day28-The road less traveled

2019.3.13  己亥二月初七 晴

Escape from Freedom

逃离自由

        When a psychiatrist makes the diagnosis of a character disorder,it is because the pattern of a avoidance of resposibility is relatively gross in the diagnosed individual.Yet almost all of us from time to time seek to avoid--in ways that can be quite subtle--the pain of assuming responsibility for our own problems.For the cure of my own subtle character disorder at the age of thirty I am indebted to Mac Badgely.At the time Mac was the director of the outpatient psychiatric clinic where I was completing my psychiatry residency training.In this clinic my fellow residents and I were assigned new patients on rotation.Perhaps because I was more dedicated to my patients and my own education than most of my fellow residents,I found myself working much longer hours than they.They ordinarily saw patients only once a week.I often saw my patients two or three times a week.As a result I would watch my fellow residents leaving the clinic at four-thirty  each afternoon for their homes,while I was scheduled with appointment up to eight or nine o'clock at night,and my heart was filled with resentment.As I became more and more resentful and more and more exhausted I realized that something had to be done.So I went to Dr.Badgely and explained the situation to him.I wondered whether I might be exempted from the rotation of accepting new patients for a few weeks so that I might have time to catch up.Did he think that was feasible?Or could he think of some other solution to the problem?Mac listened to me very intently and receptively,not interrupting once.When I was finished,after a moment's silence,he said to me very sympathetically,"Well,I can see that you do have a problem."

     正是由于在确诊的个体中，这种逃避责任的方式相对严重，所以心理医生确诊为性格障碍。然而几乎我们所有人都一次又一次地寻求逃避--以相当微妙的方式--为自己的问题承担责任的痛苦。对于治愈我三十岁时不易察觉的性格障碍，我得感谢麦克－百吉利。 当时麦克在我完成我的精神病科实习培训的地方任门诊病人精神病门诊部主管。 在这个门诊部我的实习同事和我轮流分配给新病人。 或许因为我比我的实习同事在我的病人和我的自己的教育上更热忱，我发现比他们工作时间长好几个小时。 他们正常情况下一周只看一次病人。 我常常一周两三次看我的病人。 结果我得眼睁睁地看着我的实习同事们每天下午4点半离开门诊回家，而我直到晚上8、9点还在安排见面，且我的心中充满愤慨。 当我变得越来越不满且越来越精疲力竭我发现有些事不得不做了。 所以我找到百吉利医生，向他解释我的心理状态。 我想为了我能赶上别人，或许我在数周内不用接纳新病人。 他会觉得那行得通么？ 或许他会考虑一些其它解决问题的方法么？ 麦克非常专心地、接纳地听我说，从不打断。 当我说完后，他沉默了一会，“看来，你确实有问题.。”他非常同情地说。

      Dr.Hilde Bruch,in the preface to her book Learning Psychotherapy,states that basically all patients come to psychiatrists with "one common problem:the sense of helplessness,the fear and inner conviction of being unable to 'cope' and to change things." One of the roots of this "sense of impotence" in the majority of patients is some desire to partially or totally escape the pain of freedom,and,therefore,some failure,partial or total,to accept responsibility for their problems and their lives.They feel impotent because they have,in fact,given their power away.Sooner or later,if they are to be healed,they must learn that the entirety of one's adult life is a series of personal choices,decisions.If they can accept this totally,then they become free people.To the extent that they do not accept this they will forever feel themselves victims.