutseguka, kusaganizira, ndi kuvomereza. Njira iyi ingayambitse njira yatsopano, yokoma, ndi yaulere yokhala ndiyekha, zomwe zingapereke umboni wotsutsana ndi mayiko omwe sakugwirizana nawo. Kulingalira kungavomereze kupeza mwayi wopezeka mu thupi ndi malingaliro ndikulimbikitsa kulimbikitsana, zomwe ndizothandiza kuthana ndi kugwirizanitsa zinthu zomwe zingachitike kwa anthu omwe ali ndi zizoloŵezi zakugonana. Zochita zokhudzana ndi kulingalira zingapatse anthu njira yopezeka ndi thupi lawo, malingaliro, malingaliro, zilakolako, ndi zofuna zawo pamene akumva mphamvu ndi ufulu. Izi zikhoza kuwonetsa chitukuko chachikulu kwa anthu omwe nthawi zambiri amavutika chifukwa chokhala ndi mphamvu yochepetsedwa ndikumverera kuti akuyenera kuthawa kukhala ndi zochitika za kanthawi.

Chitsanzo Chitsanzo

Chitsanzochi ndi chitsanzo chosonyeza momwe MMSH ingagwiritsidwire ntchito kuchipatala kuthandiza anthu omwe akufuna chithandizo kuti azichita zachiwerewere.

Samantha anali mayi wa 29 wazaka zofuna chithandizo cha kupanikizika ndi makhalidwe okhudzana ndi kugonana. Pamene adadya, adafotokoza momwe khalidwe lake lachiwerewere linayambitsa mavuto ambiri kuphatikizapo kuwonongeka kwa ntchito komanso maubwenzi, kusakhazikika kwachuma, komanso kutumiza zithunzi zake zachiwerewere kwa amuna, ngakhale atalonjeza kuti adzaima. Pamene adakambirana zambiri za mavuto omwe akubwereranso pamoyo wake, zinaonekeratu kuti ngakhale kuti anali ndi kuzindikira, adapitiriza kumva kuti ali ndi zizolowezi zakale za makhalidwe okhudzana ndi kugonana komanso maubwenzi.

Mbiri ya Samantha ikuphatikizapo kugwiriridwa ndi munthu wamkulu pamene anali ndi zaka 9 ndipo adagwiriridwa ndi mnyamata wachinyamata wazaka 13. Patapita zaka zachinyamatayo, anayamba kumwa mowa, heroin, crack cocaine, ndi cannabis. Pa zaka 7 asanayambe kumwa mankhwala opatsirana pogonana, Samantha anali woyera komanso wochepetsetsa, wogwira ntchito zachipatala chifukwa cha mankhwala osokoneza bongo, ndipo adapezeka nawo m'dera la 12.

Mbiri ya kugonana ya Samantha imaphatikizapo ululu, chisokonezo, ndi manyazi. Iye anati iye ankakhulupirira izo, "Kugonana ndi chinthu chokha chomwe ndinaganiza kuti ndinali nacho. Thupi langa ndi kugonana ndizofunikira. Kwa nthawi yaitali, sindinadziwe za izi; Ine sindinachiwone icho. Tsopano ndikuzindikira kuti zambiri zokhudzana ndi kugonana zinachokera ku malo osokonezeka. Ndili ndi anyamata omwe ndakhala nawo, ndakhala ndikuganiza kuti ndikuyenera kuwapanga. Ndinalola anthu kuti agwiritse ntchito ndikunyoza. Ndili ndi zaka 14, mankhwala osokoneza bongo omwe ndinayambapo nawo anali osamala kuchokera kwa anthu. Ndimachita chilichonse chomwe akufuna pogonana."

Samantha, chithandizo champhamvu chimene chinamulepheretsa kugwirizanitsa mkati mwake, kuti adziwe kuti ali ndi mphamvu zokhazokha. Kugonjetsa kwake, kugwiriridwa, ndi zaka zomwe amagwiritsidwa ntchito pogonana zakhala zikuthandiza kudzipatula ku mphamvu yake komanso kuchoka payekha, kuphatikizidwa, kutengeka, ndi kudzikonda. Anati kuyambira ali mwana, "kudzikonda kwanga kunatanthauzidwa ndi kugonana kwa amuna. " Kumayambiriro kwa unyamata wake, iye anali wokonzeka kuyang'ana kunja kwake, kwa amuna makamaka, kuti atsimikizidwe. Iye sanali wogwirizana kwambiri ndi malingaliro ake kapena makhalidwe ake, ndipo analibe chidaliro chotsatira zolinga zake kapena zofuna zake. Mwamvetsa chisoni anapeza kuti, "Ndakhala wotsekedwa kwambiri ndi malingaliro anga komanso kwa anthu ena, komanso kudziwa momwe zimakhalira kukhala moyo weniweni ndikusamala za wina, kuphatikizapo ndekha. "

Panthawi yomwe tinagwira ntchito pamodzi, adayamba kuona zozizwitsa ndi zikhulupiliro zokhudzana ndi iye mwini pamene adakhalapo ndikuwona umunthu wake wamkati. Kusintha kwa mkati kumeneku kunayambitsa kusintha khalidwe lake la kugonana. "Poletsa kugonana kwanga, ndikupezeka mkati mwanga. Ndisanayambe kuthamanga kwa nthawi yaitali chonchi. Kugonana ndikutaya nkhawa, kusungulumwa, ndi kuvutika maganizo kwa ine. Kuthawa pogonana kunali kuyesa kuti ndikhale wabwino, koma kunangowonjezera."

Pamene Samantha adakulitsa kuzindikira kwake, adawonanso momveka bwino maganizo ake opotoka pakali pano, zomwe zinali zosasangalatsa komanso zokhudza iye. "Lingaliro langa la zenizeni si zomwe zikuchitika. Sindikudziwa chomwe chiri chowonadi. Ndine woweruza kwambiri kwa ine ndekha ndi ena. Tsopano, ndikuyesetsa kuchita zinthu izi ndikudziwitsa bwino kwambiri. Kukhala watsopano mu kugonana, ndi zopweteka kuona bwino pamene ndikunyansidwa ndi ine ndi khalidwe langa, kotero zimandivuta kukhala ndi chimwemwe chokhala ndi moyo, chifukwa kugonana ndikuchititsanso chisangalalo cha chimwemwe ndi mtendere, popeza ndinali wachinyamata. Ndi zopweteka kuvomereza kuti ndikuchita mwachangu makhalidwe omwe akukhumudwitsa moyo wanga kuti ndipeze zomwe ndimaganiza kuti ndikufunikira. Ndimasewera masewera a m'maganizo ndekha. Ndikanatha kugonana ndi anthu zana, koma palibe kugwirizana. Zilibe kanthu. Ndi zopweteka. "

Samantha anaphunzira kubweretsa chifundo kwa ubale wake ndi iye yekha ndipo zakhala zothandiza kuti iye apitirize kugwira ntchito yovuta komanso yovuta ya kuchiritsa. Machiritso ake ndi kukula kunapitirira. "Tsopano, ndikuchira, kugonana kwanga kusintha. Asanayambe, ndinkaganiza kuti anthu omwe ndimagwira nawo ntchito zogonana ndizo zonse zomwe ndimayenera; tsopano ndikusintha maganizo anga. Chirichonse chinali chokhudza kugonana, maubwenzi anga kuntchito, momwe ndimayanjanirana ndi amuna. Zonsezi zinadalira kugwiritsira ntchito kugonana. Sindinkakhala ndi abwenzi enieni aakazi, chifukwa sindinayambe kugwiritsa ntchito nthawi kapena mphamvu chifukwa sindinagwiritse ntchito kugonana kuti ndiwononge akazi. Mphamvu ndi kuyanjana ndi akazi sizinayankhulidwe ndi mphamvu zogonana izi, kotero sindinasokoneze kapena kuwayamikira anzanga achikazi. Ndili ndi chizolowezi chogonana, ndikuyesera kudzichepetsa mumtima mwanga ndipo sizinagwire ntchito. Ine ndinali kufa mkati. "

Ntchito yochiritsidwa ndi machiritso, imathandizira kukhala kapena kubwerera ku zochitika zenizeni za thupi, mpweya, ndi maganizo. Mafunso okhudzidwa mu magawo angagwiritsidwe ntchito kuti apeze zambiri ndi kufufuza zikhulupiriro zazikulu ndi anthu omwe akuchiritsidwa. Pamodzi, wodwala ndi wodwala angagwire ntchito limodzi kuti akulimbikitse kumvetsetsa komwe kungabwere kuchokera kumalingaliro akudzifunsa za zomverera ndi thupi. Kuganizira izi kungakhale njira yowonjezera yowunikirira zinthu zakuthupi pamene akupanga kusintha kupita ku machiritso, kuyanjana, ndi kukula.

Zotsatirazi ndi zolemba za Samantha ndikufunsanso momwe angagwiritsire ntchito mankhwalawa ndikuwonetsa momwe zochita zodzidzimitsira komanso kukhudzidwa kwake kuthamangitsira zododometsa zakhazikitsa zizoloŵezi zabwino. N'chizoloŵezi kuti anthu asamatsatire kuchepetsa kuganiza kuti akumva zamkati, makamaka mwa anthu omwe adakumana ndi zowawa ndi kuledzera. Choncho, ndikofunika kuti therapeutically ipange malo otetezeka kuti akhale ndi zigawo zamkati ndi zomwe sizikumveka bwino. M'ndandanda 1, timalongosola masitepe ofunsa mafunso ndi cholinga cha gawo lililonse. Kufunsa mwachidwi kungaphatikizepo wodwalayo kutseka maso kapena kuyang'ana mopepuka ndikuyang'ana mpweya ndi thupi kuti athe kupezeka kumadera akumkati. Ngakhale kuti wothandizira angapereke malingaliro a momwe angayang'anire, wodwalayo amalemekezedwa. Amapemphedwa kuti afotokoze zomwe akuwona zikuchitika, ndi zochitika mwachindunji pa mphindi iliyonse yamalingaliro ndipo gawo losadziwika likuyendetsedwa pamodzi. Zingakhale zothandiza kupatsa wodwala ichi chithunzi chofotokozera cha mphamvu zamphamvu zowatsimikizira kuti wodwalayo ali woyenera kulamulira; mu ndondomekoyi yofunsira, wodwala akuyendetsa galimoto akuyendetsa galimotoyo, potsiriza kupanga zosankha za komwe angatsogolere chidwi ndi malangizo omwe angapite kukafufuza zochitika, pamene udindo wa wothandizira ndi umodzi wa wokwera m'galimoto yopereka Mapu ndi kutsogolera pothandizira njira zothandizira. Kulemba mafunso okhudzidwa kumatsatira:

• Samantha: "Ndikuona kuti ndikuyesera kusunga phokoso ndi maganizo akunja za zomwe zingadzachitike pambuyo pake."
• Wopatsa: "Tawonani kuti mukuganiza kuti mutha kukankhira kutali ndipo tsopano yang'anani zomwe mukuziwona ndi mpweya wanu, thupi lanu."
• Samantha: "Ndikuona kuti ndili ndi nkhawa kwambiri, ngati ndikuthawa. Ndizochita zomwe zimachitika ndikudzimva ndikukhala wamng'ono. Pamene ndimasuka, ndikusiya tsopano, ndimamva kupweteka m'chiuno mwathu ndi mchira ndikusiya. Zimakhala zosafunikira kukhala maso ndi kupuma nthawi imodzi. "
• Wopatsa: "Inde, izi ndi zosiyana ndi zatsopano. Bwerezerani chidwi ndi chidwi ndi exhale yanu. Mukukumana ndi chiyani pano? "
• Samantha: "Ndimaona mpata pakati pa mphuno ndi milomo yanga ndi mpweya wa kunja kwanga. Ndimamva kuuka ndi kugwa kwa chifuwa changa. Kukhala mu chikhalidwe ichi si zachilengedwe kwa ine. Ndimamva mphamvu ndikuganiza kuti ndikusintha. Ine ndikuyang'ana chinachake ^ chosokoneza. Ndimamva ngati ndikufuna kudumpha khungu langa. Si zachilendo kuti mumve bwino. Zimamva zosakhala zachikhalidwe, kungokhala chete. Cholinga chimenecho chothawa, KUSANKHA KUKHALA ndi kolimba kwambiri komanso kawirikawiri. Ine ndakhala ndikugwira ntchito kuchokera ku chikhulupiriro chakuti, 'iwe sungakhoze kugwedeza zolinga, kotero pitirizani kusuntha!' Mwanjira ina, kuthawa kunakhala njira yanga yosasinthika. Ndikovuta kukhalapo ndikukhazikitsidwa m'thupi langa. Ndikuwonanso chitetezo chosasinthika kunena kuti, 'izi ndi' fayilo ya 'airy'. Ndikuwonanso chinachake chimene ndinamva Brene Brown akuti, 'imani malo anu opatulika'. "
• Wotere: "Ndicho chimene mukuchita tsopano. Izi ndi zomwe zimamveka kukula muzochita zanu ndi mphamvu kuti mugone. Kukhala ndi mpweya wanu, thupi lanu, ndi moyo wanu wonse pamene mutayima malo anu opatulika. "

Mauthenga a Samantha amasonyeza malingaliro ndi malingaliro osiyana m'maganizo ndi thupi lake. Zizolowezi zamakhalidwe zomwe zimayambitsa zoopsa zimatha kulimbikitsa kulimbana ndi kukhalabebe, ndipo khalidwe labwino limene adayamba kulikhulupirira linali lodzipangira yekha, lachititsa kutaya ndi kudzivulaza pa nthawi yayitali. Chizoloŵezi chochita mwadzidzidzi m'makhalidwe angayesedwe poyambitsa chikhulupiliro chosiyana. Monga momwe Samantha akufotokozera, "njira yopezera chitetezero" ndiyo yomwe imamulepheretsa kukhala yekha, kuthamanga, ndi kuyang'ana zododometsa. Gawo limenelo limakhala ngati likuwopsyeza, likukankhira kutali, likulepheretseratu, ndipo likufuna kuti liwononge iye kukhala ndi chiyanjano chozama ndi iye mwini chifukwa cha maganizo okhudzidwa ndi mafunso okhudza kuti ndi "airy-fairy stuff". Amawona malingaliro awa ndi maumboni ena uthenga umachokera mkati. Samantha akuwona zosiyana zake ndi mauthenga osiyanasiyana, malingaliro, ndi zikhulupiriro. Ngakhale kuti ndondomeko zokhudzana ndi kusintha kumeneku ndizomwe zikuchitika pakadali pano, zitsanzo zina zamaganizo pogwiritsa ntchito njirayi zimasonyeza kuti kusintha komwe kumafotokozedwa pamwamba kumagwirizana ndi omwe amagwiritsa ntchito njira zowonongeka.

Nkhani ya Samantha ikuwonetseranso kukula komwe kungakhalepo pakakhala zochitika za MMSH. Pakalipano, akupitiriza kugwiritsira ntchito njira zowonongera maganizo ndi thupi, kulamulira maganizo, ndi kugwiritsa ntchito mfundo zamkati kuti atsogolere kupanga njira zokhudzana ndi kugwiritsira ntchito mankhwala ndi kugonana. Zitsanzo zina zowonjezera zingadalire kwambiri pa mbali zosiyanasiyana za MMSH (Table 1), malinga ndi mafotokozedwe apadera.

M'ndandanda 1, timalongosola masitepe ofunsa mafunso ndi cholinga cha sitepe iliyonse. M'ndandanda 2, timalongosola momwe MMSH imakhudzira mwachindunji zomwe zili ndi malingaliro okhudzana ndi machitidwe opatsirana kuti athe kupeza malingaliro angapo mwa kufufuza mwakuya pa zodetsa za wodwalayo. Gome sichiyimira mndandanda wa zowonjezereka koma zimapereka zitsanzo monga momwe angafunse mafunso komanso momwe MMSH ingagwiritsire ntchito. Njirayi iyenera kukhala yodziwika payekha pokhapokha ngati pali chifukwa chomveka chothandizira anthu kukhazikitsa ndi kugwiritsa ntchito luso lolimbikitsa kugonana wogwirizana.

Mawuwo

M'nkhani ino, timakumbukira mwachidule zitsanzo zoyenera zogonana ndi malingaliro okhudzana ndi kugonana ndikupereka MMSH yatsopano yomwe imaphatikizapo zinthu zina za kummawa ndi kumadzulo kwa filosofi ndipo zingagwiritsidwe ntchito pochiza anthu omwe ali ndi matenda osokoneza bongo. Chitsanzochi chikuphatikizapo madera asanu ndi atatu omwe akukhudzana ndi zolepheretsa ku thanzi komanso njira zomwe zingalepheretsedwe kuchipatala. Kuwonjezera pa kuthandiza anthu kuti ayambe kupezeka ku matenda osokoneza bongo (kuphatikizapo zolaula zimagwiritsidwa ntchito), MMSH ikhoza kukhala yopindulitsa mu maphunziro a chiwerewere ogwirizana, kugonana kwachisokonezo chogonana, komanso kulimbitsa thanzi labwino kwambiri.

Zopereka za olemba

GRB inapanga chitsanzo, kupereka thandizo lachipatala pomwe nkhaniyo inakhazikitsidwa, ndipo inapanga ndondomeko yoyamba ya mndandandawo. MNP adalangiza pa chitukuko cha chitsanzo, kupereka thandizo panthawi yokonzekera kulembedwa kwa zolembedwamo, ndikukonzanso ndikukonzanso malembawo. Olemba onsewo anavomereza malembawo.

Kusamvana kwa chidwi

Olembawo alibe zovuta zokhudzana ndi zomwe zili pamwambowu. Dr. MNP walandira thandizo lachuma kapena malipiro a zotsatirazi: adafunsira kwa Shire, INSYS, RiverMend Health, Opiant / Lakelight Therapeutics, ndi Jazz Pharmaceuticals; adalandira thandizo lofufuza kafukufuku wochokera ku Mohegan Sun Casino ndikupereka chithandizo kuchokera ku National Center for Gaming Response; ndipo adafunsira mabungwe amilandu ndi kutchova njuga pazinthu zokhudzana ndi kusokoneza maganizo. Mlembi winayo akufotokoza kuti palibe zotchulidwa.

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