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从解脱到自我和解：长期关系受伤与自杀性丧亲背景下复杂哀伤辅导的个案研究
DOI: 10.12209/j.hrssx.2026060203
基金项目:
From Relief to Self-Understanding: A Case Study of Complex Grief Counseling in the Context of Long-term Relational Harm and Suicide Bereavement
摘要
在华人家庭语境中，当丧失叠加终末期照护、长期关系受伤、自杀性死亡、熟人社会污名与内化的“善终”理想时，复杂哀伤未必主要表现为外显悲伤，而更可能表现为解脱感之后的羞耻、内疚与自我审判。本文采用回顾性、理论导向的单一个案研究写法，结合延长/复杂哀伤、自杀性丧亲、预期性哀伤、双过程模型、意义重建与自我同情等理论，对来谈者在丧亲初期的一次个别辅导及其后续反馈进行分析。结果表明，来谈者的核心困难不在于“悲伤不足”，而在于长期关系受伤背景下，解脱感与伦理压力、社会评价及自我责难交织形成的复杂心理冲突。复杂哀伤辅导在此类处境中的重点，不在于将来谈者导向标准化悲伤表现，而在于减少其因自身反应而产生的二次伤害，并促进其在更复杂、更现实的理解中重组与逝者、家庭及自我的关系。
Abstract
Within the cultural context of Chinese families, when bereavement is intertwined with end-of-life caregiving, long-term relational wounds, suicide-related death, stigma in acquaintance-based communities, and internalized ideals of a “good death,” complicated grief may not primarily manifest as overt sadness. Instead, it may present as a sense of relief followed by shame, guilt, and self-judgment. This study adopts a retrospective, theory-informed single-case design. Drawing on theories of prolonged/complicated grief, suicide bereavement, anticipatory grief, the dual process model, meaning reconstruction, and self-compassion, it analyzes an early-stage counseling session and subsequent feedback from the client after bereavement. The findings suggest that the client’s core difficulty does not lie in a “lack of grief,” but rather in a complex psychological conflict shaped by the coexistence of relief, moral pressure, social evaluation, and self-blame against the background of long-standing relational injury. In such contexts, the focus of complicated grief counseling should not be to guide clients toward standardized expressions of grief. Instead, it should aim to reduce secondary harm arising from their own emotional responses and facilitate the reconstruction of relationships with the deceased, the family, and the self through a more nuanced and realistic understanding.

Szuhany KL, Malgaroli M, Miron CD, Simon NM. Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment[J]. Focus (Am Psychiatr Publ), 2021, 19(2): 161-172. DOI:10.1176/appi.focus.20200052.

Eisma MC. Prolonged grief disorder in ICD-11 and DSM-5-TR: Challenges and controversies[J]. Australian & New Zealand Journal of Psychiatry, 2023, 57(7): 944-951. DOI:10.1177/00048674231154206.

Young IT, Iglewicz A, Glorioso D, Lanouette N, Seay K, Ilapakurti M, Zisook S. Suicide bereavement and complicated grief[J]. Dialogues in Clinical Neuroscience, 2012, 14(2): 177-186. DOI:10.31887/DCNS.2012.14.2/iyoung.

Hanschmidt F, Lehnig F, Riedel-Heller SG, Kersting A. The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review[J]. PLoS ONE, 2016, 11(9): e0162688. DOI:10.1371/journal.pone.0162688.

Pitman AL, Stevenson F, Osborn DPJ, King MB. The stigma associated with bereavement by suicide and other sudden deaths: A qualitative interview study[J]. Social Science & Medicine, 2018, 198: 121-129. DOI:10.1016/j.socscimed.2017.12.035.

Creuzé C, Lestienne L, Vieux M, Chalancon B, Poulet E, Leaune E. Lived Experiences of Suicide Bereavement within Families: A Qualitative Study[J]. International Journal of Environmental Research and Public Health, 2022, 19(20): 13070. DOI:10.3390/ijerph192013070.

陳增穎, 顏原達. 雙重「被污名化的死亡」對遺族悲傷經驗影響之探究[J]. 輔導與諮商學報, 2019, 41(1): 1-19.

Li C, Tang N, Yang L, Zeng Q, Yu T, Pu X, Wang J, Zhang H. Effect of caregiver burden on anticipatory grief among caregivers of elderly cancer patients: Chain mediation role of family functioning and resilience[J]. Frontiers in Psychology, 2023, 13: 1020517. DOI:10.3389/fpsyg.2022.1020517.

劉乃誌, 李英芬, 劉景萍, 賴允亮. 安寧療護與預期性悲傷[J]. 安寧療護雜誌, 2005, 10(3): 286-296. DOI:10.6537/TJHPC.2005.10(3).6.

Waldrop DP. Caregiver grief in terminal illness and bereavement: A mixed-methods study[J]. Health & Social Work, 2007, 32(3): 197-206. DOI:10.1093/hsw/32.3.197.

Boerner K, Schulz R. Caregiving, bereavement and complicated grief[J]. Bereavement Care, 2009, 28(3): 10-13. DOI:10.1080/02682620903355382.

Stroebe M, Schut H. The dual process model of coping with bereavement: Rationale and description[J]. Death Studies, 1999, 23(3): 197-224. DOI:10.1080/074811899201046.

Neimeyer RA. Searching for the meaning of meaning: Grief therapy and the process of reconstruction[J]. Death Studies, 2000, 24(6): 541-558. DOI:10.1080/07481180050121480.

Neimeyer RA. Meaning reconstruction in bereavement: Development of a research program[J]. Death Studies, 2019, 43(2): 79-91. DOI:10.1080/07481187.2018.1456620.

Peri T, Hasson-Ohayon I, Garber S, Tuval-Mashiach R, Boelen PA. Narrative reconstruction therapy for prolonged grief disorder—rationale and case study[J]. European Journal of Psychotraumatology, 2016, 7: 30687. DOI:10.3402/ejpt.v7.30687.

Lenferink LIM, Eisma MC, de Keijser J, Boelen PA. Grief rumination mediates the association between self-compassion and psychopathology in relatives of missing persons[J]. European Journal of Psychotraumatology, 2017, 8(Suppl 6): 1378052. DOI:10.1080/20008198.2017.1378052.

何仁富. 善生与善终：中国生命文化的安宁追求[J]. 协和医学杂志, 2024, 15(1): 18-23. DOI:10.12290/xhyxzz.2023-0631.

Coelho A, Albuquerque S, Neto DD. Bereavement support guidelines for caregivers in palliative care: A scoping review[J]. Frontiers in Psychology, 2025, 16: 1541783. DOI:10.3389/fpsyg.2025.1541783.

图1主要系统原理图1
Fig.1Main system schematic diagram

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