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特集 複雑性PTSDの臨床

複雑性PTSDに対する身体志向心理療法のアプローチ

著者: 牧野有可里1

所属機関: 1マキノ・サイコセラピー・ラボ/ソマティック・アプローチ・ジャパン

ページ範囲:P.1145 - P.1151

抄録
 身体志向心理療法は,トラウマ的出来事によってもたらされたクライエントの神経・生理学的側面(扁桃体の活性化,前頭前野の機能低下,自律神経系の調整不全など)に介入し,それらの機能の回復をサポートする療法で,単回性の心的外傷後ストレス障害(posttraumatic stress disorder:PTSD)に有効であることが数多くの研究で明らかにされている。しかしながら,複雑性PTSDにおいては,神経・生理学的側面に影響をもたらし続けている認知的感情的側面,すなわち,逃げることも闘うこともできない環境で生き延びるしかなかった発達性トラウマ特有の「感情の傷つき」や,生き延びるためにクライエントが自分自身に言い聞かせてきた強力な「自己洗脳/マントラ/信念」にも注目し,人間の営み全体にアプローチすることが要であることが指摘されるようになり,身体志向心理療法領域でも,複雑性PTSDの特性を踏まえたトレーニングのアップデートが盛んに行われている。本稿では,身体志向心理療法について説明し,その中でも複雑性PTSDの特徴を踏まえ,クライエントの身体・感覚・感情・認知に包括的にアプローチする方向で開発されたセンサリーモーターサイコセラピーとEMDR(eye movement desensitization and reprocessing:眼球運動による脱感作と再処理)について,その内容,施行法,有効性のエビデンスを紹介・解説する。

参考文献

1)Ogden P, Minton K, Pain C:Trauma and the Body:A sensorimotor approach to psychotherapy. W.W. Norton & Company, 2006
2)Levine PA:In an Unspoken voice:How the body releases trauma and restores goodness. North Atlantic Books, 2010[ラヴィーン・P(著),牧野有可里,池島良子,他(訳):身体に閉じ込められたトラウマ—ソマティック・エクスペリエンシングによる最新のトラウマ・ケア.星和書店,2016]
3)Kabat-Zinn J:Full Catastrophe Living:Using the wisdom of your body and mind to face stress, pain, and illness. Bantam, 2013
4)Porges SW:The Polyvagal Theory:Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W.W. Norton & Company, New York, 2011
5)van der Kolk BA:The Body Keeps the Score:Brain, mind, and body in the healing of trauma. Penguin Books, 2014
6)Fisher J:Working with the neurobiological legacy of trauma. Psychotherapy Networker 42:34-41, 2018
7)Felitti VJ, Anda RF, Nordenberg D, et al:Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults:the Adverse Childhood Experiences(ACE)study. Am J Prev Med 14:245-258, 1998
8)Anda RF, Felitti VJ, Bremner JD, et al:The enduring effects of abuse and related adverse experiences in childhood:a convergence of evidence from neurobiology and epidemiology. Eur Arc Psychiatry Clin Neurosci 256:174-186, 2006
9)Hughes K, Bellis MA, Hardcastle KA, et al:The effect of multiple adverse childhood experiences on health:a systematic review and meta-analysis. The Lancet Public Health 2:e356-e366, 2017
10)Dube SR, Felitti VJ, Dong M, et al:Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use:the adverse childhood experiences study. Pediatrics 111:564-572, 2003
11)Brown DW, Anda RF, Tiemeier H, et al:Adverse childhood experiences and the risk of premature mortality. Am J Prevent Med 37:389-396, 2009
12)Herman JL:Complex PTSD:a syndrome in survivors of prolonged and repeated trauma. J Traumatic Stress 5, 377-391, 1992
13)Van der Kolk BA, Roth S, Pelcovitz D, et al:Disorders of extreme stress:the empirical foundation of a complex adaptation to trauma. J Trauma Stress 18:389-399, 2005
14)Heller L, LaPierre A:Healing Developmental Trauma:How early trauma affects self-regulation, self-image, and the capacity for relationship. North Atlantic Books, 2012[ヘラー・P,ラピエール・A(著),松本功(監訳),牧野有可里,玉木素子,他(訳):発達性トラウマ その癒やしのプロセス—早期トラウマは,自己調整,自己イメージ,および対人関係能力にどのように影響するか.星和書店,2021]
15)Ford JD, Courtois CA(Eds):Treating Complex Traumatic Stress Disorders:An evidence-based guide. Guilford Publications, 2014
16)Shapiro F:Eye Movement Desensitization and Reprocessing:Basic Principles, Protocols and Procedures(2nd edition). Guilford Press, New York, 2001
17)Lee CW, Cuijpers P:A meta-analysis of the contribution of eye movements in processing emotional memories. J Behav Ther Exp Psychiatry 44:231-239, 2013
18)Forgash C, Copeley M:Healing the Heart of Trauma and Dissociation with EMDR and Ego State Therapy. Springer Publishing Company, 2008
19)Paulsen SL:EMDR and ego state therapy for personality disorders. J EMDR Prac Res 3:82-93, 2009
20)Gonzalez A, Mosquera D:Integrating EMDR and ego state treatment for clients with trauma disorders. J EMDR Pract Res 6:161-171, 2012
21)International Society for the Study of Trauma and Dissociation[ISSTD]:Guidelines for treating dissociative identity disorder in adults, third revision. J Trauma Dissociation 12:115-187, 2011
22)Cloitre M, Courtois CA, Charuvastra A:Treatment of complex PTSD:results of the ISTSS expert clinician survey on best practices. J Trauma Stress 24:615-627, 2011
23)Jongh AD, Resick PA, Zoellner LA, et al:Critical analysis of the current treatment guidelines for complex PTSD in adults. Depress Anxiety 33:359-369, 2016
24)Van der Hart O, Nijenhuis E, Steele K:The Haunted Self:Structural dissociation and the treatment of chronic traumatization. W.W. Norton & Company, 2010
25)Van der Hart O, Groenendijk M, Gonzalez A, :Dissociation of the personality and EMDR therapy in complex trauma-related disorders:applications in the stabilization phase. EMDR Pract Res 8:74-89, 2014
26)Hersey B:IFS-Informed EMDR. In Leeds PF, Marich HK(Eds), EMDR Therapy and Adjunct Approaches with Children:Complex trauma, attachment, and dissociation, pp 197-208, New York:Springer Publishing Company, 2018
27)Gonzalez-Vazquez AI, Rodriguez-Lago L, Seoane-Pillado MT, et al:The progressive approach to EMDR group therapy for complex trauma and dissociation:a case-control study. Fronti Psychology 8:2377, 2018
28)Langmuir JI, Kirsh SG, Classen CC:A pilot study of body-oriented group psychotherapy:effects of a brief treatment on psychological symptoms associated with childhood sexual abuse. J Child Sex Abus 21:665-683, 2012
29)Price CJ:Body-oriented therapy in recovery from child sexual abuse:an efficacy study. Altern Thera Health and Med 11:46-57, 2005
30)Herman JL:Complex PTSD:a syndrome in survivors of prolonged and repeated trauma. J Trauma Stress 5:377-391, 1992
31)Walker P:Complex PTSD:From Surviving to Thriving. Azure Coyote Publications, Oakland, CA, pp 47-48, 2013[ウォーカー・P(著),牧野有可里,池島良子(訳):複雑性PTSD—生き残ることから生き抜くことへ.星和書店,2023]
32)Courtois CA, Ford JD(Eds):Treating Complex Traumatic Stress Disorders:An evidence-based guide. Guilford Press, 2013
33)Ford JD, Courtois CA, Steele K, et al:Treatment of Complex Trauma:A sequenced, relationship-based approach. Guilford Press, 2020
34)Heller L:DARe:Healing early attachment wounds. Somatic Psychotherapy Today 1:1-5, 2010
35)Schwartz R:Our multiple selves:Applying systems thinking to the inner family. Family Therapy Networker 11:24-31, 1987

掲載雑誌情報

出版社:株式会社医学書院

電子版ISSN:1882-126X

印刷版ISSN:0488-1281

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