从人格发展理论的视角探索道德创伤的作用机理  

Exploring the mechanism of moral injury from the perspective of personality development theory

作　　者：黄强 王璐颖 HUANG Qiang;WANG Luying(Department of Procurement Management,the 924th Hospital of Joint Logistics Support Force,Guilin 541002,China;School of Basic Medical Sciences,Naval Medical University,Shanghai 200433,China)

机构地区：[1]联勤保障部队第九二四医院采购管理科,广西桂林541002 [2]海军军医大学基础医学院,上海200433

出　　处：《中国医学伦理学》2024年第2期229-233,共5页Chinese Medical Ethics

基　　金：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);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);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);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：人格发展理论从个体的生理需求出发,提出“潜意识”和“意识”为主体的“二部人格结构”进而推导“本我、自我和超我”为主体的“三部人格结构”,以此为框架构建本能的人格动力图式,探索出自我失衡的成因。以此为落脚点,从人格动力图式推导出道德创伤的形成,从自我、本我和超我自相矛盾中发现的道德焦虑,基于弗洛伊德的“焦虑”推导道德创伤的表征形式。进而将个体的人格发展差异性引入道德创伤研究,区分焦虑情绪与道德创伤症状中的内疚可以更好地理解道德创伤。Personality development theory starts from the physiological needs of individuals,proposes the“two-part personality structure”with“subconscious”and“consciousness”as the subject,and then deduces the“three-part personality structure”with“id,ego,and superego”as the subject.Based on this framework,an instinctive personality dynamics schema was constructed to explore the causes of self-imbalance.Taking these as a foothold,the paper deduced the formation of moral injury from the personality dynamic schema,found the moral anxiety from the self-contradiction of ego,id,and superego,as well as deduced the representation form of moral injury based on Freud’s“anxiety”.Furthermore,the differences in individual personality development are introduced into the study of moral injury to distinguish between anxiety and guilt in the symptoms of moral injury,in order to better understand moral trauma.

关 键 词：人格发展理论 弗洛伊德 道德创伤 

分 类 号：R-052[医药卫生]