- I-Journal of Addictions of Behavioral >
- Uhlu Lwezinkinga >
- Volume 5, Issue 2 >
- I-DOI: 10.1556 / 2006.5.2016.034
UWilliam Van Gordon
* Umbhali ohambelana: UWilliam Van Gordon; Isigaba sePsychology, iNottingham Trent University, iNottingham, iNottinghamshire, NG1 4BU, UK; I-imeyili: william@waketowisdom.
abstract
Umlutha wezocansi ukugula okungaba nemiphumela emibi yokusebenza okuhle. Ucwaningo olusebenzayo lokwelapha umlutha wezocansi okwamanje aluthuthukiswa, futhi ukungenelela ngokuvamile kususelwa kwizinkomba zokwelapha ezinye izimilo zokuziphatha (kanye nokwamakhemikhali). Ngenxa yalokho, kunesidingo sokuhlola ngokwelashwa okwenzelwe ukuqondisa izimpawu ezithile zomlutha wobulili. Kuphakanyisiwe ukuthi ukungenelela kokuqonda okwenziwa isizukulwane sesibili (SG-MBIs) kungaba yindlela efanele yokwelapha umlutha wezocansi ngoba ngaphezu kokusiza abantu abathile ukukhulisa ibanga lokuqonda kusuka ekufuneni izinto ezihlangenwe nakho kanye namava, amanye ama-SG-MBIs aqukethe ukuzindla okuhloselwe ukwehlisa ukunamathela ebulilini kanye / noma emzimbeni womuntu. Ucwaningo lwamanje lwenza uphenyo lokuqala lwezokwelashwa ekusebenzeni kwengqondo lokwelapha umlutha wobulili.
Kwenziwe ucwaningo olunzulu lokuhlolwa kwemitholampilo okubandakanya owesilisa osekhulile ophethwe umlutha wobulili owathola ukwelashwa esebenzisa i-SG-MBI eyaziwa ngokuthi yi-meditation Awareness Training (MAT). Ngemuva kokuphothulwa kweMAT, umhlanganyeli wakhombisa ukuthuthuka okuphawulekayo emikhakheni yokuziphatha kwezocansi okuluthayo, kanye nokunciphisa ekucindezelekeni nasekucindezelekeni kwengqondo. Ukungenelela kweMAT kuholele futhi ekuthuthukisweni kwekhwalithi yokulala, ukwaneliseka komsebenzi, kanye nokunganamatheli wena uqobo kanye nokuhlangenwe nakho. Imiphumela yemalutical yagcinwa ekulandelweni kwenyanga ye-6.
Ucwaningo lwamanje lunikeza izincwadi ezihlola ukusetshenziswa kwengqondo ngokuphatha umlutha wokuziphatha, futhi okutholakele kukhombisa ukuthi uphenyo olwengeziwe lomtholampilo endimeni yokucabanga ngokulapha umlutha wobulili luvunyelwe.
Isingeniso
Ingxenye:
Yize umlutha wobulili awemukelwa ukufakwa kuhlobo lwamuva (lwesihlanu) lwe-Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (I-American Psychiatric Association, i-2013), zokuziphatha okubi ngokweqile okungahlukani nobumfihlo kufakwe kwi-DSM-III njenge- "Disorder Disgency Not Not Specified" (I-American Psychiatric Association, i-1987). Ngaphezu kwalokho, bobabili i-American Society of Addiction Medicine (2011) kanye ne-International Classization of Diseases (10th ed .; I-World Health Organization, i-2007ukwamukela ukuthi ukuziphatha ngokweqile kwezocansi kungakha isisekelo sokugula kwezokwelapha. Ukulinganiswa kokuxhaphaka kokulutha ngokocansi kuyahlukahluka ngokuya ngobulili, ubudala, isiko, ukuthanda ezocansi, intela yentela (isb. Ucansi olukhokhelwayo, i-cybersex, izithombe zocansi, njll.), Kanye nenqubo yokuxilonga (nayo ehlukahluka kakhulu), futhi ibanga phakathi kuka-1% no-8 % kubantu bonke (isb. Amakhadi, i-1999; UKinsey, uPomeroy, noMartin, ngo-1948; Ababukeli, i-2003; USussman, uLisha, noGriffiths, 2011; UTreeen, Spitznogle, noBeverfjord, 2004). Umlutha wobulili (kwesinye isikhathi obizwa ngawo - phakathi kwamanye amagama amaningi - njenge-hypersexuality disorder) uye wachazwa ngokuthi “ukuphazamiseka kwesifiso sobulili okubonakaliswa imvamisa enkulu kanye nokuqina kwemicabango efikelwa ngocansi, ukuvusa inkanuko, ukunxenxa, nokuziphatha okuhambisana nokuhlanganiswa kokuthile okungahambi kahle - impendulo yokuziphatha okungalungile nemiphumela emibi"(I-Kafka, i-2010, iphe. I-385).
Ukulutha ngokocansi kuhlotshaniswa (phakathi kwezinye izinto) nezimo zokuziphatha okubeka engcupheni (isb. Ukusetshenziswa kwezidakamizwa kanye nabalingani abaningi bezocansi), ukucindezeleka nokukhathazeka, ukungabi nesifiso, isizungu, ukuzenyeza, kanye nezitayela zokunamathisela ezingavikelekile (bona izibuyekezo UDhuffar & Griffiths, 2015; URosenberg, uCarnes, no-O'Connor, ngo-2014; USussman et al., 2011). Izimpawu ezibalulekile zifaka inqubo ngayinye kweziyisithupha zeGriffiths '(2005) imodeli yezakhi 'zomlutha: (i) ukuthamba (Ukuziphatha kobulili kuba yinto ebaluleke kakhulu empilweni yomuntu futhi kubusa ukucabanga kwabo, imizwa nokuziphatha kwabo), (ii) ukuguquka kwemizwelo (okuhlangenwe nakho okuphathelene nokukodwa okubikwa ngabantu njengomphumela wokuzibandakanya ekuziphatheni okuhlobene nokuya ocansini), (iii) ukubekezelelana (isidingo samazinga akhuphukile noma ubungako bokuziphatha kocansi ukufeza umphumela owufunayo), (iv) ukuhoxiswa (okungukuthi, izimpawu zokuhoxa kwengqondo - njengokucasula kanye nemizwelo - ekuyekisweni kwephethini yokuziphatha ngokocansi), (v) ukungqubuzana (zombili izingxabano eziphakathi kwabantu nezangaphakathi komqondo ngenxa yokuchitha isikhathi esiningi kuziphathelene nokuziphatha okuhlobene nobulili), kanye (vi) ubuyela emuva (ukuthambekela kokuphindiselwa okuphindaphindiwe emaphethini wangaphambilini wokuziphatha kobulili ukuze abuyele emuva kwesikhathi eside sokungavunyelwa noma sokulawula).
Izibonelo zokungenelela okuvame ukusetshenziselwa ukwelapha umlutha wobulili yizinqubo zokwelapha zokucabanga okubonakalayo, izindlela zokuphambanisa, ulimi lwengqondo, ukuqeqeshwa komndeni, ukuqeqeshwa kokugqugquzelwa, isinyathelo se-12 nezinhlelo zokusekelwa kontanga, ukuzisiza, ukudla nokuqinisa ukuzivocavoca, ne-psychopharmacology (UDhuffar & Griffiths, 2015; Griffiths, i-2012; URosenberg et al., 2014). Kodwa-ke, ucwaningo lokusebenza kahle kokwelashwa kokuluthwa ngokocansi luyathuthukiswa futhi ukungenelela okuningi okungenhla kususelwe kwizincomo zokwelapha ezinye izimilo zokuziphatha (kanye nokwamakhemikhali) (URosenberg et al., 2014). Ngenxa yalokho, kunesidingo sokuhlaziya ngokwelashwa nangokwezifo ngokwelashwa okwenzelwe izimpawu eziqondile zezimpawu zokuluthwa ngocansi.
Ukuthuthuka kwakamuva kokwelashwa kwemilutha yamakhemikhali neyokuziphatha kube ucwaningo lokuhlola ukusebenza ngempumelelo kwezokwelapha kwengqondo. Ukutholwa okutholakalayo okutholakalayo kokusetshenziswa kwengqondo ekwelapheni izidakamizwa / ukuphazamiseka kokusebenzisa utshwala (Witkiewitz, Marlatt, & Walker, 2005), ukuphazamiseka kokugembula (UGriffiths, uShonin, noVan Gordon, ngo-2016; UShonin, uVan Gordon, noGriffiths, 2014a), ukusebenza kanzima (UShonin, uVan Gordon, noGriffiths, 2014b), kanye nomlutha we-inthanethi (Iskender & Akin, 2011). Kodwa-ke, kuze kube manje, akukho cwaningo oluye lwahlola ukusetshenziswa kwengqondo yokwelapha ukungezwa kocansi. Noma kunjalo, uShonin, uVan Gordon, noGriffiths (2013) siphakamise ukuthi ukucabanga ngokunengqondo kungenzeka kube yindlela efanele yokwelapha umlutha wezocansi ngoba ngaphezu kokusiza abantu abathile ukukhulisa ibanga lokuqonda kusuka ekunxaneleni izinto ezifiselekayo kanye nokuhlangenwe nakho, ezinye izindlela zokungenelela ezisuselwa ekuqondweni kwesizukulwane sesibili (SG-MBIs) zisebenzisa ngqo ukuzindla okuhloselwe ukuhlehlisa okunamathiselwe kwezocansi kanye / noma emzimbeni womuntu.
Isizukulwane sesibili sokungenelela okususelwa emqondweni okukhuthazwe nguShonin et al. sebenzisa imodeli yokwelashwa ehlukile kunaleyo yokungenelela okususelwa kwisizukulwane sokuqala (i-FG-MBIs). Ama-FG-MBIs abhekisela ekungeneleleni okufana nokuNciphisa Ukucindezeleka Okucatshangelwe Ngengqondo kanye Nokwelashwa Kokuqonda Okusekelwe Emqondweni futhi ngokuvamile ubhalisela IKabat-Zinn's (1994) incazelo yokuthi ukucabanga ngokubandakanya kubandakanya “ukunaka ngendlela ethile: ngenhloso, okwamanje, futhi hhayi ukwahlulela”(1994, iphe. 4). Ama-SG-MBIs, njengokungenelela kokuZindla ukuQinisekiswa kokuzindla (i-MAT), ahlanganisa ububanzi bezindlela zokuzindla futhi abhalise encazelweni yokuqonda okucatshangelwa ukuthi kwakhiwa ngokuhambisana nokwakhiwa kwendabuko kwendabuko. Ukuchazwa kwe-SG-MBI okuhlongozwayo kokunaka ukuthi "inqubo yokubandakanya ukuqwashisa okugcwele, okuqondile, nokusebenzayo kwezinto ezinolwazi (i) ezingokomoya, futhi (ii) ezigcinwe kusuka umzuzu owodwa kuye komunye"(UVan Gordon, uShonin, noGriffiths, 2015a). Ngenxa yalokho, igama elithi "ukuqwashisa ngqo" ekuchazweni kwe-SG-MBI liphikisana ngqo nokusetshenziswa kwegama elithi "ukungagwebi" encazelweni ye-FG-MBI. Ngokusho kukaVan Gordon et al. (2015a), esikhundleni sokufundisa ababambiqhaza ukuthi bangahluleli, isizathu sokuthi ama-SG-MBIs angahle afaneleke ekwelapheni ukulutha kokuziphatha yingoba bakhuthaza abasebenza ukucabanga ukuthi (i) bazi ngokuhlelekile isikhathi esifushane nesikhathi eside imiphumela yezenzo zabo futhi (ii) banikwe amandla ngokomoya okuhlobene nokucabanga njengendlela yokuphila, kunendlela yokwelapha okufanele isetshenziswe kwezinye izimo kepha hhayi ezinye.
Leli phepha limelela ucwaningo lokuqala lokuhlola ukusetshenziswa kwengqondo ngokulapha umlutha wobulili. Ngokucacile, kunikeza isifundo esijulile sokwelashwa komuntu wesilisa okhulile oziphethe kabi ngokobulili owelashwa nge-SG-MBI.
Case Vignette nokuHlola
“U-Adamu” useminyakeni engamashumi amathathu futhi ungowesilisa waseBrithani ohlukane yedwa, ohlukanisile nomhlophe ngaphandle kwabondlayo. Umlando wakhe wezifo zengqondo uhlanganisa izinkathi ezimbili zeziqephu ezicindezelayo (ngasinye sihlala cishe izinyanga ze-6) esenzeka eminyakeni ye-3 edlule (Isiphithiphithi Esikhulu Sokucindezela, Isiqephu Esilandelanayo, Isinomusa; I-DSM-IV-TR Code 296.31) kanye ne-5 edlule (Isiphithiphithi Esikhulu Sokucindezelwa, Isiqephu Esisodwa, Sobumnene; I-296.21). Kuzo zombili iziqephu, kwabulawa izingcindezelo. Umlando wekliniki ka-Adamu awunakuqhathaniswa, kepha wachaza ukuthi ezinyangeni ezedlule i-42, isashada, "waqala waba umlutha wobulili. ”Ngaphandle kokuya kwiqembu lokuzisiza esikhathini samaviki e-6 cishe ngonyaka we-1, ubengakaze afune ukwelashwa ngokuziphatha kwakhe kwe-hypersexual.
Umlando wamacala
U-Adam usebenza endaweni yokuthengisa ebandakanya ukuhamba njalo kwasekhaya nokuhlala amahhotela ubusuku bonke. Indima yakhe imnikeza ukusetshenziswa kwemoto yenkampani esetshenziswe ngokuphelele futhi imhlinzeka ngokuguquguquka okukhulu ngokwemibandela yendawo yomsebenzi. Imvamisa uchitha ubusuku obuthathu ngesonto ehhotela futhi uvame ukuvakashela amahhovisi enkampani usuku lwe-1 isonto ngalinye. U-Adamu uqashwe endimeni yakhe yamanje yeminyaka ye-4 edlule. Phambilini wenza izindima ezahlukahlukene zokuthengisa futhi waphothula nohlelo lweminyaka engu-2 lokuthola iziqu njengoba ethole eyunivesithi. Amathuba okukhushulwa nomqashi wamanje ka-Adamu akhangiswa kuzwelonke, kepha abasebenzi bayakhuthazwa ukuthi bafake izicelo (futhi bavame ukunikezwa kuqala). Eminyakeni eyedlule ye-2, u-Adamu ukhuthazwe ngabaphathi abaphezulu ukuthi afake izicelo zezikhundla ezimbili zangaphakathi, kodwa wanquma ukungakwenzi lokho ngoba "ntofontofo”Endimeni yakhe yamanje.
U-Adam wakhuliswa ngabazali bakhe bemvelo bobabili abasebenza ezinhlakeni zomphakathi. Abazali baka-Adam bahlukanisa lapho eneminyaka eyi-16, futhi bobabili abazali baphinde bashada. U-Adam uchaza abazali bakhe njengo “onakekelayo noxhasayo,"Futhi unomuzwa wokuthi yena kanye nomfowabo wakini (udadewabo omncane) bakhuliswe kahle. Uhlala kahle nabalingani bomzali wakhe futhi u "wasetshenziswa"Iqiniso lokuthi manje kunokuxhumana okuncane phakathi kukamama wakhe nobaba wakhe wokuzalwa. U-Adamu akazange adalule imininingwane yezinkinga zakhe zempilo yengqondo kunoma yiliphi elinye lamalungu omndeni wakhe.
U-Adam waphumelela enyuvesi yaseBrithani eneziqu ze-BSc awaphasa ngezifundo eziphakeme zesigaba sesibili. Ngesikhathi sokuthweswa iziqu, wacabanga ukuqeda u-a Masters Business Administration kodwa uthathe isinqumo sokuthatha umsebenzi okhokhelwayo. Ufunde esikoleni sikahulumeni futhi amamaki akhe e-A enza ukuthi akwazi ukungena enyuvesi ayikhethile okokuqala.
Kuze kube yisikhathi sehlukaniso, iningi lokuzibandakanya kuka-Adam kwezenhlalo bekubandakanya yena nomkakhe ukuhlangana neminye imibhangqwana eshadile. U-Adam wahlangana nomkakhe cishe eminyakeni emibili ngemuva kokuyeka eyunivesithi futhi wayeshade iminyaka engu-2. Kusukela ngedivosi, u-Adam uhlala engashadile futhi ukuzibandakanya kwakhe nomphakathi njengamanje kubandakanya ikakhulu ukuhlangana (i) nozakwabo emsebenzini, (ii) umngani wesilisa wesikhathi eside amazi kusukela eyunivesithi, (iii) abantu abaziwayo nabangaziwa (ikakhulukazi abanye osomabhizinisi) ahlangana nabo emahhotela, kanye (iv) nabantu asebenzisana nabo ngenxa yokuziphatha kwakhe okunenkinga kwezocansi.
U-Adamu akazange achaze abazali bakhe bemvelo njengabakholelwa kakhulu enkolweni. Bazihlukanisa njengama-Anglican Christian futhi ngokusho kuka-Adamu, babeya esontweni ngoKhisimusi kuphela. U-Adam wathi ngesikhathi eyunivesithi, "Ngaba nesithakazelo ohlangothini lwami olungokomoya”Futhi waqala ukuhlola ubuKristu ngobuqotho. Kodwa-ke, u-Adamu wadunyazwa amasiko athile obuhle obuKristu futhi wanquma ukuthi kukhonaumehluko omkhulu phakathi kwezimfundiso zikaKristu nezimfundiso zeBandla. ”Ngenxa yalokho, u-Adamu waba nesithakazelo kubuBuddha. Wazama ukuzindla futhi wahambela amazwe amaBuddha eThailand neNepal (kufaka phakathi ukuhambela amathempeli amaBuddha kula mazwe). U-Adamu wayevame isikhungo samaBuddha e-UK isikhathi sezinyanga ze-6 phakathi namashumi amabili eminyaka. Wakujabulela ukufunda ngeBuddhist kodwa waqala waphelelwa isithakazelo ngoba ethola abafundisi ukuthi “libheke ngababili futhi alibizi. ”U-Adamu ugcina isasasa kumkhuba wamaBuddha kodwa ube nokuxhumana okuncane kakhulu nobuBuddha kule minyaka edlule ye-3.
Ukubonwa kokuziphatha
Ekuhlolweni kwakhe kokuqala ne-psychotherapist (nasemhlanganweni ngamunye owalandela), u-Adamu wayeqashelwa umuntu, indawo, isikhathi, kanye nesimo. Ubethulwe kahle futhi egqoke izingubo ezingashayi eceleni ezenziwe izingubo ezihlotshisiwe (izinto eziningi zokugqoka zibonisa ilebuli yomklami). Ubuso bakhe babuphuculwe futhi wasebenzisa umkhiqizo wesitayela ezinweleni zakhe ezazisanda kugawulwa. U-Adam wayegqoka i-cologne kanye nefoni yakhe ephathekayo newashi libonakale liyimodeli yakamuva nephezulu kakhulu. U-Adamu wenza umzamo ofanayo ngokubonakala kwakhe ngesikhathi ngasinye sezikhathi zokwelashwa ezalandela.
Ekuhlolweni kokuqala (nangeseshini yesibili neyesithathu masonto onke), amehlo ka-Adam ayebomvu ngokulingene, futhi yize aphika ukuthi ukhathele, wabonakala ediniwe. Isilinganiso esihle kakhulu se-psychotherapist ukuthi u-Adam ungamamitha ayi-6 cm ubude futhi unesisindo esingama-183-85 kg. Lokhu kuzofanelana ne-Body Mass Index ka-87.5-26, okusho ukuthi u-Adam ukhuluphele kancane. U-Adam akanayo imidwebo ebonakalayo noma ukubhoboza. Ngaphandle kokubuzwa, wajika ifoni yakhe yathula ekuqaleni kweseshini yokuhlola (nangeseshini ngayinye elandelayo).
U-Adam uyazethemba futhi ukhulunywa kahle. Uzisizile ngamabhisikidi nekhofi (uphuze izinkomishi ezimbili zekhofi ngesikhathi semizuzu engama-90). Yize u-Adam engakhombisanga zinkinga ekuvezeni imizwa yakhe, i-akhawunti yezinkinga zakhe zokuya ocansini eyinkinga eyanikezwa ngesikhathi sokuqala yabonakala iphindaphindwa. Lapho ekhuluma ngokuningiliziwe ngezimpawu zakhe, u-Adam wakhuluma isikhathi eside kunesidingekayo futhi wayezozama ukucubungula imininingwane ebalulekile. Kwesinye isikhathi wayezikhulumela ngaphandle (okungukuthi, ngaphandle kokulinda ukuthi udokotela wezifo zengqondo aqedele isigwebo sabo). Imvamisa yokuphazamiseka okunjalo - ebibonakala iyimizamo yokushintsha isihloko - inyuke cishe ngama-50% lapho inkhulumomphendvulwano iqala ukubhekana nokucaciswa okusondelene kokuziphatha kwakhe ngokocansi. Ngalezi zikhathi, u-Adam wacabanga ukuma komzimba okushubile futhi wazethemba ngokweqile futhi wazivikela emingceleni. Lokhu kuziphatha kubukeka kungumzamo wokufihla amahloni kanye / noma ukufihla icala lakhe.
Esifundweni sakhe sokuqala sokuhlola, u-Adamu wathi "Ngizizwa ngingakhululekile ukukhuluma ngakho konke lokhu"Futhi"ungumuntu wokuqala engikhulume naye kahle. ” Kwesinye isikhathi, wayebonakala ekhombisa izimpawu zemizwelo ephansi (isb. Ukungabi nathemba, ukungakhathali, nokuthukuthela), futhi ezikhathini eziningana, wayebanda futhi ephazanyiswa. Lapho ebhekene nodokotela wezifo zengqondo ngalokhu, u-Adam waxolisa futhi wachaza ukuthi “Nginokuningi kwiplate yami manje. "
Kwethula izikhalazo
U-Adam wachaza ukuthi cishe eminyakeni emi-4 eyedlule (okungukuthi, unyaka owodwa ngaphambi kokuba ahlukanise), wathatha izinyathelo zokuzama ukunika amandla “impilo yobulili obuxakile”Kanye nokwehluleka komshado. U-Adamu wazisa umkakhe ekubukeleni amafilimu ezocansi ngaphambi nangesikhathi sokuya ocansini. Uveze ukuthi yena noma umkakhe bebengenaso isasasa lezithombe ezingcolile ngaphambi kwalesi sikhathi. U-Adamu wabika ukuthi esikhathini cishe sezinyanga ze-2, imvamisa nesikhathi sokuxhumana ngocansi nonkosikazi wakhe sikhuphukile. Kodwa-ke, umphumela waba wesikhashana ngoba ngokusho kuka-Adamu, umkakhewaba nesithukuthezi ngakho. ”Ngakolunye uhlangothi, u-Adamu, wathola amafilimu wezithombe zobulili ezingcolile evusa inkanuko yezocansi futhi wayeqhubeka nokuwabuka ngaphandle kolwazi lomkakhe.
U-Adam waqala ukuthola iqoqo lamafilimu ezithombe zocansi aku-inthanethi naku-inthanethi futhi waqala ukuzisebenzisa njengokugxila ekushaya indlwabu. Ezinyangeni eziyisithupha ngemuva kokuqala kwakhe ukubuka izithombe zobulili ezingcolile (okungukuthi, izinyanga eziyisithupha ngaphambi kokuhlukanisa), u-Adam wayeshaya indlwabu cishe kahlanu ngesonto. Uthe cishe kwakungalesi sikhathi lapho naye aqala khona ukuvuswa ngocansi ngokubuka abesilisa beshaya indlwabu, nangokubuka amafilimu ocansi lwezitabane (kuze kube yileli qophelo, u-Adam wayehlale ezichaza njengomuntu onobungqingili). Waqala ukwengeza amafilimu ezocansi ezithandweni zakhe eziku-inthanethi nezingaxhunyiwe ku-inthanethi, futhi wanquma ukuthi wayeziphathisa ngokocansi.
U-Adamu wathi cishe izinyanga ezingama-5 ngaphambi kokuba ahlukanise, "Izithombe ezingcolile zobulili ziyekile ukwenele" futhi "Bengidinga ukuzihlola ngocansi." Ukushilo lokho "Umkami ubengafuni ukwazi ngakho-ke kwesinye isikhathi ngangiqala ukusebenzisa abahamba nabesifazane nabesilisa." U-Adamu wachaza ukuthi ngalesi sikhathi, uzohlangana nomphephezeli cishe kube kanye ngosuku olulodwa. Uveze ukuthi yize umshado wakhe wehluleka, isehlukaniso sahluleka lapho unkosikazi wakhe ethola ukuthi ubukela amafilimu abukisa ngezitabane ezingcolile ekhompyutheni yakhe. U-Adamu wayeshiye ikhompiyutha yakhe ukuze aphendule emnyango kepha wayeshiya ifilimu eliku-inthanethi lidlala. Ifilimu yabonwa ngunkosikazi wakhe ngubani “Sikhululeke” futhi baphuma endlini yabo i-5 ezinsukwini ezizayo.
U-Adam uchaze ukuthi isikhathi esiyizinyanga ezingaba ngu-18 kulandela isehlukaniso, waye "ngokulawula”Futhi wayejabulela inkululeko yakhe yezocansi ayesanda kuyithola. Wayakhe inethiwekhi yokuxhumana nabesifazane nabesilisa ezweni lonke, kufaka phakathi inani elincane labantu abenza nabo ucansi ngendlela engakhokhelwa (ie, abayitoho). U-Adam wathi ngaleso sikhathi (okungukuthi, izinyanga eziyi-18 ngaphambi kokwethula ukwelashwa), umholo wakhe wanyanga zonke wawungasakhokhi izindleko zokuxhaphaza kwakhe ngokocansi okuvame ukubiza u- £ 350 ngesonto. Ngenxa yalokho, wanquma ukuthengisa ikhaya lakhe ukuze athole imali futhi wathuthela endaweni yokuhlala.
Emhlanganweni wokuqala wokuhlola nokulandela isikhuthazo esikhulu, u-Adam waveza ukuthi maqondana nokuziphatha kwakhe njengamanje kwezocansi, ujwayele (i) ukusebenzisa izinsizakalo zokuphelezela kathathu ngesonto (ukuhlangana ngakunye ngokocansi okukhokhelwayo kuvame ukuhlala imizuzu engama-30-60, futhi lezo ezihlala imizuzu engama-60 ngokujwayelekile kuzoholela ekutheni u-Adam akhishwe kabili), (ii) uchitha u- £ 500 ngeviki ezinsizakalweni zokuphelezela, (iii) wenza ucansi olungakhokhelwa amahlandla amathathu ngesonto (ukudweba echibini eliguqukayo lokufika kwabayishumi nabesilisa abayitoho abalingani ocansini), (iv) unocansi lwe-inthanethi (imvamisa lubandakanya ukushaya indlwabu) kahlanu ngesonto, (v) amawashi “ama-gay noma ama-sex ocansi aqondile”Cishe imizuzu engama-60 usuku ngalunye ngezikhathi ezintathu kuya kwezine zokubuka ezihlukile (okungukuthi, isikhathi ngasinye se-15-20-min), futhi (vi) ukushaya indlwabu kahlanu ngesonto ngenkathi ubuka amafilimu ezocansi. U-Adam wathi uhlale evikela ucansi nokuthi ngokwazi kwakhe, akakaze athole isifo esithathelwana ngocansi. Ukuqinisekisile ukuthi akakaze ahlanganyele ezocansi (noma abuke amafilimu ezocansi abandakanya) abantu abangaphansi kweminyaka eyi-18.
U-Adamu wachaza ukuthi ngonyaka owedlule, kwesinye isikhathi wayezwa "akunalutho futhi ashibhile”Kulandela ukuhlangana kwezocansi. Uthe "Ngiyazi ukuthi ngidinga ukuguqula [kepha] ngiyijabulela kakhulu. ”U-Adamu uzame ukwehlisa imvamisa yokuhlangana okuhlobene nokuya ocansini amahlandla ambalwa ezinyangeni ze-12 ezedlule. Kodwa-ke, wachaza ukuthi "noma nini lapho ngizama futhi nginciphisa khona kuhlala izinsuku ezimbalwa, noma kwesinye isikhathi ngeviki, kodwa-ke kuba kukhulu kakhulu futhi ngizoqeda [ukukhokha ubulili kanye / noma ukushaya indlwabu] amahlandla ayisikhombisa noma ayisishiyagalombili phakathi namahora we-48."Uthe"Ngiyazi ukuthi akulungile ukuthi uBuddha abe kanjena. "
U-Adam uvumile ukuthi uvame ukushaya indlwabu (okungukuthi, ngesikhathi socansi lwe-inthanethi noma ngenkathi ebuka ifilimu yezocansi) ukumsiza alale, nokuthi ujwayele ukulala i-5-6 hr ubusuku ngabunye. Ubike ukuthi muva nje, une “waqala ukungakhathalelwa”Futhi usebenzise ucingo lwakhe lwasemsebenzini ne-laptop yakhe ngezinhloso ezihlobene nezocansi. U-Adam uchaze ukuthi ngaphandle kokuthi umuntu ahlangana naye online anikeze inkomba eqinile yokuthi usuku luzoholela ekuxhumaneni ngokocansi (isb., Ngokuthumela izithombe ezivusa inkanuko), uyenqaba ukuhlangana mathupha. Uvumile ukuthi indlela yakhe yamanje yokuziphatha ngokocansi kungenzeka inciphise amathuba akhe okuhlangana nabalingani bobudlelwano besikhathi eside kepha wachaza ukuthi "Angiqiniseki ukuthi ngikulungele ukuthola umfazi noma umlingani oqinile kulesi sigaba empilweni yami. "
U-Adamu wenqabile noma yimiphi imibono yokuzibulala kanye nokugembula, izidakamizwa, noma ukuncika kotshwala (kodwa wachaza ukuthi iningi lokuhlangana kwakhe ngokocansi kuhambisana nohlobo oluthile lokuphuza utshwala). Kwesinye isikhathi ubhema ugwayi kodwa athi lokhu akusebenzisaizinhloso zenhlalo”Nokuthi akancikile ku-nicotine. U-Adam ujwayele ukubhema osikilidi abayi-5-10 ngosuku, ikakhulukazi lapho ezijabulisa kusihlwa noma lapho ehlangana nabalingani bobulili emini noma kusihlwa.
Ukutholwa kokukhonjwa
Ukuziphatha kuka-Adam okunenkinga kwezocansi kwandulelwa yisigaba sokucindezeleka okukhulu okwenzeka ezinyangeni eziyi-18 ngaphambi kokuqala kokulutha kwakhe ngokocansi (U-Adam wahlangabezana nesigaba sesibili sokucindezeleka okukhulu okwenzeka ezinyangeni eziyisithupha ngemuva kokuqala kokuziphatha kwakhe okunenkinga ngokocansi). Ngokunikezwa ngokulandelana kwesikhathi, kungenzeka ukuthi ukulutha kuka-Adam ocansini kwakuyinkulumo (okungukuthi, kunokuba kube imbangela) yenkinga yokuguquguquka kwemizwa. U-Adam uhlolwe kusetshenziswa izindlela ze-DSM-6 eziqinisekise umbono we-psychotherapist wokuthi njengamanje ubhekene nesiqephu sokucindezeleka, nokuthi ukuxilongwa kwakhe kwangaphambilini Isiphithiphithi Esikhulu Sokucindezela (Okuvamile, Okumnene) yayisikhona yamanje. Ngaphezu kokukhubazeka kokulala, esinye isici esibalulekile sephrofayili yomtholampilo ka-Adamu Izinkinga Zenkolo noma Ezingokomoya (DSM-5 code V62.89) okuholela (i) kokuhlangenwe nakho okucindezelayo okubandakanya ukulahleka noma ukubuzwa kokholo kanye (ii) nokubuzwa kwezindinganiso zikamoya.
Izindlela zokwelashwa
Into ye-45 Ukuhlolwa Kokuluthwa Kwamakhompiyutha - Kubukezwe (I-SAST-R; Izinhlamvu, Okuhlaza okotshani, nezinqolobane, 2010) Kwabhalwa ukuthi kuhlolwe umkhuba wokuziphatha kobulili obuhangayo. Izinto ze-SAST-R zikalwe njengamanje noma azikho, futhi impendulo ethi "yebo" ezintweni eziyisithupha noma ngaphezulu zezinto ze-20 esikalini esiphakathi zibonisa umlutha wobulili ongahlekile. Ama-subscales ahlukahlukene ahlola ubukhulu bokulutha kocansi futhi adinga izimpendulo ezimbili noma ezintathu (yebo noma ezine noma ezinhlanu zemibuzo) ukukhombisa inkinga kuleyo simo esithile. Izibonelo zezinto ze-SAST-RUkhona yini umuntu olinyazwe ngokomoya ngenxa yokuziphatha kwakho kocansi?"Futhi"Ngabe ucabanga ukuthi isifiso sakho sobulili sinamandla kunawe?”Isilinganiso sokuqala sika-Adam esikalini esiyisisekelo sasingu-16 (kokungaba ngu-20), okukhombisa ukuthi wahlangabezana nezindlela zokuxilonga zokulutha ngokocansi. Uphendule ngezimpendulo zika "yebo" kuningi lemibuzo esezingeni eliphansi, ephakamisa ukuthi lezi zimpawu ezilandelayo ziyizici ezibalulekile zokuziphatha kwakhe okuyinkinga: (i) ukukhathazeka, (ii) ukwehluleka ukulawula, (iii) ukuphazamiseka kobudlelwano, kanye (iv ) kuthinta ukuphazamiseka.
Into ye-21 Ukudangala, Ukukhathazeka, kanye ne-Stress Scale (Dass; ILovibond neLovibond, 1995) ihlola ukucindezeleka ngokomzwelo futhi iqukethe izikali ezingaphansi kokudangala, ukukhathazeka, kanye nengcindezi. Isikali sitholwe esikalini se-Likert samaphoyinti amane (kusuka: 0 = Akusebenzanga kimi nhlobo kuya ku-3 = Kusetshenziswa kimi kakhulu noma isikhathi esiningi) futhi ifaka izinto ezinjenge Benginomuzwa wokuthi impilo ayinanjongo. ” I-DASS igcwaliswa maqondana nesikhathi esandulele se-7-day kanti amaphuzu kulesilinganiso esithathu ngasinye angaqokelelwa ndawonye ukuhlinzeka ukuhlolwa okuphelele kokucindezeleka kwengqondo (UVan Gordon et al., 2013). Ngokuya kwencwajana ye-DASS (ILovibond neLovibond, 1995), ama-percentile cutoffs (nezimpawu ezihambisanayo) zokuqina kwesimpawu imi ngalendlela elandelayo: 0-78 (M ≤ 13) = ejwayelekile, 78-87 (M = 14-18) = imnene, 87-95 (M = 19-28) = ngokulinganisela, futhi> 95 (M ≥ 28 = ezinzima). Isilinganiso sokuqala sika-Adam sasingu-24 (okungukuthi, silinganisiwe).
The Kufinyezwe uJobe ku-General Scale (I-AJIGS; URussel et al., 2004) siyisilinganiselo sezinto eziyisishiyagalombili sokwaneliseka komsebenzi. Isikali siqukethe iziphawulo ezilandelayo noma imishwana emfushane maqondana nomsebenzi umuntu oqashwe kuwo njengamanje: “Kungenza ngigculiseke,” “ngcono kunabaningi,” “kuhle,” “akuvumelani,” “kuhle,” “kumnandi,” “Mpofu,” futhi "Ayifaneleki." Kwinto ngayinye, abaphendulayo babuzwa uma bevumelana (“yebo”), abaqinisekile (“?”), Noma abavumelani (“cha”). Kubalwa amaphuzu amathathu ku-"yebo," elinye ku-"?," No-zero ngo "cha." Izinto ngazinye zibizelwa ukunikela amaphuzu emhlabeni kanye nezinto ezinamagama ezingezinhle ziyahlatshwa amaphuzu. Izikolo eziphakeme zibonisa amazinga aphezulu wokwaneliseka komsebenzi. Isikolo sika-Adamu sokudla sasihlangene nesikhombisa (ngaphandle kwe-24), okubonisa izinga eliphansi lokweneliseka komsebenzi.
Into eyisikhombisa Isikali Esinganamathiseli (I-NAS; ISahdra, iCiarrochi, iParker, iMarshall, neZulu, ngo-2015; ISahdra, Shaver, & Brown, 2010) isuselwe kwimodeli kaBuddha yokugula kwengqondo futhi ihlola ukuthi umuntu unamathiselwe kanjani ezingxenyeni ezahlukahlukene zezengqondo, zenhlalo, nezokuphila. Ngokuzenzakalelayo, i-NAS iphinde ilinganise izinga lokuthi abantu abathile “banamathele kubo” ngoba ngokomqondo wamaBuddha, ukunamathela emqondweni noma ezimweni zangaphandle kuncike emcabangweni oqinile wokuzithanda (UVan Gordon, uShonin, uGriffiths, no Singh, 2015b). Isikali sakhiwe emcabangweni wamaBuddha wokuthi isiqu asikho ngokwaso nokuthi lokho okunamathiselwe kuwe (nezinto ezingokwengqondo nezingokwenyama) ngakho-ke kuyisimo esingalungile [bona uShonin, uVan Gordon, noGriffiths (I-2014c) ukuthola incazelo eningiliziwe yokuthi okunamathiselwe kucatshangwa kanjani ngokuhlukile kubuddhism kuqhathaniswa ne-Western Psychology]. I-NAS ithola isikali esikalini samaphuzu ayisithupha se-Likert (kusuka ku-1 = ngivume kakhulu kuya ku-6 = vuma ngamandla) futhi ifaka izinto ezinjenge- “Lapho isipiliyoni esimnandi siphela, ngingaqhubekela phambili kulokho okulandelayo. ”Izikolo eziphakeme kakhulu zibonisa amazinga aphansi okunamathiselwe (noma amazinga aphezulu wokunganamathiseli). Isikolo sika-Adamu esiyisisekelo bekuyi-16 (ngaphandle kwe-42).
Into eyisikhombisa IPittsburgh Sleep Quality Index (I-PSQI; Buysse, Reynolds, Monk, Berman, & Kupfer, 1989) ihlola ikhwalithi yokulala phakathi nenyanga edlule kwizizinda zekhwalithi yokulala ngokuzithoba, ubuthongo bokulala, isikhathi sokulala, ukusebenza kahle kokulala, ukuphazamiseka kokulala, ukusetshenziswa kwemithi yokulala, kanye nokungasebenzi kahle emini. I-PSQI itholwa esikalini se-Likert samaphuzu amane (0 = abukho ubunzima futhi 3 = ubunzima obukhulu) futhi ifaka izinto ezinjenge- “enyangeni edlule, ungalilinganisa kanjani ikhwalithi yakho yokulala jikelele?"Isibalo somhlaba wonke se-≥5 sikhombisa ikhwalithi embi yokulala. Isikolo sika-Adamu sokuqala sasingu-14 (ngaphandle kwe-21).
The Isikali se-Goal Attainment (GAS; Kiresuk & Sherman, 1968) Kuhlola ukutholakala kokuthola ukwelashwa futhi kufaka phakathi iklayenti kanye nodokotela ovumayo ovumelana ngochungechunge lwezinhloso. Izinga lokutholwa kwezinhloso linqunywa izincazelo zokuziphatha kokusebenza. Izikolo zisukela ku-−2 (regression) nge-0 (umphumela olindelekile) otholwayo) wokufika ku + 2 (umphumela olindelekile udluliwe) kunhloso ngayinye okuvunyelwene ngayo. Amaphuzu ezinjongo ngazinye ahlanganiswe bese kukhiqizwa ukhiye we-GAS ukubala amaphuzu emhlabeni jikelele. Ocwaningweni lwamanje lomtholampilo, kwenziwa izinhloso ezinhlanu ezinesisindo esifanayo. Isikolo se-50 sikhombisa izinga elilindelwe lokufinyelelwa kwegoli futhi nezikolo eziphakeme zibonisa amazinga aphezulu wokufezeka kwenhloso.
Izinguquko esilinganisweni ngasinye semiphumela elandelayo - ngokususelwa enkathini eyedlule yezinsuku eziyi-14 - zahlolwa kusetshenziswa ukugcinwa kwezinkomo kwansuku zonke ngu-Adam (amanani ayisisekelo akhonjiswa kubakaki): (i) isikhathi esichithwa kubukwa amafilimu ezithombe zocansi aku-inthanethi naku-inthanethi (13.5 hr) , (ii) isikhathi esichithwe ku-cyber-sex (i-10 hr), (iii) imvamisa yokuhlangana ngokocansi okukhokhelwayo (imihlangano eyi-12), kanye (iv) nezindleko zezinsizakalo zokuphelelisa (£ 1,050). Imiphumela ngayinye eshiwo ngenhla ihlolwe ngezikhathi ezine ezihlukene zesikhathi: (i) isisekelo (t1), (ii) ukwelashwa okuphakathi (t2 [iviki 5]), (iii) ukunqanyulwa kokwelashwa (t3 [iviki 10]), kanye (iv) nokulandela izinyanga eziyisithupha (t4). Zonke lezi zikali ezingenhla zingamathuluzi wokuhlola asunguliwe anezindawo ezinhle zepsyometri.
Case Ukwakheka
Ukuveza kuka-Adam kuqala intshisekelo ezithombeni zobulili ezingcolile kubonakala kuhloswe kahle (okungukuthi, isinyathelo esithathiwe ukusiza ukubuyisa umshado wakhe). Kodwa-ke, ngokuwohloka komshado wakhe futhi ebona ukuthi unkosikazi wakhe ubengenandaba nezocansi, wazibonela ngokushaya indlwabu esebenzisa izithombe zobulili ezingcolile kanye nokuxhumana ngezikhathi ezithile nabaphelezelwa ngokocansi ukuze kube yindlela ebaluleke kakhulu yokwanelisa izifiso zakhe zocansi. Cishe isikhathi esiyizinyanga eziyi-12, u-Adam ukhombise izinga elifanele lokulawula izifiso zakhe zocansi, futhi kungenzeka ukuthi ukusebenzisa kwakhe izithombe zobulili ezingcolile kanye nabaphelezeli bobulili akuzange kube umlutha futhi kube yinkinga kwaze kwaba ngemuva kokuhlukanisa.
Esikhundleni sokufuna ubudlelwane besikhathi eside ngemuva kokwehlukanisa, u-Adamu wavalelwa enkambisweni yakhe yokuziphatha kobulili futhi wakuvumela ukuba kukhule. Ngeshwa, indlela yakhe yokuziphatha kobulili yaqala ukuba yingozi futhi kwavela isimangalo sempendulo. Ukubuka izithombe zobulili ezingcolile noma ukuzibandakanya ku (okhokhelwayo) othintana naye kwezocansi kufaka phakathi izifiso ezakhayo zesikhashana nezomzwelo. Lezi, futhi, zenze ukuthi kube nezinkumbulo ezivumayo (UBaker, uPiper, uMcCarthy, uMajeskie, noFiore, 2004). Ukuxhumana okwalandela nesikhuthazo kwezocansi kwavusa lezi zinkumbulo futhi kwaholela ekulangazeleleni kabusha ukuthola impendulo ehambisanayo neyokuzwa. Ukulangazelela kwaneliswa ngokuzibandakanya okwengeziwe kuhlobo olufanayo lokuziphatha kobulili okuthi, ngaphezu kokuguqulwa okufisayo esimweni semizwa, okuholele ekufomeni kwezinkumbulo ezingeziwe ezihlangene (IHoulihan neBrewer, 2015). U-Adamu uqhubeke nokuqinisa indlela yakhe yokuziphatha okuyinkinga yokuzibandakanya ocansini kuze kube yilapho izingxabano zangaphakathi nezomqondo zifinyelela eqophelweni lokuthi ngeke esakwazi ukuphika ukuthi isenzo sakhe besingalawuleki esikhathini eside.
Ukusetshenziswa kokuqala kuka-Adam izithombe zobulili ezingcolile kanye nabaphelezelwa ocansini kungenzeka bekungahlobene nezimpawu zakhe zokucindezeleka. Kodwa-ke, lapho efika khona wafuna usizo lwe-psychotherapist, ucansi kanye nokuziphatha okuhlobene nocansi (i) kwase kuyindlela yokugwema imizwa yokudangala (nezinye izinkinga empilweni yakhe), futhi (ii) nokwengeza izimpawu zakhe zemizwelo ephansi futhi kubangele imizwa yecala ibonakale.
Izici zokubikezela
Ukwahlukaniswa kwabazali baka-Adamu phakathi neminyaka yakhe yobusha kwaba nomthwalo ongokomzwelo. Kodwa-ke, u-Adamu wavela (esikhathini samanje nangesikhathi sokuhlukanisa kwabazali bakhe) ukusamukela futhi waphawula ukuthi "benze konke okusemandleni abo ukunciphisa umthelela ku- [kimi nakudadewethu]. ”Izimpawu zokuqala zempi ephawuleka phakathi kwezengqondo nezengqondo zaqhamuka ngenkathi u-Adam eseyunivesithi futhi ebhekene nengxabanoisifiso esingokomoya.”Izidingo zika-Adamu ezingokomoya azizange zihlangabezane nokuhlangana kwakhe nobuKhrestu noma ubuBuddha, futhi lokhu kwabonakala kuzwela kwakhe ngokwasemoyeni nangokomoya. Ngokusho kukaVan Gordon, uShonin noGriffiths (2016), ukungondleki kahle ngokomoya kungaba yisisusa esiyisihluthulelo se-psychopathology futhi kungenzeka sabamba iqhaza ekuqaleni kokudangala kuka-Adamu nokuziphatha kwe-hypersexual.
Izici zokuvikela nezinkinga
Isifiso sika-Adamu ekukhuleni ngokomoya (futhi ikakhulukazi kuBuddha) kungenzeka sisetshenziswe njengento evikelayo. Eqinisweni, u-Adamu ukuqinisekisile ukuthi isisusa sakhe esiyinhloko sokusondela ku-psychotherapist kungenxa yobuchwepheshe babo ekusebenziseni okwelapha izimiso nemikhuba yamaBuddha. Uhlobo olungenamkhawulo lomsebenzi ka-Adamu alusizi isimo sakhe. U-Adamu akaphonswa inselelo endimeni yakhe yamanje lapho ethola ukuqondiswa okuncane. Isizathu sakhe esiyinhloko sokwenqaba ukufaka isicelo samathuba entuthuko yangaphakathi ukuthi umthwalo owandisiwe uzophazamisa imisebenzi yakhe yezocansi. Kodwa-ke, uma inzalo ka-Adamu emsebenzini wakhe ingavuselelwa, indima enomthwalo wemfanelo owengeziwe nayo ingaba yinto evikelayo.
Intervention
Ngokuhambisana nokungabikho kwezimpawu zengqondo, isifiso sika-Adamu sobulili sibonisa ukufaneleka kwemodeli yokutakula esekwe ekuzindleni. Ngokusho komqondo wokuzindla, ukubonwa okucatshangwayo kwezifiso kanye nezindawo ezingezinhle eziphikisanayo kusiza ukufezekisa le micimbi engokwengqondo, yokuthi ingadli kakhulu futhi kungadedelwa (UVan Gordon et al., 2015b). Ngemuva kwemvume enolwazi, u-Adamu uthole ukungenelela kwe-MAT okwakuphethwe ngumlobi wesibili (uthisha wezengqondo nokufundisa ngokuzindla). IMAT ilandela indlela ebanzi yokuzindla lapho ukucabanga kuyingxenye ebalulekile - kepha akakhi ukugxila okukhethekile - wohlelo (UVan Gordon, uShonin, uSumich, uSundin, noGriffiths, ngo-2014).
Ngaphezu kokucabanga, i-MAT ifaka imikhuba elandelwa ngokwesiko ngabasebenza ngokuzindla ngamaBuddhist kufaka phakathi izindlela ezihlose ukuhlakulela: (i) ukuba yisakhamuzi, (ii) ukucaciseleka okuqondayo, (iii) ukuqwashisa kokuziphatha nokuzwela, (iv) ukuqonda ngokuzindla (isib. imiqondo ecashile enjengokungabi nalutho nokungagcwaliseki), (v) ukubekezela, (vi) ukuphana (isb. isikhathi namandla akho), kanye (vii) nombono wempilo. Iseshini ngayinye ye-10 yamasonto onke eya ku-Adam yathatha imizuzu engama-90 futhi yayiqukethe izigaba ezintathu: (i) ingxoxo nomelaphi (cishe ama-40 min), (ii) into efundisiwe (cishe ama-20 min), kanye (iii) nokuzindla okuqondisiwe (cishe imizuzu engama-20). Ikhefu le-10-min lahlelwa ngokushesha ngaphambi kokuzindla okuqondisiwe, futhi u-Adam wathola i-CD yokuzindla okuqondisiwe ukwenza lula ukuzenzela nsuku zonke.
Lolu cwaningo lwathola imvume yokuziphatha ekomitini lezimilo lesikhungo sababhali. Umhlanganyeli unikeze imvume ebhaliwe yokuthi imininingwane yabo ishicilelwe ephephabhukwini lezemfundo ngendlela engaziwa.
Isigaba sokungenelela ngaphambi kwesikhathi (amasonto 1-2)
Isigaba sokungenelela kwangaphambilini sigxile ekusunguleni umfelandawonye wezokwelapha, kanye nezimo zokwelapha eziyisisekelo njengokulalela okusebenzayo, ukubhekelwa okuhle okungenamibandela, uzwela olunembile, inhlonipho, kanye nobuhle (Wells, 1997). I-Psychoeducation nayo yasetshenziswa ngalesi sigaba sokwelashwa ukuqinisa ukuqonda kuka-Adam (i) umlutha kanye ne-loop impendulo yomlutha, (ii) ukwelashwa kwengqondo ngokusho kohlaka lokuzindla, kanye (iii) ne-etiology, ukwanda, kanye nenkomba yezimpawu zokuziphatha kocansi.
Phakathi nesonto lesibili lokwelashwa, izinhloso ezinhlanu ezihambisanayo ze-GAS zaphakanyiswa ngu-Adam (futhi kwavunyelwana nodokotela wezifo zengqondo): (i) ukunciphisa ngo-50% imvamisa yokuhlangana ngokocansi okukhokhelwayo nokungajwayelekile, (ii) ukuqeda ukusetshenziswa kwezithombe zocansi kanye ne-cyber- amawebhusayithi ezocansi, (iii) ukukhawulela ukuthintana kocansi kwabalingani abathathu abakhokhelwayo noma abenza ucansi abathandana nabo u-Adam abebona sengathi ucansi lunenjongo kakhulu, (iv) ukufaka isicelo sethuba elilodwa langaphakathi noma langaphandle lokuthuthukisa umsebenzi isonto ngalinye, kanye (v) nokuthola inqubo ejwayelekile yokuzivocavoca umzimba . Umgomo wokunciphisa ukusetshenziswa kwezimali okuhlobene nocansi kwehlisiwe ngoba kuthathwa njengokunye okungakhuthaza ukuziphatha okuyingozi kocansi (isb., Ukusebenzisa abaqwayizi basemgwaqweni abavamise ukukhokhisa amanani aphansi ezinsizakalo zabo zocansi kunabakhaphi).
Isici sokuqala esibalulekile sesigaba sokungenelela sokuqala sasingenisa u-Adamu kumkhuba wokuqwashisa ngokuqaphela nangokuqwashisa ngokuphefumula. Wafundiswa ukusebenzisa ukugcinwa kokuphefumula njengesikhonkwane sokunaka ngokunaka cishe i-50% yokuqaphelisisa kokuphefumula kwakhe kanye ne-50% kulokho okwenzeka esikhathini samanje. Ngale ndlela, u-Adamu waqala ukwakha izisekelo ezidingekayo zokuthuthuka okulandelayo kanye nendlela yokubopha ukucabanga okuhle.
Isigaba sokungenelela maphakathi (amasonto 3-8)
Isigaba sokungenelela okuphakathi sasiqukethe izinto ezinhlanu ezibalulekile ezanikezwa ngokuhlangana nokuqeqeshwa kokucophelela:
| 1. | Ukwakheka komzimba nokubola: Lesi sici salo mkhuba sisebenzise amaBuddhist sutras afaka ukuzindla okuningiliziwe ngokwakhiwa komzimba nokubola kwawo ngemuva kokufa. Inhloso bekuwukusiza u-Adam aqonde kabanzi ngemvelo yeqiniso lento ayifisayo (okungukuthi, umzimba). Isibonelo, okunye kokuzindla okuqondisiwe kubandakanye ukwakhiwa komzimba ngokomzimba nokukhomba izingxenye zawo ezingathandeki ngokwazo (isib. Izipikili, izinwele, amafinyila, indle, umchamo, ubomvu, ukugabha, igazi, umsipha, isikhumba, ithambo, amazinyo, inyama, umjuluko, njll.). Okunye ukuzindla okuqondisiwe kufaka phakathi ukubona inqubo yokubola umzimba odlula kuyo emva kokufa (okungukuthi, njengengxenye yokuqonda ubunjalo bomzimba nekusasa elingenakugwemeka elilindelwe). | ||||
| 2. | Ukwelashwa ngokuchayeka kokuzindla: U-Adamu wabhekana nobunzima ekusebenziseni le ndlela ngaphandle kwezikhathi zokwelapha, futhi wacela ngokuqondile indlela eqondile futhi yokusekela. Ngenxa yalokho, kwaqhutshwa indawo elawulwayo lapho u-Adamu ahlala khona eceleni komeluleki ngekhompyutha yelaptop eyayinomsindo uvaliwe. Wanikezwa ukuzindla okuqondiswa ngenkathi enye yamafilimu akhe kwezocansi akwi-inthanethi (udokotela wengqondo engakwazi ukubona ifilimu). U-Adamu wacelwa ukuba avale amehlo kodwa ngezikhathi ezithile futhi abavule kafushane ukubheka ifilimu. Wayalelwa ukuba ahambisane nenqubo yezengqondo neyomuntu eyabangelwa ifilimu ngokuthi "yinto eyenzekile nje." Ngamanye amagama, u-Adamu wafundiswa ukucacisa lezo zinqubo futhi ahlanganyele nazo njengombukeli obambe iqhaza. Ngaleyo ndlela u-Adamu wakhonjiswa ukuthi angakwazi ukuhlala ngokwengqondo nangokusebenza nezifiso zobulili ngaphandle kwabo ukubabikela isimo sakhe sengqondo nokuziphatha. | ||||
| 3. | Ukuzindla nobubele bothando kuzindla: U-Adam waziswa ukuzindla ngomusa nomusa wothando ngezizathu ezahlukahlukene, kepha inhloso eyinhloko kwakuwukwazisa ngokuhlupheka kwabanye, kufaka phakathi nabantu ayekhokha nabo ukuya ocansini. U-Adam wakhuthazwa ukuthi abheke abantu abanjalo njengabantu (okusho, abanezinkinga namathemba abo) hhayi njengezinto zokwanelisa izifiso zakhe zocansi. | ||||
| 4. | Ukuzindla kokuhlaziya: U-Adamu waqondiswa esebenzisa ukuzindla okuhloselwe ukuhlehlisa ukukholelwa ukuthi umuntu uqobo (noma leyo ndaba) uvele ngokuthile (bheka isigaba seNgxoxo ukuthola enye imininingwane). | ||||
| 5. | Ucansi ngomongo: Lesi sici sokwelashwa kuka-Adam besigxile kakhulu ezingxoxweni futhi sigxile ekusizeni u-Adam afake eminye imininingwane yakhe nokuzindla. Kwasetshenziswa amasu afana nokutholwa okuqondisiwe, ukubonisana okunengqondo nokubuzwa kweSocratic ukusiza u-Adam avivinye ubuqiniso bemicabango yakhe ephathelene nezocansi. Isibonelo, u-Adam waqondiswa ukwamukela ukuthi (i) isifiso sokuya ocansini kuyinto ejwayelekile futhi eqhutshwa ngokwemvelo, (ii) alikho inani elifanele lobulili (okungukuthi, wonke umuntu wehlukile), (iii) ucansi luyinto ebalulekile yokuphila , kepha kunezinye izinto eziningi (eziphikisanayo) ezibalulekile, (iv) lapho abantu abadala ababili bevuma ukuzibandakanya ocansini, imicabango yabo (okusho, hhayi uhlobo lwesenzo socansi olwenziwe) olunquma ukuthi ukuhlangana kuyakha noma kuyonakalisa, (v) ngombono wamaBuddha, ukusebenzisa izinsizakalo zokuhanjiswa kwabantu abadala ngokocansi akulona iphutha, inqobo nje uma kungekho muntu olimalayo (kuyavunywa, kunezizathu eziningi - kufaka phakathi ifilosofi - izimpikiswano ezisekelayo nezigxekayo ezingasetshenziswa maqondana nalokhu), futhi (vi) ubulili ngaphakathi komongo wobudlelwano besikhathi eside kungenzeka buphephe futhi buqondakale. | ||||
Ukupheliswa kokwelapha (amasonto 9-10)
Isigaba sokugcina sokwelashwa sigxile ekukulungiseleleni u-Adamu ukuqeda ukwelashwa. Ngenkathi ezwa ukuthi impilo yakhe engokwengqondo nokulawula izifiso zobulili sekuthuthuke kakhulu, u-Adamu waveza ukukhathazeka ngokubuyela emuva ngenxa yokulahleka kokuxhumana ubuso nobuso. Ukusiza ukunciphisa ukukhathazeka okunjalo, u-Adamu welulekwa ukuthi aqhubeke nomkhuba wakhe wansuku zonke wokuzindla nokugcina irejista yansuku zonke yokuziphatha kobulili, amazinga okucindezela, nezindlela zokulala. Amakhadi e-cue amasu wokulinganisa enzelwa ukuthi u-Adamu avume ukuwabhekisa kuye njalo ngeviki. Ekugcineni, kwaxoxwa inqubo yezimo eziphuthumayo, izinsuku nezikhathi zokuxhumana ngocingo zahlelwa, futhi kwahlelwa izikhathi ezintathu ze-90-min zokulwa ngezikhathi ze-4-sonto.
Imiphumela
Ngemuva kokuphothulwa kweMAT (okungukuthi, t3), u-Adam wahlolwa waqhathaniswa nenqubo yokuxilongwa ye-DSM-5 yokudangala okukhulu. Ukhombise ushintsho olubalulekile emtholampilo (okungukuthi, kuya ngaphansi komkhawulo wokuxilonga) olugcinwe ekulandeleni kwezinyanga eziyi-6 (ie, t4). Njengoba kukhonjisiwe kuMfanekiso 1, wakhe t3 futhi tIzikolo ze-4 kuzo zonke ezinye izindlela zokuphumela nazo ziphakamise ukuthi ukungenelela kube yimpumelelo. U-Adamu uphendule ngo- “yebo” ezinhlwini ezinhlanu ze-SAST-R okukhombisa ukuthi ubengasahluphi ngokuziphatha umlutha kwezocansi. Izikolo zakhe zokwelashwa ngemuva kokuthola ukwelashwa ku-Dass ziveze izinga "elijwayelekile" lobukhulu bezimpawu, nezakhe tIzikolo ze-3 kuwo womabili ama-AJIGS ne-NAS ziphindwe kabili uma ziqhathaniswa nesisekelo (kuthambekele ekufinyeleleni ekuthuthukisweni okwengeziwe t4). Okwa-Adamu tIsikolo se-3 ku-PSQI sincishiswe kakhulu (kusuka tI-1 = 14 kuya tI-3 = 8), kepha ibisengaphezulu komkhawulo (we-≥5) wokulala okungeyona inkinga. Ukuthuthuka okuqhubekayo kukhwalithi yokulala kubonisiwe phakathi t3 futhi tI-4, nesibalo se-PSQI sika-Adamu esiyisihlanu ngokulandelwa kwenyanga ye-6 bekungaphandle kwendlela yokulala ikhwalithi “evamile” yokulala.
Umdwebo 1. Shintsha ezikolo eziguquguqukayo zomphumela ngokuhamba kwesikhathi, lapho t1 = okusisekelo, t2 = iviki 5, t3 = isonto 10 (ukuqedwa kokwelashwa), tI-4 = ukulandela kwezinyanga kwe-6. Imigqa enamachashaza akhombisa ukususwa kobukhulu bophawu “obujwayelekile” (lapho kutholakala khona) kubantu abadala
Between t3 futhi tI-4, u-Adamu wayegwema ukubuka izithombe zocansi futhi asebenzise amawebhusayithi ocansi ku-inthanethi. Izindleko zakhe kwezokuya ocansini zehle nge-60% phakathi t1 futhi t3 (kuya ku- £ 420 ngezinsuku eziyi-14; ukuhlangana okukhokhelwe kathathu ngeviki), kanye no-73% phakathi t1 futhi t4 (£ 280 ngezinsuku eziyi-14; ukuhlangana okubili okukhokhelwayo ngesonto). U-Adam ngokufanayo wehlise inani labantu kwinethiwekhi yakhe yabalingani abenza ucansi abangakhokhelwa (kusuka tI-1 = 10, ukuze t3-tI-4 = 3), futhi phakathi t3 futhi tI-4, imvamisile ukuthi wayehlangana nomuntu athandana naye yedwa ocansini ongakhokhelwa isonto ngalinye (uma kuqhathaniswa neminye imihlangano emithathu yamasonto onke lapho t1). Isikolo sangemva kokulashwa kwe-GAS sika-Adamu se-74 sihambelana nokufinyeleleka kuwo wonke amagoli wegoli. At t4, u-Adam ubike ukuthi (i) ubethole ukukhushulwa kwangaphakathi obekufanele kuqale esikhathini sezinyanga ezi-2, (ii) ubehambela iqembu lokuzindla lamaBuddha masonto onke, futhi (iii) akasazizwa enecala ngokocansi kwakhe ukuziphatha “uyangisebenzela futhi uqonde kakhulu. "
Ingxoxo
Leli phepha libika okutholakele ocwaningweni lokuqala lomtholampilo ukuphenya ngokusetshenziswa kokucabanga ngokwelapha ukulutha kocansi. Ukungenelela okusetshenziswe esifundweni samanje (okungukuthi, i-MAT) kungokwesizukulwane sesibili sokungenelela okususelwa engqondweni futhi kulandela indlela ephelele yokufundisa nokusebenza kwengqondo. Umuntu obambe iqhaza omdala (u-Adam) ukhombise ukuthuthuka okuphawulekayo emitholampilo ekuziphatheni ngokocansi okuluthayo kanye nokudangala nokucindezeleka kwengqondo. Intuthuko yokwelashwa kwangemuva nayo yabonwa ngekhwalithi yokulala, ukwaneliseka komsebenzi, nokungahambisani nokuzibandakanya nokuhlangenwe nakho. Imiphumela yomholo yagcinwa ekulandelweni kwezinyanga eziyisithupha.
Lolu cwaningo luqokomisa isidingo sokuvumelanisa imiphumela yokwelashwa ngokwesisekelo icala. Umphumela omuhle ngabe u-Adamu waveza isifiso sokuthola umlingani wobudlelwano besikhathi eside nokugwema ukuhlangana ngocansi okukhokhelwayo nokungakhokhelwanga. Kodwa-ke, obambe iqhaza kwacaca ukuthi ubudlelwane besikhathi eside abukho kwi-ajenda yabo yomuntu, ngakho-ke izinhloso zokwelapha kufanele zilungiswe ngokufanele. Yize u-Adamu eqhubeka nokusebenzisa ucansi ngemuva kokuphathwa ngocansi, ukusetshenziswa kwakhe kwakusezingeni eliphansi kakhulu, kanti amaphuzu ku-SAST-R aphakamisa ukuthi wayengasamlutha ngocansi. Ngaphezu kwalokho, imiphumela yazo zonke ezinye izindlela zokuziphatha kuka-Adamu kocansi yabonisa ukuthi wayesekwazi ukulawula izinkanuko zakhe zocansi.
Ukhiye ohlongozwayo umakhenikha ukuthi ukunaka ingqondo kukhulisa ibanga elibonakalayo kusuka ekunxephezelweni okuqhutshwa umlutha, futhi ngaleyo ndlela kusiza inqubo "yokuncenga ukusebenzisa i-surfing" (I-Appel neKim-Appel, ngo-2009). Ngamanye amagama, ukubona isifiso sokuziphatha kusiza ukucacisa lokhu futhi kuvumela lokho ukuzikhulula. Kodwa-ke, empeleni, ubukhulu bokuthi isifiso sobulili bungasho ukuthi ukucabanga kukodwa akwanele, nokuthi ezinye izindlela zokwelapha zokuzindla ziyadingeka. Ngempela, ngokwezincwadi zendabuko zamaBuddha, ngokujwayelekile kuthatha iminyaka ukuthi umuntu abe nekhono ekusebenzeni ngemicabango (UShonin et al., 2014c). Lokhu kuphakamisa ukuthi abantu abanezinkinga zokuziphatha ezinenkinga (kanye nezinye izingqinamba zempilo yengqondo) akunakwenzeka ukuthi baqoqe isisekelo esidingekayo ekucabangeni (okungukuthi, ukuze bakwazi ukulawula izinkomba ezibhalwe kabi) ngemuva kokuya emihlanganweni yokuqeqeshwa kwengqondo eyi-8-10.
Ngokusho kukaShonin et al. (2013, 2014a), lapho usebenzisa ukuzindla ekwelapheni ukulutha kokuziphatha, kubalulekile hhayi kuphela ukusiza abantu bafunde ukuthi bangahlose kanjani ukucabanga (okungukuthi, ngokwenza umcabango), kepha nokubanika amandla okusebenzisa amasu okuzindla anciphisa ngqo ukunamathela entweni yokulutha . Ama-SG-MBIs, ajwayele ukuhlanganisa izindlela ezahlukahlukene zokucabanga, ngakho-ke kufanelekile ukuthi alaphe ukulutha kokuziphatha. Ngaphezu kokukhomba ekulangazeleleni ukuxhumana ngokocansi (okusho, ngokusebenzisa ukuzindla ngesimo somzimba esihlanganisiwe nesingapheli), i-MAT ifaka nokuzindla okuhloselwe ukubukela phansi ukukholelwa kumuntu ongaphakathi futhi ozimele okhona (UVan Gordon et al., 2014). Izizathu ezingemuva kwale ndlela zivela Ithiyori Yomlutha We-Ontological (OAT) lapho "umlutha we-ontological" uthathwa njengembangela eyisisekelo yezinqubo zokuqonda okungalungile nezokuziphatha (UShonin et al., 2013).
Umlutha we-Ontological uchazwa ngokuthi "ukungafuni ukulahla inkolelo eyiphutha nejulile yokukholelwa 'ku-' noma 'Mina' kanye 'nokungasebenzi kahle' okuvela kule nkolelo"(UShonin et al., 2013, k. 64). Ukukholelwa ebuntwini kubhekwa njenge "mbumbulu" ngoba "uqobo" lubonakala ngokuncika kuzo zonke ezinye izinto ezikhona endaweni yonke. Uma ukukholelwa ebukhoneni bemvelo yomuntu uqobo kungabekelwa phansi, khona-ke ngokuzenzakalelayo, nenkolelo enjalo yokuba khona kwanoma yini into efiswa yi "uqobo". Ngokusho kwe-OAT, ukuxhumana ngocansi akuyona into engenamsebenzi, kepha njengayo yonke eminye imisebenzi, kufanele kwenziwe ngaphandle kokwaba izinsizakusebenza ezingqondo nezomzwelo ezinjengokuthi ezocansi (noma umzimba womuntu) zinikezwe ikhwalithi ekhangayo engenangqondo futhi okudlula ukubaluleka kwangaphakathi kwalo (UShonin et al., 2014c).
Njengoba kuphawulwe kwezinye izifundo zamacala omtholampilo ze-MAT ezibandakanya abantu abanokulutha kokuziphatha [isb., Ukugembula okunenkinga (UShonin et al., 2014a); i-workaholism (UShonin et al., 2014b)], ezinye izindlela okungenzeka ukuthi i-MAT isebenze ngayo kwezokwelapha yilezi: (i) ukuzindla okuzindla okuholela ekwehliseni ukuvuswa kokuzimela, ukuvuswa kwengqondo, nokungafisi, (ii) "ukufaka esikhundleni senjabulo" lapho injabulo yezinzwa nengqondo etholakala ekuzindleni iyanda amandla okunciphisa ukuzanelisa ngokocansi, (iii) amazinga akhuphukile omusa wothando, uzwelo, nokuzizwela okukhuthaza ukuqwashisa ngokuziphatha futhi kubukele phansi izinhlelo zokuzikhukhumeza, futhi (iv) ukondleka okungokomoya okwandisa umqondo wenhloso kanye nomsebenzi nokwaneliseka kwempilo. .
Kuze kube manje, ucwaningo lokuhlola ukusetshenziswa kwengqondo maqondana nokuziphatha kobulili kugxile kakhulu ekuthuthukiseni ukungasebenzi kahle kwezocansi kanye / noma nokuzijabulisa (isib. I-Brotto, iBasson, neLuria, ngo-2008; UBrotto et al., 2012). Lolu cwaningo lunabisa lolu ncwadi ngokubika ngokusetshenziswa kwengqondo njengokungenelela kwezokwelapha ekwelapheni umlutha wobulili. Njengazo zonke izifundo zocwaningo lwezemitholampilo, ukwakheka kwesihloko esisodwa, kanye nokungabikhona kwesimo sokulawula, kusho ukuthi okutholwayo kungenzeka kungahambeli abanye abantu abahlushwa umlutha wobulili. Lolu cwaningo belunqunyelwe nokusebenzisa isikhathi sezinsuku ezingama-14 sokuhlola izici zokuziphatha kobulili, ngoba lesi sikhathi ngeke siveze amaphethini wokuziphatha wesikhathi eside. Noma kunjalo, imiphumela yokwelashwa ethembisayo ka-Adamu ikhombisa ukuthi ukuhlolwa okwengeziwe komtholampilo kokusebenza kwe-MAT kokwelapha umlutha wobulili kufanelekile.
Siyaqinisekisa ukuthi bonke ababhali balesi sihloko babefinyelele kwimininingwane yokufunda, banesibopho sokuqukethwe konke kwendatshana, futhi babenegunya ngaphezu kokulungiselela ukubhala ngesandla kanye nesinqumo sokuhambisa lo mbhalo ozobhaliwe.
Ababhali abanayo intshisekelo yokuncintisana abangayimemezela.
Lolu cwaningo lwathola imvume yokuziphatha ekomidini lezokuziphatha laseNottingham Trent University College of Business Law kanye neSayensi Yezenhlalo. Siyaqinisekisa ukuthi obambe iqhaza wanikezela ngemvume ephelele ebhaliwe yokuthi imininingwane yabo ishicilelwe kwijenali yezemfundo ngendlela engaziwa. Siyaqinisekisa ukuthi yonke imininingwane yomhlanganyeli ekhomba / imininingwane isusiwe kumbhalo wesandla ngokufanele.
Okubhekwayo
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