Ingxoxo ngu-Irving Bieber kunye noRobert Spitzer

NgoDisemba 15 1973 IBhodi yeTrasti yeAmerican Psychiatric Association, inikezela ngoxinzelelo oluqhubekayo lwamaqela abungqingili, yavuma utshintsho kwizikhokelo ezisemthethweni zokuphazamiseka kwengqondo. "Ubungqingili bolu hlobo," iitrasti ezivotayo, mazingasabonwa njengengxaki yengqondo; Endaweni yoko, kufuneka ichazwe njengolwenyusa imeko yokuziphatha ngokwesondo. 

URobert Spitzer, MD, unjingalwazi oncedisayo kunyango lwezifo zengqondo kwiYunivesithi yaseColumbia kunye nelungu lekomiti yokuchongwa kwamaphepha eAPA, kunye noIrving Bieber, MD, uprofesa wezonyango kwizifundo zengqondo kwiNew York College of Medicine kunye nosihlalo wekomiti yokufunda ngobufanasini besilisa, baxoxa ngesigqibo seAPA. Oku kulandelayo yinguqulelo efinyeziweyo yengxoxo yabo.

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Amanqaku aphambili engxoxo:

1) Ubungqingili ngokwesini nganye ayihambelani nenqobo yokuphazamiseka kwengqondo, kuba ayisihambelani noxinzelelo kunye nokuphazamiseka ngokubanzi ekusebenzeni kwentlalo, kodwa oku akuthethi ukuba ubufanasini buqhelekile kwaye bugcwele ngokupheleleyo njengobungqingili.

2) Bonke abantu abathandana besini esifanayo bahlakulele ukukhula okuqhelekileyo kobungqingili ngenxa yokoyika okuthintela ukukhula kwezesondo. Ukuthandana kwabantu besini esifanayo kuphatha i-DSM ngendlela efanayo ne-frigidity, kuba ukufrigidity kukwaphula nomsebenzi wezokwabelana ngesondo okubangelwa luloyiko. 

3) Ngokutsho kwenkcazo entsha, kuphela "i-egodystonic" abantu abathandana nabantu abathandana nabo abangonwabanga yimeko yabo abaya kufunyaniswa. Umda phakathi kweentlobo ezimbini zobufanasini, xa oyena mntu unesini esinobungqingili exelelwa ukuba usempilweni, kwaye oyena mntu ukhathazekileyo, ogcina amandla okubuyisela ubufanasini bakhe, uxelelwa ukuba uyagula-akukho ngqiqweni.

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UGqr Spitzer: Xa usondela kumbuzo wokuba ingaba ubufanasini kukugula ngengqondo okanye akunjalo, kufuneka sibe neendlela ezithile zokugula ngengqondo okanye ukungalunganga. Ngokwenqobo yam ecetywayo, imeko kufuneka ihlale iphazamisa ukuphazamiseka okanye inxulunyaniswe rhoqo nokonakala kwintsebenzo yoluntu okanye ukusebenza. Kucacile ukuba ubufanasini ngokwabo abuhlangabezani nezi mfuno: uninzi lwamafanasini lwanelisekile kukhetho lwazo ngokwesondo kwaye alubonakalisi nakuphi na ukwaphulwa ngokubanzi. 

Ukuba ubufanasini abuhlangabezani neenqobo zokuphazamiseka engqondweni, yintoni leyo? Ngokwenkcazo, sinokuthi le yindlela yokuziphatha ngokwesondo. Nangona kunjalo, ngokungaqwalaseli ubufanasini njengokuphazamiseka kwengqondo, asitsho ukuba kuyinto eqhelekileyo okanye ibalulekile njengobuni. Kuya kufuneka sivume ukuba kwimeko yamafanasini axhalabile okanye angoneliseki ziimvakalelo zobufanasini, sijongana nengxaki yengqondo, kuba kukho ukuphazamiseka okuzimeleyo apha. 

UGqr Bieber: Okokuqala, makhe sichaze amagama kwaye singasebenzisi "isifo" kunye "nokuphazamiseka" ngokungafaniyo. Ngokwengqiqo ethandwayo, ukugula ngengqondo kuthetha ukuphazamiseka kwengqondo. Andiqondi ukuba ubufanasini sisifo sengqondo ngaloo ndlela. Ngokumalunga namalungelo oluntu, ndixhasa ngokupheleleyo onke amalungelo oluntu kubantu abathandana besini esinye. Kungakhathaliseki ukuba ulungelelwaniso oluthile lwezesondo lufezekiswa njani kumntu omdala, ukuziphatha ngokwesondo phakathi kwabantu abadala abavumayo yinto yangasese. 

Owona mbuzo wethu uphambili yile: ngaba ubufanasini luhlobo oluqhelekileyo lwesini olukhula njengasekhohlo kwabanye abantu, okanye ngaba lumele uhlobo oluthile lokuphazamiseka kwezesondo? Andithandabuzi ukuba onke amadoda athandana namanye amadoda ahamba kwinqanaba lokuqala lokukhula kwabantu besini esahlukileyo kuqala, kwaye bonke abantu abathandana besisini esinye banokuphazamiseka kuphuhliso oluqhelekileyo ngokwesini esinye ngenxa yoloyiko olubangela uxinzelelo kunye nokuthintela ukukhula kwesondo. Ukuziqhelanisa nobufanasini kukutshintsha. 

Ndingathanda ukukunika isifaniso. Ngepoliyo, umntu ufumana inani lokuphendula okubuhlungu. Abanye abantwana bakhubazeke ngokupheleleyo kwaye abakwazi ukuhamba. Abanye banokuhamba nge-brace, kwaye abanye banemisipha eyaneleyo yokuhlaziya kunye nokuzimela. Kumntu omdala olifanasini, umsebenzi wesini esahlukileyo ukhubazeke ngendlela efanayo nomsebenzi wokuhamba kwixhoba lepoliyo. Isifaniso asifani, inye into yokuba umothuko ovela kwipoliyo awunakulungiseka.

Sibiza ntoni? Uya kuphikisana ukuba oku kuyinto eqhelekileyo? Ngaba umntu onemilenze ekhubazeke ipoliyo ngumntu oqhelekileyo, nangona ipoliyo ingasasebenzi? Uloyiko oludale ubungqingili kunye nokuthintela kwengqondo ngokungathandabuzekiyo lolunye uhlobo lokuchongwa kwengqondo. 

UGqr Spitzer: Kubonakala ngathi ngelixa uGqirha Bieber engabuthathi ubufanasini njengesigulo sengqondo, angathanda ukuluhlula kwindawo ethile phakathi. Ukuba kunjalo, kutheni engonwabanga sesi sigqibo? Ayitsho ukuba ubufanasini buqhelekile. Ithi kuphela ukuba ubufanasini abuhlangabezani neendlela zokugula ngengqondo okanye ukuphazamiseka. Kodwa ngaphambi kokuba uGqirha Bieber awuphendule lo mbuzo, ndifuna ukubonisa ukuba uninzi lolwimi alusebenzisayo (amafanasini onzakele, onzakele) zezona nkcazo zichazwa ngoku ngabantu abathandana besisini esinye. Amafanasini anyanzelisa ukuba akasafuni kuzibona ngale ndlela.

Isizathu sokuba esi sindululo samkelwe ngokungagungqiyo ziikomishini ezintathu ze-APA kwaye, ekugqibeleni, yiBhodi yeTrasti ayisiyiyo yokuba i-APA yathinjelwa ngabavukeli basendle okanye abantu abathandana abatshatileyo. Sivakalelwa kukuba kufuneka sihambisane namaxesha. I-Psychiatry, eyayikhe yathathelwa ingqalelo njenge -wayard yentshukumo yokukhulula abantu kwiingxaki zabo, ngoku ithathelwa ingqalelo ngabaninzi, kunye nokuzithethelela, njengearhente yolawulo lwentlalo. Ke ngoko, isengqiqweni into yokuba ndingazibeki nakuphazamiseka kwengqondo kwabo bantu banelisekileyo kwaye bangangqubani nendlela yabo yokuziphatha ngokwesondo.

UGqr Bieber: Khange nditsho ukuba ubufanasini kukugula ngengqondo. Ngaphezulu, iNcwadi yokuNxibelelanisa yeDSM yeeNgozi yeNgqondo ikwaneminye imibandela engangqubani nenkcazo kaGqr Spitzer, endingayithathiyo njengengxaki zengqondo, ezinje nge-voyeurism kunye ne-fetishism. 

UGqr Spitzer: Andikhange ndihlawule nganto ingako njengoGqirha Bieber kwimiba ye-voyeurism kunye ne-fetishism, mhlawumbi ngenxa yokuba i-voyeurs kunye ne-fetishists abakadibani kwaye basinyanzela ukuba senze njalo. Kodwa kuyinyani ukuba kukho ezinye iimeko, kwaye kunokwenzeka ukuba zibandakanya i-voyeurism kunye ne-fetishism engazifezekisiyo iikhrayitheriya zokuphazamiseka kwengqondo. Ndingakuxhasa kwakhona ukuhlaziywa kwala mazwe ngokunjalo. 

Ndingathanda ukukubuza: ungakuxhasa ukongezwa kwesimo sokusebenza ngokugqibeleleyo okanye ukungatshati kwi-DSM?

UGqr Bieber: Ukuba umntu akanabudlelwane obuphathelele kwezesondo, ngaphandle kwamalungu obuchule obuthile, njengabefundisi, ifuneka phi le nto? Ewe, bendiyaxhasa. 

UGqr Spitzer: Ngoku, uyabona, oku kubonisa ngokuchanekileyo ukuntsokotha kombuzo wethu. Zimbini izinto ekuthethwa ngazo kwimeko yengqondo. Kukho abo, njengam, bakholelwa ukuba kufanele ukuba kukho umda osondeleyo kufutshane nemodeli yezonyango, kwaye kukho abo bakholelwa ukuba nayiphi na indlela yokuziphatha engahambelani nawo nawuphi na umgangatho oqhelekileyo wokuziphatha - ukuthandabuza, ubuhlanga, chauvinism, imifuno , ubukho be-xxue-kufuneka kongezwe kubizo. 

Ngokususa ubufanasini kwi-nomenclature, asitsho ukuba yinto engaqhelekanga, kodwa nathi asitsho ukuba yinto eqhelekileyo. Ndikwakholelwa ukuba "okuqhelekileyo" kunye "nokungaqhelekanga" akusiyo, ngokungqongqo, amagama engqondo.

UGqr Bieber: Ngoku lo ngumcimbi weenkcazo.

UGqr Spitzer: Ewe, ngokuchanekileyo. Kukubamba oku.

UGqr Bieber: Ndithetha njengenzululwazi. Ndicinga ukuba ndiyicacisile into yokuba, njengomxhasi wamalungelo oluntu, ndiye phambili kumlo wokulwela amalungelo abantu abathandana abathandanayo. Nangona kunjalo, le yingxaki eyahlukileyo ngokupheleleyo. Singoogqirha bengqondo. Ngokuyintloko ndingusosayensi. Okokuqala, andithandabuzi ukuba wenza impazamo enzulu yesayensi. Okwesibini, ndinomdla kwiziphumo ezinazo ebantwaneni, nakuwo wonke umba wokuthintela. Ndingalichonga lonke iqela lomngcipheko wobungqingili bamadoda eneminyaka emihlanu, emithandathu, isixhenxe, iminyaka esibhozo. Ukuba uncedo lonyango lubonelelwe kwaba bantwana, kunye nabazali babo, abayi kuba ngabungqingili. 

UGqr Spitzer: Ewe, okokuqala, xa sithetha ngokunceda, ndicinga ukuba ayikhathaleli ukungavumi ukuba inani labantu abathandana nabantu abatshatileyo abafuna uncedo lincinci. Ingxaki yokwenyani kukuba inani labagula ngengqondo abanokubanceda aba bantu lincinci. Kwaye ikhosi yonyango inde kakhulu. 

UGqr Bieber: Ayinamsebenzi. 

UGqr Spitzer: Hayi, ibalulekile. 

UGqr Bieber: Ngaba ucinga ukuba ubugqwirha kufuneka bube kwi-DSM? 

UGqr Spitzer: Ndingathi xa luphawu lokubandezeleka, ewe ewe. 

UGqr Bieber: Oko kukuthi, ukuba umfazi uyabanda, kodwa angakhathazeki yile nto, ke ... 

UGqr Spitzer: Akanangxaki yengqondo. 

UGqr Bieber: Ke ngoko wobume benomdla wokungenisa ucalucalulo olubini? Konke okuseleyo kukungunda, okubangela uxinzelelo, akunjalo? 

UGqr Spitzer: Hayi, andiqinisekanga ukuba kunjalo. Ndicinga ukuba ukhona umahluko. Ngobushushu, umsebenzi womzimba ngokungathandabuzekiyo kwenzeka ngokungabikho komsebenzi owenzelwe wona. Oku kwahlukile kubufanasini. 

UGqr Bieber: Inqaku lam yile: kwi-DSM yangoku, kukho iimeko ezingachananga ngokungahambi kakuhle kwengqondo. Andiqwalaseli ubungqingili njengesigulo sengqondo okanye ukuphazamiseka kwengqondo kule meko. Nangona kunjalo, ndiyithatha njengomonakalo ekusebenzeni ngokwesondo, okubangelwa luloyiko lwengqondo. Ukuthandana kwabantu besini esifanayo kuphatha i-DSM ngendlela efanayo ne-frigidity, kuba frigidity nayo ngumonakalo ekusebenzeni ngokwesondo okubangelwa luloyiko. 

Umhleli: Nguwuphi umahluko phakathi kobufanasini njengokugula ngengqondo kwi-DSM okanye akunjalo? 

UGqr Spitzer: Oku, kunjalo, kunempembelelo yokwenyani yokuziqhelanisa nomsebenzi wengqondo. Ndicinga ukuba akukho mathandabuzo ukuba kwakunzima kubantu abaninzi abagula ngengqondo ukuphatha abantu abathandana nabantu abatshatileyo abafuna uncedo kwiimeko ezizezinye ngaphandle kobungqingili babo.

Ndikhumbula indlela umntu ongumfanasini weza kum kwiminyaka embalwa eyadlulayo, owaxinezeleka emva kokuqhawula isithandwa sakhe. Uye wayenza yacaca kum ukuba akafuni buchaphazeleka ubufanasini bakhe. Ndamxelela ukuba andikwazi ukujongana nenxalenye yemeko yakhe, kuba ndikholelwa ukuba iingxaki zakhe zinxulunyaniswa nobungqingili bakhe. 

Ndicinga ukuba abantu abaninzi abangamafanasini bakhetha ukungalufuni uncedo lwengqondo ngenxa yokoyika ukuba ubufanasini babo buza kuhlaselwa. Olu tshintsho luzakwenza lula unyango lwabantu abathandana nabantu abatshatileyo xa befuna unyango, kodwa bangafuni ukuba abantu abathandana nabo baphazamiseke. 

UGqr Bieber: Ndicacisa isigulana ukuba siya kuba yindoda okanye amafanasini, kwaye into eyenzayo ngobomi besondo sisigqibo sayo. Umsebenzi wam ndimncedise ukusombulula iingxaki zakhe ezininzi kangangoko kunokwenzeka. Ke, kwakhona, kuya kufuneka senze umgca phakathi kwendlela yesayensi kunye neenjongo zokusebenzisa, nokuba zezentlalo, ezopolitiko okanye ukutsala ezinye izigulana. 

UGqr Spitzer: Ndingathanda ukucaphula uFreud, owathi ngo-1935, ephendula ileta evela kumama abathandana nabantu besini esinye, wathi oku kulandelayo: “Ndayiqonda kule leta yakho ukuba unyana wakho ulifanasini. Ukuthandana kwabantu besini esinye ngaphandle kwamathandabuzo ayisiyo inzuzo, kodwa kungenasizathu sokuphoxeka, okanye ububi okanye ukonakaliswa. Ayinakwahlulwa njengesifo. Sikholelwa ukuba olu luvo lokungafani ngokwesondo olubangelwa kukuma okuthile kuphuhliso lwesini. " Kungaziphi izizathu ongavumelani noluvo lukaFreud lokuba ubufanasini ayisosifo? Okanye ngoku uthi awusithathi njengesi sifo? 

UGqr Bieber: Zange nditsho ukuba sisifo. Makhe ndikunike inkcazo yokusebenza: abantu abathandana nabantu besini esinye bayaphindaphinda okanye bakhethe indlela yokuziphatha ngokwesondo phakathi kwamalungu esini esifanayo, eqhutywa luloyiko. 

UGqr Spitzer: Ndicinga ukuba abantu abaninzi emsebenzini wethu baya kuvuma ukuba amagama kaGqirha Bieber angabhekiselela kubantu abathile abathandana nabantu abathandana nabo. Kodwa sikufumanisa kunzima ukukholelwa ukuba oku kuyasebenza kubo bonke abantu abathandana besini esinye - ngoku okanye kwezinye inkcubeko, njengeGrisi yakudala, ekwakukho kuyo ubufanasini.

UGqr Bieber: Ndibeka ibango lobuchwephesha kumava kuphela kwisimo senkcubeko yanamhlanje. Yonke into endiyithethayo isebenza kuphela kwinkcubeko yethu yangoku. Ndingakuxelela inani lenkcubeko apho ubufanasini bungabikho konke konke. Umzekelo, kwi-kibbutzim kwa-Israel phantse ukuba ayikho ngokupheleleyo. 

UGqr Spitzer: Le ngxoxo kufanele ukuba ibimalunga nokuba ubufanasini sisifo. 

UGqr Bieber: Asinguye. 

UGqr Spitzer: UGqr Bieber ufuna ukuchaza ubufanasini. I-APA iyavumelana naye ukuba esi ayisosifo, kodwa ayisixeleli. 

UGqr Bieber: APA akavumelani nam. Ukusuka ekuphindweni ngokutsha kwe-APA, kulandela ukuba ubufanasini yinto eqhelekileyo, efanayo nobungqingili. Ndithetha ukuba ubufanasini yinto eyonakalisayo engqondweni, kwaye indawo yayo kwisikhokelo ngasinye kwezengqondo. Oku akuthethi ukuba ndibona ubungqingili njengesifo ngaphezu kokuba ndicinga ukuba sisifo. Kodwa ngelixa into efana ne-frigidity iyakukukhokela phakathi kokuphazamiseka ekusebenzeni ngokwesondo, ubufanasini kufuneka nabo babekhona. Kwaye ukwahlula phakathi kwezi ntlobo zimbini-ukuthatha oyena mntu ulimele kakhulu, kwaye uthi makangabikho kwi-DSM, kodwa omncinci owenzakeleyo, oye wagcina ithuba lokubuyisa ubungqingili bakhe, ukufumanisa isifo sokuziphatha ngokwesini - kubonakala ngathi kulungile kum. 

UGqr Spitzer: Kubonakala kukubi kuwe, kuba ngokwenkqubo yakho yeenqobo, wonke umntu ufanele ukuba abe ngokwahlukileyo kuye.

UGqr Bieber: Ngaba ucinga ukuba le "yinkqubo yexabiso"? Ngaba ndicinga ukuba onke amafanasini namhlanje afanele abe ngabantu besini esahlukileyo? Akunjalongo noko. Maninzi amafanasini, mhlawumbi isibini esithathwini kubo, abo bathandana besini esahlukileyo ayiseyiyo inketho.

UGqr Spitzer: Kodwa ngaba kufuneka baphile nemvakalelo yokuba ubungqingili babo bonakalisiwe okanye bunesiphoso?

UGqr Bieber: Ukuba bafuna ukuchaneka, bona ngokwabo baya kubona ukuba ubungqingili babo bungathandabuzekiyo.

UGqr Spitzer: Ukonzakala sele kukufanele.

UGqr Bieber: Ukulimala akulona ixabiso. Umlenze ophukileyo awuyixabiso.

UGqr Spitzer: Andinakusebenza ngokwesini, kodwa andiyi kuthatha njengokulimala. Uya kwenjenjalo.

UGqr Bieber: Le ayisiyonjongo.

UGqr Spitzer: Ndicinga ukuba kunjalo. Ngokweembono ze-psychoanalytic, siza kweli lizwe sinobuthathaka bezesondo.

UGqr Bieber: Andiyamkeli le nto.

UGqr Spitzer: Ubukumkani bezilwanyana babonisa ukuba sizalwe ngokwenyani nangokwesini. Ngenxa yamava, nangona ezinye izinto zemfuzo nazo zinokudlala indima, uninzi lwethu lubungqingili, kwaye abanye baba ngamafanasini.

UGqr Bieber: Ndiyamangaliswa kukuba wena, njengesazi sebhayoloji ungatsho njalo. Isilwanyana ngasinye, isilwanyana ngasinye, esizalwayo kuxhomekeka emtshatweni wesini esahlukileyo, sineendlela zemvelo eziqinisekisa ubungqingili.

UGqr Spitzer: Nangona kunjalo, amandla okuphendula kwabantu abathandana nabo abungqingili kwindalo iphela kubukumkani bezilwanyana.

UGqr Bieber: Kuya kufuneka uchaze "impendulo yobufanasini." Kodwa ngaphambi kokuba siqhubeke, sinokuvuma sobabini ukuba ubufanasini ayisosifo sengqondo.

Umhleli: Yintoni ke ongavumelani nayo?

UGqr Spitzer: Ewe, asivumelani malunga nendlela ubufanasini ekufuneka bohlulwe ngayo, kwaye kuya kufuneka ndivume ukuba kulula kum ukuba manditsho ukuba ayifanele ukuba yahlulwe njani njengoko kufanelekile. Andiqwalaseli ubungqingili njengeyona nto ifanelekileyo njengokukhula kobungqingili. Ndiyavumelana noFreud ukuba kukho into eyenzekayo ekuphuhliseni inkanuko yesini ekhokelela kukungakwazi ukusebenza okanye ukungathandani ekusebenzeni kwabantu abathandanayo. Nangona kunjalo, andifuni ukusebenzisa igama elithi "ukuphazamiseka" ngenxa yeziphumo ezininzi ezibandakanyekayo.

Umhleli: Makhe ndibuze umbuzo omnye wokugqibela: Wahlula njani phakathi "kwesiphithiphithi" kunye "nokuphazamiseka kwezesondo"?

UGqr Spitzer: Andicaluli. Uluhlu oluthi “Ingxaki Yokuziqhelanisa Nesondo” lwaphuhliswa ukulungiselela amafanasini angquzulana nobufanasini bawo. Abanye babo banokucela uncedo. Bambi basenokufuna ukuba neentlobano zesini esahlukileyo, abanye basenokufuna ukufunda ukuphila nobufanasini babo baze bahlukane nokuziva benetyala.

UGqr Bieber: Ukuba umsebenzi wobungqingili abalingani awunakubuyiselwa, andifuni ukuba acinge ukuba unetyala ngobufanasini bakhe. Ndifuna ukuba onwabe.

umthombo: The New York Times, Disemba 23, 1973

Ukongeza:

Imbali yokukhutshelwa ngaphandle kwamafanasini kuluhlu lweengxaki zengqondo