道德叙事:道德创伤治疗路径探析  

Moral Narration:the Therapy Pathway of Moral Injury

作　　者：常运立 CHANG Yunli(School of Basic Medicine,Naval Medical University,Shanghai 200433,China;Humanistic Medicine Research Center,Shandong University,Jinan 250012,China)

机构地区：[1]海军军医大学基础医学院,上海200433 [2]山东大学人文医学研究中心,山东济南250012

出　　处：《中国医学伦理学》2020年第11期1311-1317,共7页Chinese Medical Ethics

基　　金：2016年度中国博士后科学基金面上资助项目“道德创伤:一种新的战争创伤范式”(2016M592210);2019年度国家社科基金军事学项目“道德创伤:军事创伤的实践转向”(2019-SKJJ-C-022);2019年度上海市哲学社会科学规划青年课题“医学生群体道德创伤防治与道德韧性建构研究”(2019EKS005);2020年度上海市教育科学一般项目“虚拟现实在医学生道德创伤教育防治中的应用研究”(C20038)。

摘　　要：道德创伤是道德事件对个体的道德认知、道德情感、道德信仰造成的冲击与伤害;是特定道德场景之下,个体“生活世界”与“生命世界”的割裂。道德叙事作为叙事理念向道德生活中的延展,叙事过程中对道德生命的解构与建构,为受创者重回道德生活提供了实践路径。将道德叙事用于道德创伤治疗,可通过重拾创伤事件、对话道德权威、辩明创伤归因、分离“问题事件”、挖掘“闪光事件”、激活道德情感和重塑道德价值等系统操作,以实现重塑受创者完整的“道德自我”。在叙事治疗中,治疗师必须明确自身角色——是倾听者而非布道者,是支持者而非责难者,是体验者而非旁观者。Moral injury is the impact and trauma caused by moral events on the individual’moral cognition,moral emotions and moral beliefs,which is the separation of the individual’s“living world”and“life world”under a specific moral scene.As an extension of narrative concept to moral life,moral narrative deconstructs and constructs moral life in the process of narration to provide a practical path for the injured to return to moral life.The use of moral narrative in moral injury treatment can be achieved through system operations such as recovering traumatic events,dialogue with moral authority,discerning trauma attribution,separating“problem events”,mining“flash events”,activating moral emotions,and reshaping moral values so as to achieving the reconstruction of the completely traumatized“moral self”.In narrative therapy,the therapist must be clear about his or her role as a listener rather than a preacher,as a supporter rather than a reprover,as an experiencer rather than a spectator.

关 键 词：道德创伤 道德叙事 治疗路径 

分 类 号：R-052[医药卫生]