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01변증법적 행동치료 : 새로운 이론적 접근
Marsha Linehan(1993b, 1993c)
Dialectical Behavior Therapy : DBT
.
DBT , DBT -
(Marra, 2004).
Linehan DBT parasuicidal 1)
(Koerner & Linehan, 2000; Linehan, Armstrong, Suarez, Allmon,
& Heard, 1991; Linehan, Heard, & Armstrong, 1993; Linehan, Tutek, Heard, & Armstrong,
1994; Sherarin & Linehan, 1994; Westen, 2000),
. , Linehan
, , , , ,
,
1) (parasuicidal) :
6_ 변 증 법 적 행동치료
, .
. DBT
,
.
DBT ,
DBT (pathogenesis : 3 ), (pathotopology : 4 ),
(psychotherapeutic intervention :
5 7 ) .
. ,
, .
, ,
.
.
, .
,
.
,
, , . DBT
.
제1장 변증법적 행동치료 : 새로운 이론적 접근_7
DBT란 무엇인가?
DBT .
.
. ,
.
DBT ( )
emotional psychopathology .
DBT
( 4 ).
. , , ( 3 ),
( 3 ) .
, (
) , emotional baseline2)
.
DBT (
) ,
,
, , (
-
) .
DBT ,
2) (emotional baseline) :
8_ 변 증 법 적 행동치료
. ,
(Jacobson , 1996).
.
, .
.
DBT ( , , )
.
fire ,
. kindling DBT
.
.
DBT ,
( ) .
, . DBT
.
DBT
,
.
dialectic (
, , , , , ).
, . DBT
제1장 변증법적 행동치료 : 새로운 이론적 접근_9
. ,
.
, .
.
Linehan ,
(1993b).
unwillingness
DBT .
( )
.
. (
, , )
.
기술 대 심리치료
skill
. CD
.
. DBT ( , , ,
, ) CD ,
.
DBT ,
.
.
10_ 변 증 법 적 행동치료
,
. ( )
. 7 ,
.
치료의 불특정 효과
DBT ,
.
(Bradley, 2000; Jacobson , 1996; Messer & Warren, 1995; Roth &
Fonagy, 1996). nonspecific ( , , ,
) .
(Beutler & Howard, 2003; Beutler, Machado, & Neufeldt, 1994; Crits-Christoph ,
1991; Henry, 1998; Luborsky , 1986, 1999; Norcross & Hill, 2003; Wampold, 2001),
DBT
. DBT
,
. , ,
.
이론적 지향점으로서 DBT
Freud , Rogers
, Pearls , Skinner , Meichenbaum
제1장 변증법적 행동치료 : 새로운 이론적 접근_11
, Bandura ,
. DBT
,
,
.
정신분석적 접근과의 비교
DBT , , ,
cathexis3)
anticathexis( ),
,
. DBT ( , ,
) .
( , ) ,
.
DBT Freud (Hall, 1954),
. , ,
, .
continua . ,
.
. ,
.
( 4 ),
dis-ease .
3) cathexis : ( )
12_ 변 증 법 적 행동치료
. Freud
.
, ,
(1914, p. 116) . Freud
, DBT
Adlerian ,
. Freud , ,
(Mosak & Dreikurs, 1973),
( ) .
DBT Adler
, Adler
. Adler , , ,
, right-wrong (Mosak &
Dreikurs, 1973) . Adler
Freud ,
. , security
, ,
,
(Dreikurs, 1957).
DBT Freud . ,
.
.
,
제1장 변증법적 행동치료 : 새로운 이론적 접근_13
.
. Freud
? Freud
,
. Freud
,
.
. DBT
.
. DBT ,
frame
.
,
. ,
,
abandonment .
19 Freud cathexis anticathexis .
. want need .
urgency . DBT
,
,
. (
)
. , (Freud )
. DBT
14_ 변 증 법 적 행동치료
,
(
) . DBT
. ,
.
DBT
. Freud
(Wachtel, 1977). (
, , )
.
( 3 ),
.
. Freud
. (
),
. DBT .
.
object
. DBT
,
.
. DBT
.
제1장 변증법적 행동치료 : 새로운 이론적 접근_15
.
DBT
,
(Whitmont & Kaufman, 1973). DBT
. DBT
( )
. .
인본주의적 접근과의 비교
, ,
,
(Meador & Rogers, 1973).
. , ,
.
.
, ,
(Rogers, 1957). Rogers
7 :
, , , , , ,
. Rogers
, ,
.
DBT DBT
. DBT
16_ 변 증 법 적 행동치료
,
. DBT (
)
( ),
( ).
DBT
,
, DBT
( )
.
게슈탈트 또는 실존주의적 이론과의 비교
gestalt
polarization (Kempler, 1973),
DBT .
, .
,
.
,
( , ).
,
DBT .
,
. DBT
, DBT
제1장 변증법적 행동치료 : 새로운 이론적 접근_17
.
DBT .
,
. approbation (Kempler,
1973).
,
.
DBT .
validation , DBT
. ,
,
.
행동적 접근과의 비교
Watson
(Watson & Rayner, 1920). Joseph Wolpe
.
Wolpe ,
.
.
( ) ,
.
18_ 변 증 법 적 행동치료
, , ,
.
. ,
. ,
.
,
(Goldstein, 1973, p. 218).
Skinnerian model
.
(Wachtel, 1977).
부분적 강화 효과
.
DBT
.
,
.
(Goldstein, 1973).
DBT .
, .
.
,
제1장 변증법적 행동치료 : 새로운 이론적 접근_19
.
. ,
,
(Goldstein,
1973).
행동주의의 인지적 혁명
, , flooding,
,
(Beck, Rush, Shaw, & Emery, 1979; Elkin , 1989; Jacobson , 1996). DBT
. DBT
(Marks & Dar, 2000), DBT
.
, .
, acceptance and commitment therapy : ACT Hayes, Strosahl,
Wilson (1999, p.
45) . ACT
, (p. 57-58)
. mindfulness 3
DBT
. National Institute
of Mental Health
20_ 변 증 법 적 행동치료
(Vieth , 2003). DBT
.
, DBT (Beck , 1979) (Bohus ,
2000; Bradley, 2000; Eisenberg , 1996; Field, 1994; Kagan, 1994; Lazarus & Folkman,
1984; Shearin & Linehan, 1994; Thompson, 1994; Wagner & Linehan, 1999; Wiser &
Telch, 1999)
. DBT behavioral
contingency (Addis & Hatgis, 2000; Bradley,
2000; Carek, 1990; Davidson & Goleman, 1977; Eisenberg , 1996; Field, 1994; Goleman,
2003; Gray, 1991; Segal, Williams, & Teasdale, 2002; Teasdale, Segal, & Williams, 1995,
2003; Thompson, 1994).
(Bradley, 2000; Carek, 1990; Goleman, 2003; Kagan,
1989; Lazarus & Folkman, 1984; Segal , 2002).
DBT
(Koerner & Linehan, 2000; Linehan, 1987; Linehan
, 1991, 2002; Rizvi & Linehan, 2001; Segal , 2002).
. ,
(Cassidy & Kobak, 1988; Jacobson , 1996; Kagan,
1989; Segal , 2002).
DBT ,
.
DBT , DBT
. .
, .
제1장 변증법적 행동치료 : 새로운 이론적 접근_21
. emotional dysregulation
.
,
. DBT , , , , ,
.
제1장 요약
DBT , , ,
. DBT ,
, ,
. DBT
, ,
.
