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第二十一卷

 

性成癮症

范幸玲

 

摘 要
    
「性成癮症」目前沒有被列為診斷與統計手冊第四版(DSM-IV)裡的一種正式醫學診斷。但是「性成癮症」已經成為近年來流行的一個專有名詞,用來解釋及描述傾向於自我毀滅及耽溺於性愛的行為。然而,在心理保健專業領域裡,對於是否要接納用「成癮」的模式來治療強迫慌習性異常有不斷的爭議。除了「成癮」的觀念外,很多學者也提出不同的概念模式來解釋耽溺於性受的極度行為。在這麼多的爭議當中,科門(Coleman)的強迫性人格模式與卡內斯(Carnes)的對癮模式一直是爭議的焦點。此際,不同的治療方式,例如:認知行為、創傷基礎、心理分析及行為治療等方式都分別被不同的諮商師所嚐試。然而,性成癮症這名詞繼續被一般人及諮商師所使用。近來,有些學者提出整合各種概念模式來達到更好的治療「性成癮症」的效果。除了綜論各種不同的學術見解之外,這篇文章主要是對於性成癮症的一般性討論,包括了定義、診斷準則,病因,個人、配偶互動,家族的評估及治療方法。筆者當時在美國所諮商的一個個案也列入文中討論。
 

 

關鍵詞成癮模式、性成癮症、評估,診斷準則、強迫性人格模式

 

 

Sex Addiction

Shing-Ling Fan

 

Abstract
    Sexual addiction is not a DSM-IV diagnosis, but it has become a conventional term to specify and define self-destructive sexual behavior in recent years. Yet, in the field of the mental health professional, the acceptance of incorporating the addiction model to treat compulsive sexual disorder has remained controversial for the past decade. Besides the addiction model, many researchers have also suggested different comceptual models to specify excessive sexual behavior. Among all controversies, there is an ongoing conflict between Coleman’s obsessive-compulsive model and Carnes’ addiction model (Shaffer, 1984; Lennon, 1994: Sunderwirth, Milkman, & Jenks, 1996). Meanwhile, different therapists have also proposed different approaches to treatment. They are such as the cognitive – behavioral, the trauma-based, the behavioral therapy. Nevertheless, the term "sexual addictions" continues to be used by both the therapist and the layman. Recently, some researchers also suggest integrating different approaches in treating sex addiction for a better effect. After reviewing many different approaches, the author focuses on a general discussion of sex addiction including its definition, diagnostic criteria, andetiology. Individual, interactional, and intergenerational assessments are introduced. Individual, couples and family therapy are discussed. A clinical case is also presented at the second half of this paper.   
 

Keywords: Addiction model, Sex addiction, Assessment, Diagnostic criteria, Obsessive-compulsive model

 

 

背景圖

彰化師大輔導與諮商學系
Department of Guidance & Counseling, National chunghua University of Education