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

"Uyindoda edabukile, edabukisayo ," kusho uHarold emdlalweni kaMart Crowley othi "The Band Players." "Ungumuntu ongqingili, awufuni ukuba ngumuntu onjalo, kodwa awukwazi ukwenza lutho ukushintsha . "

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

“Lapho nje kwaziwa ukuthi siphatha ubungqingili ngempumelelo ethile, sagcwala izicelo zosizo,” kuphawula udokotela wezifo zengqondo waseNew York obhala kabanzi ngale ndaba.

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.

Ukuphelelwa yithemba kwaqala ukuphela eminyakeni eyisishiyagalombili edlule ngokushicilelwa kocwaningo olwenziwe yiqembu lezazi zengqondo ezabika ukuthi ama-27% eziguli ezingu-106 zobungqingili ezathola ukwelashwa kwengqondo zaba ngabantu abathandana nabobulili obuhlukile kuphela. Ithimba locwaningo, eliholwa nguDkt. Irving Bieber waseNew York Medical College, libize imiphumela yalo ngokuthi "imiphumela enethemba kakhulu nethembisayo etholakale 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 ubike ukuthi isiguli esisodwa esineminyaka engu-30 ubudala sithole ukwelashwa okuphelele kwabantu abathandana nabobulili obuhlukile zingakapheli izinyanga ezintathu zokwelashwa. Le ndoda, eyayingenalo nhlobo ulwazi lwabantu abathandana nabobulili obuhlukile, yaqala ukwelashwa iseduze nokuzibulala ngemuva kokuhlukana nomlingani wayo weminyaka emibili. "Ngemva kwemihlangano eyisishiyagalolunye yemizuzu engu-45 kanye nemihlangano yokulalela engu-27, le ndoda yathembisana umshado futhi yagcina ubuhlobo bobulili obuphumelelayo nesoka layo izikhathi eziningana ngesonto ," 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 uzizwa enesizathu sokuba nethemba. Esebenzisana namaqembu amadoda angongqingili, uthole ukuthi "cishe ingxenye eyodwa kwezintathu yalabo abaphikelela ekwelashweni (ngokuvamile iminyaka eminingana) bathola ukuzivumelanisa nezimo okuphumelelayo kwabantu abathandana nabobulili obuhlukile ," kanti enye ingxenye yesithathu ijwayela kangcono ubungqingili 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."

“Nakuba kungenangqondo ukucabanga ukuthi ingxenye enkulu yamadoda angongqingili izofuna ukwelashwa,” kusho ithimba locwaningo, “ sinethemba futhi silindele ukuthi njengoba izinketho zokwelapha zithuthuka futhi zitholakala kabanzi, abantu abaningi bazofuna usizo ngokuzithandela.”

Ephawula ukuthi "kuzodingeka abanye odokotela bengqondo abangu-5000 ukusiza bonke ongqingili abafuna ukusiza ," uDkt. Hatterer uphakamisa ukusungulwa "kwemitholampilo yezempilo yabantu abathandana nabobulili obufanayo" enabasebenzi abangochwepheshe. Njengoba inani labantu ababengabangqingili landa, ubona ukuthuthukiswa kwamaqembu "Abangqingili Abangaziwa" asekelwe ekuzisizeni, okuzokwenza kubantu abathandana nabobulili obufanayo lokho okwenziwa yi-Alcoholics Anonymous kubantu abaningi abaphuza utshwala.

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

Nokho, uhulumeni wayenezinye izinhlelo . Enkulumweni yakhe yeSimo Senyunyana sango-1969, uMongameli uNixon, ebiza ukukhula kwenani labantu ngokuthi "enye yezinkinga ezinkulu kakhulu ezibhekene nesiphetho sesintu," wacela izinyathelo eziphuthumayo zokulawula izinga lokuzalwa. Ososayensi abaningana baphakamise ukuvunyelwa kobungqingili njengendlela yokunciphisa izinga lokuzalwa, kwathi ngo-1974, kwasuswa ekwelashweni. Kusukela ngaleso sikhathi, njengoba owayenguMongameli we-APA uNicholas Cummings ephawula, "inhlangano yamalungelo abantu abathandana nabobulili obufanayo isithathe i-APA, futhi ukunemba kwezepolitiki, hhayi isayensi, manje sekubusa ." UDkt. Cummings uphinde wabika ukuthi phakathi kuka-1959 no-1979, abantu abathandana nabobulili obufanayo abangu-18,000 bafuna ukwelashwa emtholampilo wakhe ngezinkinga ezahlukahlukene, cishe abangu-1,600 kubo bafuna ukushintsha indlela abaziphatha ngayo ngokocansi. Ngesikhathi sokwelashwa, abaningi babhekana nezinguquko ezinhle engqondweni yabo, okwaholela ekutheni iziguli ezingu-2,400 zibe ngabantu abathandana nabobulili obufanayo.

¹ Emazwini e-LGBT* okuhloswe ngawo ukulahla ukuguqulwa kwengqondo, umuntu angakwazi ukuzwa izindaba ezijabulisayo mayelana nokuthi ongqingili abaneshwa bahlukunyezwa kanjani ngokushaqiswa kukagesi, cishe esihlalweni sikagesi. La manga aluhlaza aklanyelwe ukwesabisa kanye nokululaza labo abathandana nobulili obufanayo abaqala ukufuna izindlela zokuqeda ukukhangwa kwabobulili obufanayo, okubavimbela ukuba baphile impilo egcwele (futhi baningi babo). Lawa manga angabulala: cishe bonke ababekade bengqingili babika ukuthi imicabango yabo yokuzibulala ayivelanga ebutha balabo ababazungezile, kodwa ngenxa yokuzenyanya nemizwa yabo. ukuphelelwa yithembangoba babeqinisekile ukuthi abanandlela yokushintsha.

Kwenzekeni ngempela? Kwezokwelapha ngengqondo, kunezinhlobo ezimbili zokwelapha ezisebenzisa i-electroshock: ukwelashwa nge-electroconvulsive (ECT) kanye nokwelashwa ngokuphikiswa (ACT ). I-ECT isebenzisa ugesi wamandla angu -70-460 volt ukuletha umphumela wokwelapha ebuchosheni besiguli imizuzwana engu-0.1 kuya ku-1. Njengamanje, cishe iziguli eziyisigidi ezi-1 minyaka yonke zithola i-ECT ukwelapha izifo ezahlukahlukene zengqondo nezezinzwa, ngokuvamile ukucindezeleka okukhulu, i-catatonia, kanye ne-mania. Le ndlela, ehlotshaniswa nemiphumela emibi 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.