Ukwelashwa kobungqingili ngaphambi kwenkathi yokulungiswa kwezombusazwe

Amacala amaningi okuphumelela kokulungiswa okwelashwa kokuziphatha kobungqingili nokuheha kuchazwa ngokuningiliziwe ezincwadini zobungcweti. Bika I-National Association for the Study and Therapy ofungqingili iveza ukubukelwa kobufakazi obuqandayo, imibiko yomtholampilo kanye nocwaningo kusukela ngasekupheleni kwekhulu le-19 kuze kube manje, okufakazela ngokuqiniseka ukuthi amadoda nabesifazane abanentshisekelo bangalwenza lolu shintsho kusuka ebungqingili kuya kobungqingili. Ngaphambi kwenkathi yokunemba kwezombusazwe, kwakuyiqiniso elaziwayo lesayensi, okuyinto ngokukhululeka Ubhale umshini omkhulu wezindaba. Ngisho ne-American Psychiatric Association, ngaphandle kobungqingili be-syntonic kuhlu lokuphazamiseka kwengqondo e-1974, kuphawuliwe, lokho "Izindlela zokwelapha zesimanje zivumela ingxenye enkulu yabongqingili abafuna ukuguqula isimo sabo ukwenza kanjalo".

Okulandelayo ukuhumusha izindatshana kusuka eNew York Times ye1971.

Abongqingili abangaphezulu bakwazile ukuba nobungqingili

"Ungumuntu odabukisayo futhi odabukisayo"Kusho uHarold ku-Orchestra kaMartha Crowley. - "Ungungqingili, awufuni ukuba yibona, kepha akukho ongakwenza ukuze ushintshe".

Inkolelo esabalele yokuthi, njengoba eba ngongqingili, umuntu uhlala kuze kube phakade, ekhonjiswe kwidrama kaMnu Crowley, njalo iphikisana nabachwepheshe ezweni lonke. Besebenzisa izindlela eziningi zengqondo, abelaphi bathole ukuthi abongqingili abasebancane abazimisele ukuguqula isimo sabo sobulili banamathuba amahle kakhulu empumelelo. Ngaphezu kwalokho, abelaphi babika ukuthi basize i-25 - i-50% yeziguli zabo zobungqingili zenza ukulungiswa kobungqingili, kungakhathalekile ngeminyaka yabo noma ugqozi lokuqala.

Ngenkathi iningi labantu abathandana nabobungqingili abanasidingo sokwelashwa kwengqondo, futhi iningi lalabo abafuna ukwelashwa abafuni ukuba ngabobulili obuhlukile, abelaphi babika inani elikhulayo lamadoda angongqingili anelisekile afuna ukuguqula isimo sabo sobulili noma, okungenani, bazivumelanise kangcono nalo.

Ngokuphilayo

"Ngokushesha nje lapho kwaziwa ukuthi sibaphatha ngobungqingili ngempumelelo ethile, sithengiswa nezicelo zosizo," - kuphawule omunye udokotela wezengqondo waseNew York obhala okuningi ngalesi sihloko.

UDkt. William Masters noVirginia Johnson, abasebenza ngocwaningo lwezocansi nezokwelapha eSt. Louis imiphumela yabo yokusebenza nabantu abathandana nobungqingili ingakashicilelwa, babika inani elikhulayo leziguli zobungqingili ezibhekiswa kubo njengoba izindaba zomsebenzi wabo zisakazeka kubo imibuthano yobungcweti.

Izindlela zokwelashwa zibanga ukusuka kwindabuko yendlela yendabuko yengqondo eya ekuqondisweni kwengqondo okubhekiswe kuyo, ukwelashwa kweqembu, ukwelashwa kokuziphatha, kanye nanoma yikuphi ukuhlanganiswa ngakho. Ukungenelela kwamakhemikhali akuzange kube nemiphumela, njengoba ucwaningo luye lwabonisa ukuthi ongqingili abesilisa abavamile ngokwemvelo.

Odokotela bathi izindlela zabo zisebenza ngokufanayo kubo bobabili abesilisa nabesifazane. Kodwa-ke, baveza ukuthi abantu abathandana nabesilisa abathandana nabesilisa abayitoho abafane bafune ukwelashwa, futhi noma bekwenza, ngokuvamile abanasifiso sokushintsha isimo sabo sobulili.

Abesilisa abathandana nobungqingili abafuna ukuba ngabobungqingili bavame ukuphendukela ekwelashweni ngenxa yenkinga ehlobene ngqo nobungqingili babo, ngokwesibonelo, ukwephula ubuhlobo bokuthandana, ukudumala ngendlela yokuphila yobungqingili, ukwesaba ukudalulwa nokulahlekelwa umsebenzi, ukwesaba ukuguga nokungadingeki kunoma ngubani, noma ukufisa ukuqala umndeni .

Odokotela abaphatha ubungqingili bakholelwa ukuthi iningi lalabo abangathanda futhi bangahlomula ekwelashweni abaphendukeli kulo ngenxa yokuphelelwa yithemba okujulile maqondana nokuthi kungenzeka ukuthi kube noshintsho olukhona zombili emphakathini nakwezokuqwashisa ngolwazi.

I-Pessimism yaqala ukunyamalala eminyakeni engu-8 edlule ngokushicilelwa kocwaningo olwenziwe yiqembu lezazi zengqondo elibike ukuthi i-27% yeziguli zobungqingili ze-106 eziqhutshwa yongqondongqondo yaba ngabodwa abathandanayo. Iqembu labacwaningi eliholwa uDkt Irving Bieber waseNew York College of Medicine libabize kanjalo "Imiphumela emihle kakhulu nethembisayo kuze kube manje".

Izazi zengqondo ezibheka umgomo oyinhloko wokwelapha ukuqeda ubungqingili besaba ukuthi zingashada nabobulili obuhlukile, zithole ukuthi ukuguqulwa kobungqingili kungenzeka kungenzeka ngemuva kwamahora we-350 wokwelashwa (iminyaka emithathu noma ngaphezulu). Kulabo abake baphathwa ngale ndlela, cishe isigamu sesifinyelele ngokuphelele kulokho okungafani nabobulili obuhlukile.

Shintsha Ukuziphatha

Isazi sezengqondo saseNew York Hospital uLawrence Hatterer uthe ngokuhlanganisa indlela ye-psychoanalytic esebenzisa ezinye izindlela ezintsha zokwelapha zokuguqula izindlela zokuziphatha, "angakwazi ukufeza ezinhlelweni ze-50 ezitholakala ngokusebenza kwengqondo okujwayelekile kumaseshini e-350."

Encwadini yakhe esanda kushicilelwa, ethi The Change in Ubungqingili kuMadoda, uDkt Hatterer ubhala umsebenzi wakhe kule minyaka edlule ye-15 neziguli ezingongqingili ezingaphezu kwe-200, okwesithathu kuzo ezenze ushintsho olungafani nobungqingili.

Njengabahlaziyi be-psychoanalysts, uDkt. Hatterer uzama ukusiza iziguli zakhe ukuthi ziqonde umsuka wokuziphatha kwazo kobungqingili ngokuhlola ubudlelwane bomndeni kanye nokuhlangenwe nakho kobuntwana. Ngasikhathi sinye, uzama ukuguqula indlela yokuziphatha kwabantu bobulili obufanayo ngokusebenzisana neziguli zakhe ukukhomba nokugwema izici zempilo ezivusa iziqephu zobungqingili futhi esikhundleni sazo zithathe ubungqingili bobudlelwano bobulili obuhlukile. Isibonelo, angahle asikisele esigulini ukuthi senqabe ukuya ezindaweni zobungqingili futhi baye endaweni evamile kunalokho, noma bashintshe izithombe zocansi zobungqingili nezithombe zabesilisa ngezithombe zabesifazane.

UDkt Hatterer usebenzisa futhi amarekhodi agcinwe eziguli zokwelapha ezifanele alalelwayo neziguli ekhaya lapho ezizwa enesifiso sokubuyela ezenzweni zocansi azama ukuzigwema.

Udokotela wathi esinye isiguli esineminyaka engu-30 senza ukulungiswa ngokuphelele kobungqingili ezinyangeni ezintathu zokwelashwa. Lo wesilisa ngaphandle kokuhlangenwe nakho okuncane kakhulu wobuntu waqala ukwelashwa esondele ukuzibulala, wahlukana nale ndoda ahlala nayo iminyaka emibili. "Ngemuva kwamaminithi we-45 ayisishiyagalolunye kuphela kanye ne-27 elalele okurekhodiwe, lo mlisa ubethandana futhi egcina ubudlelwano bempilo yocansi nomakoti wakhe ngempumelelo kaningana ngevikiyebo, ”kusho uDkt. Hatterer.

UDkt Hatterer, uDkt Bieber, nabanye abaye baphatha ongqingili abaningi, bachaza lezi zici ezilandelayo zeziguli ezithanda ukulungiswa kobungqingili.

• Inhloso yokuba yindoda nobungqingili.

• Isingeniso sekwephuze ubungqingili (ukuya esikhathini noma ukuguga).

• Ukuqala kokwelashwa ngaphambi kweminyaka ye-35.

• Noma iyiphi inzalo noma isipiliyoni esingafani nobungqingili esikhathini esidlule.

• Ukuzwela abesifazane, okungenani ezingeni lomphakathi.

• Umsebenzi nendlela yokuphila ayiphethwe ukuhlangana kwabantu bobungqingili njalo.

Kodwa-ke, kusho uDkt Hatter, ezinye iziguli ezinalezi zimpawu ezimbalwa, noma ezingekho nhlobo, ziye zazuza kakhulu ekwelashweni. Isici esibaluleke kakhulu sokwelashwa ukwazisa isiguli ukuthi kunethuba lokusiza inkinga yakhe ngandlela thile.

UDkt. Samuel Hadden, udokotela wezifo zengqondo ovela ePhiladelphia, 15 eminyakeni edlule, wasiza ekwakheni indlela yokuqapha iqembu kabusha ukwenza labo abathandana nabobungqingili, akulahla “ukunganiki themba,” athi "kunengqondo ezingqondweni zabaningi bezengqondo."

UDkt Hadden unomuzwa wokuthi unesizathu sokuthemba. Esebenzisana namaqembu amadoda angungqingili, wakuthola lokho "Cishe ingxenye eyodwa kwezintathu yalabo abaphikelelayo ekwelashweni (imvamisa iminyaka eminingana) bahlangabezana nezimo ezisebenzayo zobungqingili"kanti enye yesithathu ivumelana kangcono nobungqingili babo.

Ngokusho kwakhe, indlela yeqembu inika iziguli umuzwa wokwamukela futhi isheshise ama-catharsis, njengoba amalungu eqembu evame ukuba nokuhlangenwe nakho okufanayo. Ilungu ngalinye leqembu, elilwela ukuphumelela, lisekela futhi liqinise impumelelo yamanye amalungu, futhi, ilungu ngalinye eliphumelelayo linikeza ubufakazi obuphilayo kwabanye bokuthi ukuphinda kuvuseleleke ngokocansi kungatholakala.

Ukwelashwa kweqembu lendlela ye-psychoanalytic kuyinqubo ende, odokotela abaningi bakholelwa ukuthi uma izinkulungwane eziningi zabongqingili abangazuza ekwelashweni bake bafune usizo, kuyodingeka indlela esheshayo.

Ukuhlaselwa izindlela ezintathu

E-University of Temple Institute of Behavioral Therapy, uDkt Joseph Walp nozakwabo bazama ukuphatha kuphela abathandana nobungqingili ngokuguqula indlela abasabela ngayo besebenzisa izindlela zokuziphatha.

"Ukuhlaselwa kwabo kathathu" kuthinta ukwesaba kobungqingili bokuxhumana nomuntu wesifazane, ukuheha kwakhe amadoda nokwesaba kwakhe okuphakathi kwabantu. Isibonelo, ukuze kususwe ukwesaba ngabesifazane, isiguli singena esimweni sokuphumula okujulile, bese sazisa abesifazane. Ukusula intshisekelo yabo yezocansi emadodeni, iziguli nazo zivulelwa izingcindezi “eziphikisayo” ezinjengokushaqeka kukagesi okuncane ngenkathi zibonisa izithombe zamadoda enqunu.

Njengoba le ndlela ehlanganisiwe yokuziphatha iba yintsha, uDkt Walp uthi akaqoqanga amacala anele ukuqhathanisa imiphumela noma ukuhlola ukusebenza kwabo kwesikhathi eside. Noma ngabe kunjani, "umbono" wakhe ukuthi "cishe nge-75%" yeziguli ziba nobungqingili ngemuva kwezinyanga eziyisithupha zokwelashwa.

Abanye abelaphi bakholelwa ukuthi abanye abathandana nobungqingili bangenza ubungqingili ngaphandle kokusebenzisa usizo lochwepheshe - ngokuqina, ngokujula ngokwenkolo, noma ngokwenziwa kohlelo olusha lwefilosofi. Kodwa-ke, kubantu abaningi abathandana nobungqingili abafuna ukushintsha indlela yabo yokuphila kodwa bangakwazi ukukwenza ngokwabo, ukwelashwa kungabiza, kudla isikhathi futhi kunzima ukukuthola.

Iqembu lokutadisha ubungqingili eNational Institute of Mental Health muva nje lifune "imizamo eyengeziwe yokuthuthukisa izindlela zokwelapha ezintsha futhi kwandiswe ukusebenza ngempumelelo kwezinqubo zokwelapha."

"Noma kungenakucatshangelwa ukuthi ingxenye enkulu yabantu abathandana nobungqingili iguqukela ekwelashweni," - uthi ithimba locwaningo, - “Siyethemba futhi silindele ukuthi njengoba izindlela zokwelapha zithuthuka futhi zinwebeka, abantu abaningi ngokwengeziwe bazofuna usizo.”

Ukuphawula lokho "Izazi zezengqondo ze5000 zizodingeka ukusiza bonke ongqingili abanentshisekelo"UDkt. Hatterer uhlongoza ukusungulwa “kwemitholampilo yezengqondo” nabasebenzi abayingcweti. Ngenkathi uhla lwabantu abathandana nabobungqingili luphindela, ucabanga ukuthuthuka kwamaqembu athi “Ongaziwa... Asebekiwe kumgomo wokuzisiza, ozokwenzela abobungqingili lokho okwenziwe ngabangabazi notshwala abangaziwa.

I-New York Times, uFebhu. I-28, 1971

Uhulumeni, nokho ezinye izinhlelo ngale ndaba. E-1969, enkulumweni yakhe neCongress, uMongameli Nixon, ukubiza ukwanda kwesibalo sabantu "Enye yezinkinga ezinkulu kakhulu ikusasa lesintu", ebizelwa izindlela zokuphuthumayo zokulawula ukuzala. Iningi lososayensi lihlongoze ukwenziwa kwezomthetho futhi ukukhuthaza ubungqingili njengenye yezindlela zokunciphisa inani lokuzalwa, futhi ku-1974, yathunyelwa ezweni. Kusukela lapho, njengoba uMongameli wangaphambili we-APA uNicholas Cummings efakaza, "Ukuhamba kwamalungelo wobungqingili be-APA kulawulwa ngokuqondile kwezepolitiki, hhayi isayensi". UDkt Cummings futhi kubikiwelokho ngeminyaka ye-1959 - 1979. Izitabane ze-18 000 zaphendukela emtholampilo zinezinkinga ezahlukahlukene, zazo cishe i-1 600 okuhlose ngazo ukuguqula isimo sabo sobulili. Ngesikhathi sokwelashwa, abaningi babe nezinguquko ezinhle ku-psyche yabo, ngenxa yalokho iziguli ze-2 400 ziye zaba ngabodwa.

¹ Ezinkulumweni ze-LGBT ezihlose ukwehlisa isithunzi i-psychotherapy yokuguqula, umuntu angahlala ezwa izindaba ezihlasimulisayo zokuthi ongqingili abaneshwa babehlukunyezwa kanjani ngogesi cishe esihlalweni sikagesi. Amanga aluhlaza la aklanyelwe ukwesabisa nokuqeda amandla ongqingili abaqala ukufuna izindlela zokuqeda ukukhangwa ngabobulili obufanayo, okubavimbela ukuthi baphile impilo egculisayo (futhi baningi babo). La manga angabulala: cishe bonke ababengongqingili babika ukuthi imicabango yabo yokuzibulala ayivelanga kubutha bemvelo, kepha ivela ekuzondeni kwabo kanye nasemizweni yabo. ukuphelelwa yithembangoba babeqinisekile ukuthi abanandlela yokushintsha.

Kwenzekani ngempela? Ekusebenzeni kwengqondo, kunezinhlobo ezimbili zokwelapha lapho kusetshenziswa khona i-electroshock: electroconvulsive и ophikisayo... Ekwelashweni kwe-electroconvulsive, umphumela wokwelashwa utholakala ngokudlulisa amandla kagesi anamandla kagesi I-70 - i-460 volts ngokusebenzisa ubuchopho besiguli amasekhondi angu-0.1 kuye kwayi-1. Njengamanje, cishe iziguli eziyi-1 ngonyaka ziphendukela ku electroconvulsive ukwelashwa kokwelashwa kwezifo ezahlukahlukene zengqondo nezemithambo yegazi, imvamisa ukucindezeleka okukhulu, i-catatonia ne-manic syndrome. Le ndlela, ehambisana nemiphumela engemihle yokuqonda, ayikaze isetshenziswe ngokusemthethweni ukwelapha ubungqingili.

ukwelashwa kobungqingili — Ukwelashwa okuningana (i-electrode kuma-shins)

Ukwelashwa okugudlukayo, ngokuya ngesimo sePavlov sakudala, kusingathwa nokwakhiwa kokuphikisana nezimo ezingafuneki ezingeni lesimo se-reflex. Le ndlela isetshenziselwa ukususa ngokuzithandela imilutha (kusuka ekugembuleni kuye ekusebenziseni izidakamizwa), i-phobias, ulaka, ukungasebenzi kahle kwezocansi kanye nokubhala i-spasm. Lokhu kutholakala ngokuhlanganisa isisusa esingafuneki (ugwayi, iphupho lezocansi, izithombe zocansi, njll.) Nemizwa engathandeki (ubuhlungu, isicanucanu, ukwesaba, njll.). Ukusetshenziswa kukagesi ukudala imizwa engathandeki ekwelashweni okuphindayo kubeke kakhulu ukusetshenziswa kwezidakamizwa zamakhemikhali ngoba kulula, kunembile ukusetshenziswa, futhi akunayo imiphumela emibi. Kukhiqizwa i-Electroshock izinto zokusebenzaisebenza ngebhethri le-9-volt, lapho isiguli uqobo sisungula khona isilinganiso sokukhulula esibekezelelekayo kuye, esihamba ngama-cuffs engalweni noma emlenzeni ophansi. Le ndlela yayisetshenziswa ngemvume yeziguli ukususa izifiso ezingathandeki zobungqingili. Eduze kweminyaka ye-70, izindlela zokuziphatha zokuziphatha zathola ukuthandwa okubanzi, futhi kwathengiswa izibhamu ezinkulu ze-ngisho nokusetshenziswa kwasekhaya njengendlela yokuqinisa amaphethini okuziphatha afiselekayo nokususa abangafuneki.

ukushaqeka kukagesi — Incazelo yamathuluzi we-electroshock therapy aversive ekhaya

Okubi kwendlela

Ukwelashwa okuguqukayo kubhekisa ekwelashweni kokuziphatha, okuthi, njengoba igama lalo kusikisela, asebenze ngalo kuphela isimilo - i.e. Izimpawu zangaphandle zenkinga. Ngakho-ke, ekuxazululeni izinkinga ngokusekelwe ezicini ezingokwengqondo ezingaphansi kwengqondo (njengobungqingili), ukusebenza kwawo akunakwenzeka ukuthi kuthathe isikhathi eside, ngoba umsebenzi awuhloselwe ukuqeda imbangela eyisisekelo, kepha ngokucindezela ukubonakaliswa kwayo okubonakalayo. Izikhaliphazi ezinemibandela zivela ngaphansi kwezimo ezithile futhi zinyamalale lapho zingekho. Ngakho-ke, ukuze kulondolozwe isimo sokuphambuka njalo esimweni sokuvuselela okuthile, ukuqiniswa kwangaphambilini kwalokhu kuyadingeka. Uma kungekho ukuqiniswa okuhleliwe, ukuqothulwa kwesimo se-Reflex kungabikezelwa. Ngakho ukutadisha I-1968 ikhombise ukuthi ngenxa yokwelashwa okuphindayo kokuphambuka kwezocansi, ukuthuthuka kwenzeke emacaleni angama-23 kwangu-40 (57%), kepha kuthe uma kuhlolwe ngemuva konyaka, kwavela ukuthi impumelelo ephelele igcinwe kuphela emacaleni ayi-6 (15%). Izinga lokuthuthuka kwabashintshayo, abafelokazi, kanye nama-sadomasochists laliphezulu, lingawahlaba umxhwele kakhulu ongqingili, futhi liphansi kakhulu kwabesilisa abesilisa nabesifazane. Ukuqhathanisa, iziguli eziqede inkambo yokwelashwa kwengqondo, wasala kuphela abathandana nabobulili obuhlukile nobungamashumi amabili kamuva.

Ukwelashwa okungejwayelekile kuyingxenye yezindinganiso zokwelashwa zeFederal futhi kusetshenziselwa ukwelapha izinkinga eziningi. Ochwepheshe bayavuma ukuthi ukusetshenziswa kokwelashwa okweqile kungenzeka futhi kwesinye isikhathi kudingekile, kepha ukuze kufinyelelwe imiphumela emihle kakhulu futhi ezinzile, kuyinto efiselekayo ukuthi yenziwe kanye nezinye izindlela zokwenza ingqondo.