Transcript 上癮理論在華人家庭的應用 - Christian Mental Health Services
Slide 1
上癮理論在華人家庭的應用
与華人家庭成員的相互依賴問題
Melvin Wong, Ph.D.
黃偉康博士
Licensed Clinical Psychologist (California)
ChristianMentalHealth.com
E-Mail
[email protected]
220 Montgomery St., Suite 1098, San Francisco, CA 94104
Slide 2
家家有本難念的經
Slide 3
出埃及記 Exodus 20:5-6
聖經新譯本
New International Version
不可跪拜那些像，也不
可事奉它們，因為我
耶和華你們的上帝是
忌邪的上帝；恨惡我
的，我必追討他們的
罪，從父親到兒子，
直到三四代。愛我遵
守我誡命的，我必向
他們施慈愛，直到千
代。
You shall not bow down to
them or worship them; for
I, the LORD your God,
am a jealous God,
punishing the children for
the sin of the fathers to the
third and fourth generation
of those who hate me, but
showing love to a
thousand generations of
those who love me and
keep my commandments.
Slide 4
家家有本難念的經
政治不穩定的歷史
–飢荒 有計划的大屠殺
恥辱的心理經歷与歷史文化
–面子問題
悲劇
文化
痛苦 文化
傷痕与創傷文化 婦女創傷文化
Slide 5
創傷文化華人家庭的結构
Fear: Loss of Control (External locus)
– Dependency-Enmeshment: Impaired ego development
– Performance-based: Relationships of rejection
– Perfectionism: Unable to accept failure
Detachment-Attachment Problems
– Dependency
– Addictions: To satisfy self & soothe pain
Rigidity
Slide 6
What is Codependence
相互依賴 雙依式的“愛” 無我的“愛”
(© 1998-01 M Wong, Ph.D.)
Anyone whose “Self” was underdeveloped that
s/he becomes dependent on another person to feel
complete (Emotional “Cannibalism” for Survival)
This codependent person is often addicted to the
esteem & acceptance of others for survival to the
point that it hurts the self and another
Side-Effects of Codependence: Loose-Boundaries
& Poor limits with Gullibility, Controlling
Serious Side-Effects: Deception, Manipulation,
Addictions, Self-Defeat, Tragic-outcomes, WinLose, Dehumanization & finally Death
Slide 7
出埃及記 Exodus 34:7
聖經新譯本
New International Version
為千千萬萬人留
下慈愛，赦免罪
孽、過犯和罪惡
。一定要清除罪
，追討罪孽自父
及子至孫，直到
三四代。」
maintaining love to
thousands, and
forgiving wickedness,
rebellion and sin. Yet
he does not leave the
guilty unpunished; he
punishes the children
and their children for
the sin of the fathers to
the third and fourth
generation."
Slide 8
困扰者
的悲嘆
羅馬書 7:19-25
故此，我所願意的善，我反不做；我所不願意
的惡，我倒去做。若我去做所不願意做的，就
不是我做的，乃是住在我裏頭的罪做的。
我覺得有個律，就是我願意為善的時候，便有惡
神的律；但我覺得肢體中另有個律和我心中的律
交戰，把我擄去，叫我附從那肢體中犯罪的律。
我真是苦啊！誰能救我脫離這取死的身體呢？
感謝 神，
。這樣看來，我以內心順服 神的律，我肉體
卻順服罪的律了。
Slide 9
華人家庭的結构
Father
Mother
Daughter
Son-1
Son-2
Slide 10
失效家庭成員的角色
上癮者
Adult-child:
Man with
problems;
Gambling,
affairs, rage &
irresponsibility
縱容者
1
2
3
4
Survival for me
5
Mother who
helps hide
husband’s
serious
problems
Slide 11
失效家庭成員的角色
上癮者
縱容者
1
2
3
4
5
Keep the peace: Survival for me
Mother who
is trying to
be the UN
PeaceKeeper:
Hoping
things will
not go out of
her control
Slide 12
失效家庭成員的角色
上癮者
縱容者
Win-Lose
英雄
1
2
3
4
5
Rivalry
Detach
Be Perfect: Problems will go away
I want to be hero too! I am worthy
Slide 13
失效家庭成員的角色
上癮者
縱容者
1
2
3
4
5
代罪羔羊
Rebel: Believing I am the problem
Slide 14
失效家庭成員的角色
上癮者
縱容者
迷路孩子
1
2
3
4
5
Withdraws from Relationships: Numb
Slide 15
失效家庭成員的角色
上癮者
小丑
縱容者
1
2
3
4
5
Makes laughter amidst family tragedy
Slide 16
失效家庭成員的角色
Adapted from:
Sharon Wegscheider-Cruse, 1985, Health Communications, FL
Addict 上癮者: Anger, rage, gambling, sex
Enabler 縱容者: Tries to control to make things OK
Hero 英雄: Be perfect & problems will go away
Scapegoat 代罪的羔羊: Rebel against family
problems & then finally believing that he is the problem
Lost Child 迷路的孩子: Retreats, withdraws &
isolates self from meaningful relationships
Mascot 小丑: Desperately makes everyone
laugh amidst the family tragedy
Slide 17
The Addicted Family Rules
(Unspoken)
FEEL
DON’T TALK
DON’T TRUST
DON’T THINK
DON’T CHANGE
DON’T
Slide 18
性癮-成因 理論
Attachment Deficits
– Failure to attach with a nurturing-love object
– Deny needs for nurturing person
– Denial gives rise to deprivation
Family Relationship Estrangement
Family Dynamic of Rigidity: Perfectionism
History of early sexual violation
Intimacy problem: Generational effect
Slide 19
Developing Intimacy Through Effective Communication
Copyright © Melvin Wong, Ph.D. All Rights Reserved
Sex
Commitments
Exchange Feelings
Exchange of Judgments
Exchange of Facts
Small Talk & Clichés
Slide 20
The Physical Intimacy-Orgasmic Cycle
(Copyright © Melvin Wong, Ph.D. 2000)
“Intimacy Always Feels Good!”
“Emotional Intimacy Leads to Physical Intimacy!”
“Physical Intimacy Can Lead to Orgasm!”
“Orgasm Always Feels Good!”
“Orgasmic Feeling is Intimacy?”
Physical Intimacy is an Antidote for:
Loneliness, Low-Self Worth, Boredom,
Aggression, Anger, Despair, Abandonment
(Applies to Heterosexuals and Homosexuals)
Slide 21
“Addiction-Acting-Out Cycle”
Copyright © Melvin Wong, Ph.D. 2000
Compulsivity
Deprivation
Abuser-Victim
Blame-Shame
Guilt
Impulsivity
Satiation
Slide 22
Proximal Causes of Sexual Addiction
Premature Sexual-Genital Familiarization
Over-exposure to adult pornographic materials
“My dad’s Playboy magazine”
“My uncle’s books under his bed or mattress”
“One day I found a stash of magazine in my
neighbor’s trash”
“I watched HBO after my parents went to sleep”
“I watched my mom having sex with her
boyfriend”
Slide 23
Immediate Causes of Sexual Addiction
Child was a victim of sexual violation
Molestation-Fondling: Culture specific
(Sexual curiosity of adults in Asian ethnic groups)
Men’s sexual curiosity over self: Projected on children
Men exposed self to children: To satisfy
“something” about themselves
Servant-Maid: “Bathing a toddler”
Sexual arousal as a way to soothe a child
Slide 24
Direct Causes: Biology & Psychology
Behavioral:
Stimulus-Response Cycle
– Boredom: Social-Interpersonal Isolation
– Excitation: Immediate Gratification
– Stimulus-Response: Emotional Reminders
Habit-Forming
Behaviors
– Cigarettes smoking
– Rage: Temper Tantrums
Relaxation
Cycles
– Physiological Arousal & Rest States
Slide 25
Why Sexual Addiction?
Needs for Arousal
Life is Boring
Gambling
Sex
Stimulant Drugs
High-Risk Behaviors
Slide 26
Why Sexual Addiction?
Needs for Satiation
Life is Not Satisfying-Unhappy
Sex
Over-Eating (Bulimia-Bingeing)
Depressant Drugs (Marijuana)
Narcotic Drugs (Anesthetic effect)
Alcohol
Slide 27
Why Sexual Addiction?
Needs for Fantasy
Reality is too Hard: Need a Quick Escape
Voyeuristic Sex: Intelligent fantasy & Routine
Psychedelic Drugs: LSD
Marijuana
Mystic/Artistic
Preoccupation
Slide 28
The Addiction
(Modified from Patrick Carnes, Ph.D. & Steven Arterburn, M.S.)
Craving-tension-urge
to get
emotionally intimate with others
Mental-Emotional-Visual Triggers
Pain Repression with immediate
Sexual Longing
Fantasy Development-Planning
Begins (The Thrill begins)
The Hunt (The Intrigue)
Slide 29
The Addiction
(Modified from Patrick Carnes, Ph.D. & Steven Arterburn, M.S.)
The
Connection
– “Rush” Altered state of awareness
The Act
– Under-Control: Impulsivity: Binge
The
Fulfillment
– Orgasm: Feeling Dissociation
The Let-Down
– Self-Blame: Numbness
The Vow
– Over-Control: Compulsivity: Rigidity
The
Cycle Returns again (Deprivation Sets-In)
Slide 30
Specific Treatment Areas
(Copyright © Melvin Wong, Ph.D. 2000)
Ideational
(Mindset)
– Reduction of Intrusive Thoughts
Behavioral
– Reduce Masturbation & Acting-Outs
Relational
– Increase Male Non-Sexual Friendships
Spiritual
– Increase Pursuit of Holiness-Maturity
Slide 31
Healing Compulsions & Addictions
Interpersonal: Healthy-Bonds (Safe People)
– Experiential not only rational Non-sexual intimacy
– Spiritual: Paradigm shift: Enlightenment
Intrapersonal: Mourn loss, Spiritual renewal
– Rediscover goodness in self (false guilt)
– Rediscover meaning & significance (Help others)
An Element of “A Loving but Firm
Structure” (Live-In programs, 12 step groups)
Slide 32
Self-Help Group Resources
SA: Sexaholics Anonymous
www.sa.org (615)331-6230
SLAA: Sex Love Addicts Anonymous
EA: Emotions Anonymous
(510) 471-8864
CODA: CoDependents Anonymous
(415) 905-6331
www.ChristianMentalHealth.com
Slide 33
Getting Help
Sex and Love Addicts Anonymous (SLAA)
P O Box 119, New Town Branch, Boston MA 02258 617-332-1945
Sex Addicts Anonymous (SAA)
P O Box 3038 Minneapolis, MN 55403 612-339-0217
Sexual Compulsives Anonymous (SCA)
P O Box 1585, Old Chelsea Station, NY, NY 10011 212-439-1123
National Council on Sexual Addictions, Inc
P O Box 20249, Wickenberg, AZ
602-684-7919
Sexaholics Anonymous (SA)
P O Box 300 Simi Valley, CA 93062
805-581-3343
Slide 34
困扰者
的悲嘆
羅馬書 7:19-25
故此，我所願意的善，我反不做；我所不願意
的惡，我倒去做。若我去做所不願意做的，就
不是我做的，乃是住在我裏頭的罪做的。
我覺得有個律，就是我願意為善的時候，便有惡
神的律；但我覺得肢體中另有個律和我心中的律
交戰，把我擄去，叫我附從那肢體中犯罪的律。
我真是苦啊！誰能救我脫離這取死的身體呢？
感謝 神，
。這樣看來，我以內心順服 神的律，我肉體
卻順服罪的律了。
Slide 35
馬太福音 25:34-40
於是王要向那右邊的說 你們這蒙我父賜福的，
可來承受那創世以來為你們所預備的國；因為
我餓了，你們給我吃，渴了，你們給我喝；我
作客旅，你們留我住；我赤身露體，你們給我
穿；我病了、你們看顧我；我在監裏，你們來
看我。』義人就回答說：『主啊，我們甚麼時
候見你餓了，給你吃，渴了，給你喝？甚麼時
候見你作客旅，留你住，或是赤身露體，給你
穿？又甚麼時候見你病了，或是在監裏，來看
你呢？』
Slide 36
王要回答說：『我實在告訴你們
，
這些事你們既做在我這弟兄中一
個最小的身上，
就是做在我身上了。』
馬太福音 25:34-40
上癮理論在華人家庭的應用
与華人家庭成員的相互依賴問題
Melvin Wong, Ph.D.
黃偉康博士
Licensed Clinical Psychologist (California)
ChristianMentalHealth.com
[email protected]
220 Montgomery St., Suite 1098, San Francisco, CA 94104
Slide 2
家家有本難念的經
Slide 3
出埃及記 Exodus 20:5-6
聖經新譯本
New International Version
不可跪拜那些像，也不
可事奉它們，因為我
耶和華你們的上帝是
忌邪的上帝；恨惡我
的，我必追討他們的
罪，從父親到兒子，
直到三四代。愛我遵
守我誡命的，我必向
他們施慈愛，直到千
代。
You shall not bow down to
them or worship them; for
I, the LORD your God,
am a jealous God,
punishing the children for
the sin of the fathers to the
third and fourth generation
of those who hate me, but
showing love to a
thousand generations of
those who love me and
keep my commandments.
Slide 4
家家有本難念的經
政治不穩定的歷史
–飢荒 有計划的大屠殺
恥辱的心理經歷与歷史文化
–面子問題
悲劇
文化
痛苦 文化
傷痕与創傷文化 婦女創傷文化
Slide 5
創傷文化華人家庭的結构
Fear: Loss of Control (External locus)
– Dependency-Enmeshment: Impaired ego development
– Performance-based: Relationships of rejection
– Perfectionism: Unable to accept failure
Detachment-Attachment Problems
– Dependency
– Addictions: To satisfy self & soothe pain
Rigidity
Slide 6
What is Codependence
相互依賴 雙依式的“愛” 無我的“愛”
(© 1998-01 M Wong, Ph.D.)
Anyone whose “Self” was underdeveloped that
s/he becomes dependent on another person to feel
complete (Emotional “Cannibalism” for Survival)
This codependent person is often addicted to the
esteem & acceptance of others for survival to the
point that it hurts the self and another
Side-Effects of Codependence: Loose-Boundaries
& Poor limits with Gullibility, Controlling
Serious Side-Effects: Deception, Manipulation,
Addictions, Self-Defeat, Tragic-outcomes, WinLose, Dehumanization & finally Death
Slide 7
出埃及記 Exodus 34:7
聖經新譯本
New International Version
為千千萬萬人留
下慈愛，赦免罪
孽、過犯和罪惡
。一定要清除罪
，追討罪孽自父
及子至孫，直到
三四代。」
maintaining love to
thousands, and
forgiving wickedness,
rebellion and sin. Yet
he does not leave the
guilty unpunished; he
punishes the children
and their children for
the sin of the fathers to
the third and fourth
generation."
Slide 8
困扰者
的悲嘆
羅馬書 7:19-25
故此，我所願意的善，我反不做；我所不願意
的惡，我倒去做。若我去做所不願意做的，就
不是我做的，乃是住在我裏頭的罪做的。
我覺得有個律，就是我願意為善的時候，便有惡
神的律；但我覺得肢體中另有個律和我心中的律
交戰，把我擄去，叫我附從那肢體中犯罪的律。
我真是苦啊！誰能救我脫離這取死的身體呢？
感謝 神，
。這樣看來，我以內心順服 神的律，我肉體
卻順服罪的律了。
Slide 9
華人家庭的結构
Father
Mother
Daughter
Son-1
Son-2
Slide 10
失效家庭成員的角色
上癮者
Adult-child:
Man with
problems;
Gambling,
affairs, rage &
irresponsibility
縱容者
1
2
3
4
Survival for me
5
Mother who
helps hide
husband’s
serious
problems
Slide 11
失效家庭成員的角色
上癮者
縱容者
1
2
3
4
5
Keep the peace: Survival for me
Mother who
is trying to
be the UN
PeaceKeeper:
Hoping
things will
not go out of
her control
Slide 12
失效家庭成員的角色
上癮者
縱容者
Win-Lose
英雄
1
2
3
4
5
Rivalry
Detach
Be Perfect: Problems will go away
I want to be hero too! I am worthy
Slide 13
失效家庭成員的角色
上癮者
縱容者
1
2
3
4
5
代罪羔羊
Rebel: Believing I am the problem
Slide 14
失效家庭成員的角色
上癮者
縱容者
迷路孩子
1
2
3
4
5
Withdraws from Relationships: Numb
Slide 15
失效家庭成員的角色
上癮者
小丑
縱容者
1
2
3
4
5
Makes laughter amidst family tragedy
Slide 16
失效家庭成員的角色
Adapted from:
Sharon Wegscheider-Cruse, 1985, Health Communications, FL
Addict 上癮者: Anger, rage, gambling, sex
Enabler 縱容者: Tries to control to make things OK
Hero 英雄: Be perfect & problems will go away
Scapegoat 代罪的羔羊: Rebel against family
problems & then finally believing that he is the problem
Lost Child 迷路的孩子: Retreats, withdraws &
isolates self from meaningful relationships
Mascot 小丑: Desperately makes everyone
laugh amidst the family tragedy
Slide 17
The Addicted Family Rules
(Unspoken)
FEEL
DON’T TALK
DON’T TRUST
DON’T THINK
DON’T CHANGE
DON’T
Slide 18
性癮-成因 理論
Attachment Deficits
– Failure to attach with a nurturing-love object
– Deny needs for nurturing person
– Denial gives rise to deprivation
Family Relationship Estrangement
Family Dynamic of Rigidity: Perfectionism
History of early sexual violation
Intimacy problem: Generational effect
Slide 19
Developing Intimacy Through Effective Communication
Copyright © Melvin Wong, Ph.D. All Rights Reserved
Sex
Commitments
Exchange Feelings
Exchange of Judgments
Exchange of Facts
Small Talk & Clichés
Slide 20
The Physical Intimacy-Orgasmic Cycle
(Copyright © Melvin Wong, Ph.D. 2000)
“Intimacy Always Feels Good!”
“Emotional Intimacy Leads to Physical Intimacy!”
“Physical Intimacy Can Lead to Orgasm!”
“Orgasm Always Feels Good!”
“Orgasmic Feeling is Intimacy?”
Physical Intimacy is an Antidote for:
Loneliness, Low-Self Worth, Boredom,
Aggression, Anger, Despair, Abandonment
(Applies to Heterosexuals and Homosexuals)
Slide 21
“Addiction-Acting-Out Cycle”
Copyright © Melvin Wong, Ph.D. 2000
Compulsivity
Deprivation
Abuser-Victim
Blame-Shame
Guilt
Impulsivity
Satiation
Slide 22
Proximal Causes of Sexual Addiction
Premature Sexual-Genital Familiarization
Over-exposure to adult pornographic materials
“My dad’s Playboy magazine”
“My uncle’s books under his bed or mattress”
“One day I found a stash of magazine in my
neighbor’s trash”
“I watched HBO after my parents went to sleep”
“I watched my mom having sex with her
boyfriend”
Slide 23
Immediate Causes of Sexual Addiction
Child was a victim of sexual violation
Molestation-Fondling: Culture specific
(Sexual curiosity of adults in Asian ethnic groups)
Men’s sexual curiosity over self: Projected on children
Men exposed self to children: To satisfy
“something” about themselves
Servant-Maid: “Bathing a toddler”
Sexual arousal as a way to soothe a child
Slide 24
Direct Causes: Biology & Psychology
Behavioral:
Stimulus-Response Cycle
– Boredom: Social-Interpersonal Isolation
– Excitation: Immediate Gratification
– Stimulus-Response: Emotional Reminders
Habit-Forming
Behaviors
– Cigarettes smoking
– Rage: Temper Tantrums
Relaxation
Cycles
– Physiological Arousal & Rest States
Slide 25
Why Sexual Addiction?
Needs for Arousal
Life is Boring
Gambling
Sex
Stimulant Drugs
High-Risk Behaviors
Slide 26
Why Sexual Addiction?
Needs for Satiation
Life is Not Satisfying-Unhappy
Sex
Over-Eating (Bulimia-Bingeing)
Depressant Drugs (Marijuana)
Narcotic Drugs (Anesthetic effect)
Alcohol
Slide 27
Why Sexual Addiction?
Needs for Fantasy
Reality is too Hard: Need a Quick Escape
Voyeuristic Sex: Intelligent fantasy & Routine
Psychedelic Drugs: LSD
Marijuana
Mystic/Artistic
Preoccupation
Slide 28
The Addiction
(Modified from Patrick Carnes, Ph.D. & Steven Arterburn, M.S.)
Craving-tension-urge
to get
emotionally intimate with others
Mental-Emotional-Visual Triggers
Pain Repression with immediate
Sexual Longing
Fantasy Development-Planning
Begins (The Thrill begins)
The Hunt (The Intrigue)
Slide 29
The Addiction
(Modified from Patrick Carnes, Ph.D. & Steven Arterburn, M.S.)
The
Connection
– “Rush” Altered state of awareness
The Act
– Under-Control: Impulsivity: Binge
The
Fulfillment
– Orgasm: Feeling Dissociation
The Let-Down
– Self-Blame: Numbness
The Vow
– Over-Control: Compulsivity: Rigidity
The
Cycle Returns again (Deprivation Sets-In)
Slide 30
Specific Treatment Areas
(Copyright © Melvin Wong, Ph.D. 2000)
Ideational
(Mindset)
– Reduction of Intrusive Thoughts
Behavioral
– Reduce Masturbation & Acting-Outs
Relational
– Increase Male Non-Sexual Friendships
Spiritual
– Increase Pursuit of Holiness-Maturity
Slide 31
Healing Compulsions & Addictions
Interpersonal: Healthy-Bonds (Safe People)
– Experiential not only rational Non-sexual intimacy
– Spiritual: Paradigm shift: Enlightenment
Intrapersonal: Mourn loss, Spiritual renewal
– Rediscover goodness in self (false guilt)
– Rediscover meaning & significance (Help others)
An Element of “A Loving but Firm
Structure” (Live-In programs, 12 step groups)
Slide 32
Self-Help Group Resources
SA: Sexaholics Anonymous
www.sa.org (615)331-6230
SLAA: Sex Love Addicts Anonymous
EA: Emotions Anonymous
(510) 471-8864
CODA: CoDependents Anonymous
(415) 905-6331
www.ChristianMentalHealth.com
Slide 33
Getting Help
Sex and Love Addicts Anonymous (SLAA)
P O Box 119, New Town Branch, Boston MA 02258 617-332-1945
Sex Addicts Anonymous (SAA)
P O Box 3038 Minneapolis, MN 55403 612-339-0217
Sexual Compulsives Anonymous (SCA)
P O Box 1585, Old Chelsea Station, NY, NY 10011 212-439-1123
National Council on Sexual Addictions, Inc
P O Box 20249, Wickenberg, AZ
602-684-7919
Sexaholics Anonymous (SA)
P O Box 300 Simi Valley, CA 93062
805-581-3343
Slide 34
困扰者
的悲嘆
羅馬書 7:19-25
故此，我所願意的善，我反不做；我所不願意
的惡，我倒去做。若我去做所不願意做的，就
不是我做的，乃是住在我裏頭的罪做的。
我覺得有個律，就是我願意為善的時候，便有惡
神的律；但我覺得肢體中另有個律和我心中的律
交戰，把我擄去，叫我附從那肢體中犯罪的律。
我真是苦啊！誰能救我脫離這取死的身體呢？
感謝 神，
。這樣看來，我以內心順服 神的律，我肉體
卻順服罪的律了。
Slide 35
馬太福音 25:34-40
於是王要向那右邊的說 你們這蒙我父賜福的，
可來承受那創世以來為你們所預備的國；因為
我餓了，你們給我吃，渴了，你們給我喝；我
作客旅，你們留我住；我赤身露體，你們給我
穿；我病了、你們看顧我；我在監裏，你們來
看我。』義人就回答說：『主啊，我們甚麼時
候見你餓了，給你吃，渴了，給你喝？甚麼時
候見你作客旅，留你住，或是赤身露體，給你
穿？又甚麼時候見你病了，或是在監裏，來看
你呢？』
Slide 36
王要回答說：『我實在告訴你們
，
這些事你們既做在我這弟兄中一
個最小的身上，
就是做在我身上了。』
馬太福音 25:34-40