|
Identified patient, or "IP", is a term used in a clinical setting to describe the person in a dysfunctional family who has been unconsciously selected to act out the family's inner conflicts as a diversion; who is the split-off carrier of the (perhaps transgenerational) family disturbance.〔Peter L. Rudnytsky, ''Reading Psychoanalysis'' (2002) p. 44〕 The term is also used in the context of organizational management, in circumstances where an individual becomes the carrier of a group problem.〔(Identified Patient Pattern )〕 ==Origins and characteristics== The term emerged from the work of the Bateson Project on family homeostasis, as a way of identifying a largely unconscious pattern of behavior whereby an excess of painful feelings in a family lead to one member being identified as the cause of all the difficulties - a scapegoating of the IP.〔Robin Skynner/John Cleese, ''Families and how to survive them'' (London 1994) p. 103〕 The identified patient - also called the "symptom-bearer" or "presenting problem" - may display unexplainable emotional or physical symptoms, and is often the first person to seek help, perhaps at the request of the family.〔"Dysfunctional family", ''Encyclopedia of Psychology'', April 6, 2001, http://findarticles.com/p/articles/mi_g2699/is_0004/ai_2699000448/〕 However, while family members will typically express concern over the IP's problems, they may instinctively react to any improvement on the identified patient's part by attempting to reinstate the status quo.〔Cooper, p. 17〕 Virginia Satir viewed the identified patient as a way of both concealing and revealing a family's secret agendas.〔Sara E. Cooper, ''The Ties that Bind'' (2004) p. 17〕 Conjoint family therapy stressed accordingly the importance in group therapy of bringing not only the identified patient but the extended family in which their problems arose into the therapy〔Eric Berne, ''A Layman's Guide to Psychiatry and Psychoanalysis'' (Penguin 1976) p. 295〕 - with the ultimate goal of relieving the IP of the broader family feelings they have been carrying.〔Skynner/Cleese, ''Families'' p. 104〕 In such circumstances, not only the IP but their siblings as well may end up feeling the benefits.〔Berne, p. 295〕 R. D. Laing saw the IP as a function of the family nexus: "the person who gets diagnosed is part of a wider network of extremely disturbed and disturbing patterns of communication."〔R. D. Laing, ''The Politics of Experience'' (Penguin 1984) p. 94〕 Later formulations suggest that the patient may be an "emissary" of sorts from the family to the wider world, in an implicit familial call for help,〔S. H. Buckman/A. S. Gurman, ''Theory and Practice of Brief Therapy'' (2002) p. 93〕 as with the reading of juvenile delinquency as a coded cry for help by a child on his parents' behalf.〔T. Pitt-Aikens/A. T. Ellis, ''Loss of the Good Authority'' (London 1989) p. 89, p. 118, and p. 185-6〕 There may then be an element of altruism in the IP's behavior - 'playing' sick to prevent worse things happening in the family, such as a total family breakdown.〔Robin Skynner/John Cleese, ''Life and how to survive it'' (London 1994) p. 38〕 抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)』 ■ウィキペディアで「identified patient」の詳細全文を読む スポンサード リンク
|