Ukucima iincwadi zakho zezifundo: Amadokhumenti aphinde ahlaziye iziLawuli zokuziphatha koTyala

I-American Society of Addiction Medicine
IZIPHUMO malunga nesi sibhengezo seMedical Association sokongezwa kwemithi:

I-American Society of Addiction Medicine ithi ukuziphatha kakubi ngokwesondo kunokunyaniseka kwezidakamizwa

Isiganeko esiphambili senzekile kwindawo yesayensi kunye nonyango. Iingcali eziphambili zaseMelika kwiAmerican Society of Addiction Medicine (ASAM) zisandula ukukhupha ukutshayela kwazo inkcazelo entsha yokulutha. Le nkcazo intsha iphelisa ingxoxo malunga nokuba isini kunye neziyobisi ezingamanyala "zilikhoboka lokwenyani." Bazi.

Isuka e ASAM:

Inkcazo entsha ibangelwe yinkqubo enzulu, yeminyaka emine kunye neengcali ezingaphezu kwe-80 ezisebenza ngokukuko, kubandakanya nabasemagunyeni abaphezulu kwezonyango, oogqirha bezonyango kunye nezifundo eziphambili ze-neuroscience kwilizwe liphela. … Amashumi amabini eminyaka okuqhubela phambili kwinzululwazi ye-neurosciology aqinisekisa i-ASAM ukuba umlutha kufuneka uchazwe ngokutsha ngokwenzeka kwingqondo.

Kusenokwenzeka ukuba i-ASAM isebenze, ngokuyinxenye, kuba oogqirha bengqondo abahlaziya i-DSM (Umbutho weAmerican Psychiatric Association's I-Diagnostic and Statistical Manual Izifo Zengqondo) ibe ukuhudula iinyawo ekuziseni i-DSM-5 ezayo kulungelelwaniso nenkqubela phambili kuphando lweziyobisi. Ngokwesiko, i-DSM ibonelela ngoxilongo ngokusekwe kwizifo, kodwa kuluhlu lweendlela zokuziphatha. Kuba ababhali beDSM abanakuvumelana kuluhlu lweendlela zokuziphatha ngokwesondo ezenza "iHypersexuality Disorder" (ejongene nokusetyenziswa gwenxa kwe-porn), banemisipha. Ngapha koko, banokusiphelisa esi sifo kwisihlomelo-Njengokusetyenziswa kwezilwanyana ze-intanethi phakathi kwamakhwenkwe atsha phantse iphela. (QAPHELA: Oku kwabhalwa ngaphambi kokuba i-DSM-5 izame ukwenza isigqibo se "behaudidi lwezobisi".)

Inkcazo ye-ASAM

Okuchasene, i-ASAM ingcaciso, "Ijonga indima yengqondo kwi-etiology yokulutha-kwenzeka ntoni ekusebenzeni kwengqondo kunye nokujikeleza kwengqondo okunokuthi kuchaze indlela yokuziphatha kwangaphandle ebonwa likhoboka." Kukwamkela ukuba indlela yokuziphatha ngokwesondo (umzekelo, ukubukela iphonografi kwi-Intanethi yonke imihla) inokuba bubungqina besifo sengqondo somntu ngaphandle kokubonisa isifo somnye.

Uphando lubonisa ukuba kokubili ukuziphatha kweemichiza nokuziphatha kwamakhemikhali kubandakanya ukuguqulwa okufanayo kwi-brain anatomy ne-physiology. An Umkhulumeli we-ASAM wachaza:

Inkcazo entsha ishiya ngaphandle kwamathandabuzo ukuba zonke iziyobisi-nokuba kungotywala, i-heroin okanye isini, zithi-ziyafana ngokufanayo. Ugqirha Raju Haleja, owayesakuba ngumongameli we-Canadian Society for Addiction Medicine kunye nosihlalo wekomiti ye-ASAM eyila inkcazo entsha, uxelele i-The Fix, “Sijonge ukuba likhoboka njengesifo esinye, ngokuchaseneyo nabo bababona njengabahlukileyo izifo. Iziyobisi likhoboka. Ayinamsebenzi into yokuba ingqondo yakho ibheka ngaphi, ukuba nje itshintshile, usengozini yokufumana lonke utywala. ” … Ukwabelana ngesondo okanye ukungcakaza okanye ukukhobokisa ekutyeni [konke] kuyasebenza njengokunyanga utywala okanye iheroin okanye ikristal meth.

Nasi isishwankathelo esifutshane se-American Society of Addiction Medicine amanqaku aphambili:

  1. Umlutha ubonisa ubuchopho obufanayo butshintsha nokuba luvela ekuphenduleni iikhemikhali okanye ukuziphatha.
  2. Umlutha sisifo esiyintloko. Ayinyanzelekanga ukuba ibangelwe yimicimbi yezempilo yengqondo enje ngeemood okanye ukuphazamiseka kubuntu. Oku kuphumza umbono odumileyo wokuba iindlela zokuziphatha ezichasayo zihlala zihlobo "lokuzinyanga ngokwakho" ukunciphisa ezinye iingxaki.
  3. Zomibini zokuziphatha kunye neziyobisi zenza ukuba utshintsho olufanayo olufanayo kumasekethe alungelelaniso: Ubuthakathaka, ukukhuthazwa, ukuchithwa kwemisebenzi, ukutshintsha izijikelezo zecingo, njl.
  4. Ukuzibandakanya "ekuziphatheni okungalunganga" okungapheliyo kubonisa ukuba ezi nguqu zingasentla zenzekile. Ukuziphatha okuluthayo kuya kuba kukungazi kunye nokuziqhelanisa.
  5. Inkcazo entsha ishenxisa indala "yokulutha ngokuchasene nokunyanzelwa", eyayidla ngokusetyenziselwa ukukhanyela ubukho bezinto zokuziphatha, kubandakanya ne-Intanethi.

Ngokungafaniyo nengqondo yokungcakaza, ukutya, ividiyo yevidiyo, iziyobisi zesini / iziyobisi ezingamanyala. Nangona kunjalo ubuchwephesha bobuchwephesha bokuziphatha gwenxa sele kuchazwe kakuhle, ukuba iingcali zingatsho ngokuzithemba ukuba indlela yokuziphatha ngokwesondo nayo inokuba likhoboka. Ngamanye amagama, ayisiyiyo le fomu okanye ubungakanani besikhuthazi, kodwa endaweni yoko inguqu ebangelwe kukutshintsha, ibalulekile. Ezi zicatshulwa kwii-FAAM ze-ASAM zichaza isayensi eqhelekileyo kuzo zonke iziyobisi:

UMBUZO: Yintoni eyahlukileyo malunga nale ncazelo entsha?

I MPENDULO: Ugxininiso kwixesha elidlulileyo sele libhekiselele kwizinto ezinxulumene nokulutha, njengotywala, i-heroin, i-marijuana okanye i-cocaine. Le nkcazo intsha yenza kucace ukuba umlutha awukho malunga neziyobisi, imalunga nobuchopho. Akunjalo izinto ezisetyenziswa ngumntu ezenza zibe ngumlutha; ayikho ubungakanani okanye ubukhulu bokusetyenziswa. Umlutha malunga nento eyenzekayo kwingqondo yomntu xa bevezwa zizinto ezinomvuzo okanye isimilo sokuziphatha, kwaye ingakumbi malunga nomvuzo wesekethe kwingqondo kunye nolwakhiwo olunxulumene nengqondo kunokuba kunjalo malunga neekhemikhali zangaphandle okanye indlela yokuziphatha ethi "ijike" loo mvuzo wesekethe. (Ugxininiso longezwa.)

Ukutshintsha iinguqu eziqhelekileyo zengqondo zenguqu, ezibonisa ukuziphatha njengemizamo engaphumelelanga yokulawula ukusetyenziswa, izifiso ngexesha lokuziyeka, kunye neempawu zokuhoxiswa. Kuza kube namhlanje, inguqu engundoqo iguqulwa kuzo zonke izilingo (ukungafuni, ukukhunjulwa kunye nokuzenzisa) sele sele iphawulwe kwingqondo yabantu abangcakazayo, abagqithisileyo, abadlala iividiyo. Kusenokwenzeka ukuba babakho nakubasebenzisi be-porn abanyanzelekileyo banamhlanje. Ukuba iyahamba, iyathetha kwaye isebenza njengedada, yidada. Hlaziya: IYunivesithi yaseCambridge: Iingcamango zobungqina zifumana ukutshabalalisa i-porn)

Enye intsingiselo yengxelo ye-ASAM kukuba umntu akakwazi ukuchaza "umlutha wezobisi" ngexesha elichithwe ukujonga okanye iintlobo ezibukeleyo. Pukuxiliswa komzimba kukhona kuphela ukuba utshintsho lweengqondo luyenzeka kumbukeli. Kuba ukuskena kwengqondo akunakwenzeka, i-ASAM idale uvavanyo oluyinxalenye emi-5 yokunceda abantu babone ukuba iingqondo zabo zitshintshile. Oku kuyafana nokuvavanya ukumakishwa kwesifo seswekile kwizigulana zikhalaza kwiimpawu ezixelwayo.

Le mibuzo emibili elandelayo esuka kwi-ASAM idilesi yesini kunye nokunyaniseka kokutya ngokukodwa:

UMBUZO: Le ncazelo entsha yokukhwela umlutha ibhekisela kumlutha wokubandakanya ukugembula, ukutya, kunye nokuziphatha ngokwesini. Ngaba i-ASAM ikholelwa ngokwenene ukuba ukutya kunye nesondo kuyingozi?

I MPENDULO: Umlingo wokungcakaza uchazwe kakuhle kwiincwadi zenzululwazi kwiminyaka emininzi. Enyanisweni, ukushicilelwa kwangoko kwe-DSM (i-DSM-5) kuya kuluhlu lwesifo sokungcakaza kwinqanaba elifanayo kunye neengxaki zokusetyenziswa kweziyobisi.

Intsha entsha ye-ASAM ichaza ukuhamba ngokulingana nokuxhomekeka kwendalo, ngokuchaza indlela umlutha uhlobene ngayo nokuziphatha okuvuzayo. Eli lixesha lokuqala ukuba i-ASAM ithathe indawo esemthethweni yokuba umlutha ayisiyiyo kuphela "into exhomekeke kwinto."

Le ncazelo ithi ukuxhatshazwa ngokuphathelene nokusebenza kunye neengcaphephe zengqondo kunye nokuba isakhiwo kunye nomsebenzi wobomi babantu abanomlutha bahluke njani kwisakhiwo kunye nomsebenzi wabantu abangenalo umlutha. Ithetha ngomvuzo wesiphaluka kwingqondo kunye neesekethe ezihambelanayo, kodwa ugxininiso alukho kwimbuyekezo yangaphandle esebenza kwi-system reward. Ukutya kunye nokuziphatha ngokwesondo kunye nokuziphatha okungcakaza kunokunxulunyaniswa "nokusukelwa ngokwasemzimbeni kwemivuzo" echazwe kule nkcazo intsha yokulutha. (Ukugxininiswa kwongezwe.)

UMBUZO: Ngubani ophethe umlutha wokutya okanye ukuxhatshazwa ngokwesondo?

I MPENDULO: Sonke sinomvuzo wesekethe owenza ukutya kunye nokwabelana ngesondo kunomvuzo. Le yindlela yokusinda. Kwingqondo esempilweni, le mivuzo ineendlela zokuphendula ngokuhlutha okanye 'ngokwaneleyo.' Kumntu onomlutha, isekethe iba yinto engasebenzi kakuhle kangangokuba umyalezo oya kumntu uye abe 'ngaphezulu', okhokelela ekulandeleni imbuyekezo kunye / okanye isiqabu ngokusebenzisa izinto kunye nokuziphatha.

Ngomfutshane, ukuxhatshazwa ngokwesondo, kwaye kubangelwa utshintsho olufanayo oluyisiseko kwisakhiwo sengqondo kunye ne-physiology njengemilutha yeziyobisi. Oku kwenza ingqiqo. Emva kwakho konke, iziyobisi ezingamlisi azenzi nto kodwa zanda okanye zinciphise imisebenzi eqhelekileyo yezinto eziphilayo. Baqhawula izijikelezo ze-neural ngenxa yemivuzo yemvelo, ngoko kuya kufuneka kubonakale ukuba iinguqulelo ezigqithisileyo zembuyekezo yemvelo (i-junk food, i-pornography ye-intanethi) ukuxaka ezo zijikelezo.

Kuthiwani ngezilwanyana ezingamanyala?

Ababoneleli ngezempilo banamhlanje kunye nabacebisi beengcali abadumileyo bahlala belahlekiswa malunga nomngcipheko wokusetyenziswa gwenxa kwe-Intanethi- ngokuyinxenye kuba bayazi ukuba ukuphulula amalungu esini (ngaphandle kwe-porn) kunqabile ukuba kubangele ukuba likhoboka. Ingxaki kukuba, i-intanethi ye-intanethi kungekhona nje ukugcoba. Inkolelo yokuba i-masturbation kunye ne-intanethi ye-intanethi ifanayo ibonisa ukungabikho kwengqiqo yempembelelo yengqondo yengqondo. Ngokuqhelekileyo, ukuphonywa kukukhokelela ekuvekeni. Ngokwahlukileyo, i-intanethi ye-intanethi inakho li ngaphezu satiety. Kwezinye ubuchopho, satiety ngokuvuselela ngokugqithiseleyo umthamo othobayo ukutshintsha kwengqondo yengxaki yomlutha. Ukungaqondi kakuhle kubangela iingcebiso ezingalunganga kwizigulane / abaklayenti / abafundi.

Imiceli mngeni kuphando

Xa ngabaphandi ngenye imini bejonge ubuchopho bezilwanyana zezilwanyana ze-intanethi, bayaqiniseka ukuba babone utshintsho oluye luboniswa kwezinye iindidi ze-intanethi. Hayi, uphando olungumlingo wobugqwetha lubhekana nocelomngeni olunzima:

1.Ukulawula amaqela abantu abangamadoda, abangasebenzisi i-Intanethi abangasebenzisi i-Intanethi abasenakufunyanwa, kwaye nokuba banako, iibhodi zokuphonononga ngokuqinisekileyo azizukuvuma iiprothokholi ezibabiza ukuba babukele iintlobo zamanyala kangangeeyure ezininzi ngosuku abafana banamhlanje babukele.

2. Iikhweshine ezingacacanga (ngokungafaniyo nokuskena kwengqondo) zenza kube nzima kubasebenzisi be-porn ukuba badibanise iingxaki zomsebenzi wesondo (okanye uxinzelelo lwentlalo, uxinzelelo okanye iingxaki zoxinzelelo) ngokusetyenziswa gwenxa kwe-Intanethi. Emva kwayo yonke loo nto, iphonografi ibonakala njengeyona aphrodisiac inokuthenjwa emhlabeni, kwaye abasebenzisi bahlala beziva bhetele ngelixa besebenzisa. Inokubangela njani iingxaki ekunyanga okwethutyana?

Kuphela ngolwazi olubanzi loxinzelelo, iimpawu zalo, kunye ne-etiology zayo ngabaphenyi kunye nezifundo zabo zidibanisa ngokuchanekileyo isizathu. Isitatimende se-ASAM sisekela abaphandi ekuphanduleni ukusetyenziswa kweefosora ngokusebenzisa i-lens yenguqu yenguqu.

Iingcali ziphethe uxanduva

Isibhengezo se-ASAM linyathelo eliya phambili ekuncedeni ukuphinda kufundiswe iingcali kunye nabaxhasi bazo. Uninzi lwalufundiswe ngempazamo ukuba iindlela zokuziphatha ngokwesondo azinakuvela kubuninzi bengqondo ngokuziphatha. Endaweni yoko, baqeqeshelwa ukuqinisekisa abathengi ukuba umlutha wokuziphatha ngokwesondo awuzange ube semngciphekweni- ngaphandle kokuba umthengi abe nezinye iingxaki (ezixhaphakileyo zemfuza).

Nangona kunjalo abalobi be-ASAM baqikelela ukuba i-genetics yenza kuphela isiqingatha sezizathu zokulutha. Oku kuthetha ukuba umlutha ungathuthuka ngokungabikho kweemeko zangaphambili. Ngamanye amazwi, iimpawu ezinxulumene nezocwangco ezinjengezoxinzelelo, ukuxhalaba kweentlalo, imiba yolutsha kunye neengxaki zokugxininisa kufuneka zijongwe ngendlela enokwenzeka ngayo nemiphumela yokulutha, kunokuba kuthathwa njengento yabo rhoqo unobangela.

Isiteyitimenti esitsha seyeza lokulutha ngenxa yoko sibeka uxanduva kubanyangi ukunceda abantu ababelana ngesondo kunye nabathengi be-porn ukuba benze utshintsho olusisiseko kwindlela yabo yokuziphatha. Okwangoku, abacebisi abaninzi bamane bathumela abathengi kugqirha ngamachiza okuphucula ingqondo kunye nokwabelana ngesondo. Kwangelo xesha baqinisekisa ukuba indlela abaziphethe ngayo ngokwesondo yinto eqhelekileyo kwaye ayinabungozi.

Isitatimende se-ASAM sisinyathelo esincinci kwisikhokelo esicacileyo. Ngaphakathi esi sithuba, sibheka iimpawu ezicacileyo zabasebenzisi bezonyango, ingxelo leyo ingabonisa utshintsho oluthile lweengxaki.