Создание и разрушение эмоциональных связей 14 страница

Хотя теория психопатологии, используемая Маланом и его коллегами, в некоторых отношениях отлична от кратко обрисованной здесь теории, у них есть важные сходства. Кроме того, как будет отмечено, имеется значительное сходство между принципами той техники, которую он находит эффективной, и теми принципами, которые мы защищаем здесь.

Оценка эффективности консультирования лиц, понесших тяжелую утрату, для вдов, относительно которых имел место неблагоприятный прогноз, также внушает надежду. Среди вдов, которые получили описанную выше форму консультирования, было обнаружено значительно большее их число, к концу тринадцати месяцев после утраты, развитие которых шло в благоприятном направлении, чем среди тех вдов в контрольной группе, не получивших консультирования (Raphael, Maddison, 1976).

Конечно, следует признать, что наметить в общих чертах принципы терапии намного легче, чем применять их в постоянно изменяющихся условиях клинической практики. Кроме того, сама теория привязанности все еще находится на ранней стадии развития, и еще предстоит проделать огромную работу в этом направлении. Среди приоритетных задач находится определение как диапазона тех клинических условий, для которых данная теория уместна, так и особых вариантов терапевтической техники, наилучшим образом подходящих для их лечения.

Тем временем, те люди, которые принимают теорию привязанности, полагают, что как ее структура, так и ее отношение к эмпирическим данным теперь таковы, что полезность этой концепции может быть проверена систематическим образом. В области этиологии и психопатологии она может использоваться для развития специфических гипотез, которые связывают различные формы семейного опыта с разными вариантами психиатрического расстройства, а также, возможно, с теми нейрофизиологическими изменениями, которые их сопровождают, как считает Гамбург со своими коллегами (1974). В области психотерапии она может использоваться для уточнения терапевтической техники, для описания терапевтического процесса и, при необходимости технических усовершенствований, для измерения изменений в отношении их развития, По мере продвижения исследований сама эта теория несомненно будет модифицироваться и развиваться. Это дает надежду на то, что с течением времени теория привязанности может оказаться полезной как один из компонентов внутри более обширной области психиатрической науки, для развития которой Генри Модели приложил максимум усилий.

Примечания

1 Другие клинически соответствующие области, к которым эффективно применялась теория привязанности, это исследование истоков связи мать-младенец в неонатальный период, проведенное Маршаллом Клаусом и Джоном Кеннемом (1976), исследование расстройств внутри супружеского взаимоотношения, проведенное Жанет Мэттинсон и Яном Синклером (1979) и исследование эмоциональных последствий супружеской разлуки, проведенное Робертом С.Вейссом (1975). Третий том работы «Привязанность и утрата» должен быть опубликован в начале 1980 года,

2 В главах 4 и 20 работы «Привязанность и утрата» в третьем томе я дал краткий набросок того, как можно приближаться к защитным процессам в терминах обработки данных человеческой информации. Смотрите также монографию Эммануэля Петерфрюнда (1971).

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