躁鬱症患者之繪畫風格的改變歷程之研究:以一個藝術治療之個案為例

Abstract

本縱貫研究以一名躁鬱症患者為研究對象，透過藝術治療進行五年五次期程探究其繪畫風格的發展過程，以及繪畫風格的改變與其住院治療期程之相關。研究結果如下： (一)繪畫主風格轉化歷程與出院間距： 第一期程：參與四十二週次完成三十九張畫，從「古風線狀」主風格開始，歷經逆向往「傳統的線狀」、「傳統的面塊」、「古風面塊」風格發展後，再順向至出院前的「傳統的面塊」主風格，出院候居家社區生活維持十一個月之久。 第二期程：參與六週次並完成十張畫作，從「古風線狀」主風格開始依循順時針方向往「古風面塊」發展，出院前的「傳統的面塊」，出院候維持半年的居家生活。 第三期程：參與十一週次及創作十一張畫作，從「傳統的線狀」主風格開始逆時針方向往「傳統的面塊」、「古風面塊」發展至「古風線狀」主風格時出院，兩個月後再度住院。 第四期程：參與三十週次塗鴉與創作四十張畫，從「古風線狀」主風格開始，歷經幾次以「傳統的線狀」為主風格與對立和鄰近風格擺盪後，最後呈現在「傳統的面塊」風格時出院，可持續十個月的居家社區生活。

第五期程：參與十六週次創作十八張畫作，從「古風線狀」主風格開始順時針至「傳統的面塊」風格結束。 (二)研究發現：(1)當主風格從「古風線狀」開始依順時針、或逆時針方向、甚至以對立方向轉化至「傳統的面塊」，比從「傳統的線狀」逆時針轉化至「古風線狀」，可維持較長的出院間距；這意涵著當無意識在內外在衝突矛盾的感知狀態，歷經思考性或情緒性的轉化至整合的現實層面時，出院後可維持較長的間距。(2) 歷經五次期程當「古風」與「傳統的」兩大類別發展至平衡且對現實整合的歷程，亦是促進內在發展出復原的力量。 (三)在安全信任的涵容空間與治療關係裡，促進研究對象自我洞察負向的原生家庭互動與內在矛盾攻擊情緒和依附關係的連結，歷程中注入賦權協助研究對象發展中間層的存在價值。

This five-year longitudinal study aimed to explore how a bipolar disorder inpatient developed his painting styles process in his five-period of hospital admission, and the relationship between his changes of painting styles and periods of hospitalizations. This research found the main changes of painting styles between each admission and discharge. (1) During the first period of 42 weeks：he completed 39 pictures. His painting style started from Archaic Linear Style, anti-clockwisely developed the Traditional Linear Style, Traditional Massive Style, to Archaic Massive Style. Before discharge his painting style reverted clockwise to Traditional Massive Style. The patient maintained living in the community for 11 months after discharge. (2) During the second period of 6 weeks, he completed 10 pictures. The painting style started with Archaic Linear Style, clock-wisely developed the Archaic Massive Style, to the Traditional Massive Style. The patient maintained 6 months of living at home after discharge. (3) During the third period of 11 weeks, he completed 11 paintings. The painting style began with Traditional Linear Style, reverted anti-clockwisely to Traditional Massive Style, Archaic Massive Style, to Archaic Linear Style. The patient was re-admitted 2 months later. (4) During the fourth period of 30 weeks, he created 40 drawings. The painting style started with the Archaic Linear Style, to the main painting style proceeded with Traditional Linear Style. After several switch-backs with opposite and similar styles, the main paintings style ended with Traditional Massive Style at the time of discharge. The patient maintained 10 months of communal living afterwards. (5) During the fifth period of 16 weeks, he completed 18 paintings. His painting style began with Archaic Linear Style, then proceeded clock-wisely and finished with Traditional Massive Style. This research findings are as follows. First, when the main painting style started with the Archaic Linear Style, developed either clock-wise, anticlockwise, or totally in opposite direction to Traditional Massive Style, other than when the main painting style developed from Traditional Linear Style anti-clockwisely to Archaic Linear Style, he remained longer period of being discharged. This indicates that the patient is able to remain longer discharge time if his unconscious with sensuous state of internal and external conflicts, they could be integrated into reality through intellectual and emotional transformation. Second, throughout the 5-period of art therapy process, the patient was able to balance the Archaic and Traditional categories and integrated with reality, thus developed inner strength for recovery. Third, in a safe, trusting, containing space and therapeutic relationship, it promoted the patient’s insight to be aware of the connection between inner aggressive conflicting emotions and the original family's negative interaction and attachment. The art therapy process empowered the patient to develop his intrinsic value of the middle ground.