1、災后兒童心理救助呼喚多元化音樂治療Childrens Mental Relief after Earthquake Requires Diverse Music Therapy作者：劉小天Author: Liu Xiaotian摘要：本文在國內首次從多元化視角論述了中國音樂治療實踐中文化背景與治療模式的關系。通過對兒童心理救助的案例，闡述了必須尊重并遵循兒童的文化背景，家族狀況、年齡特點和地域特征，同時立足并借助西方音樂和西方音樂治療的科學理論，根據不同對象，融會貫通地制定治療方案，才能達到相應療效。文中論述了音樂療法對于兒童心理救助不可多得的效應。重點描述了人文背景及年齡段對于音樂治療的特殊

2、要求。也闡明了針對多元化視域，因人而異采用的多元化手法音樂治療的進程及效果。Abstract: The paper firstly discusses the relationship between the cultural background and therapy type in Chinese music therapy practice from multi-aspect of view in China. It is presented in the paper that the childrens cultural background, family status, age

3、feature and regional characters must be respected through the childrens mental relief case. In addition, the corresponding curative effect can be reached via setting down the proper therapy scheme with the scientific theory of western music and western music therapy, and based on different objects.

4、The paper presents the unique effect of music therapy to childrens mental relief, and emphasizes the special requirements of humanized background and age to music therapy. Furthermore, the paper also illuminates the progress and effect of diverse music therapy that is adopted for multi aspect of vie

5、w and various objects. 與兒童語言溝通無奈時，音樂出現了The Music Emerges when Language Communication with Children Fails to Work 面對突然降臨的震災，兒童心靈蒙受打擊最大。穩定的空間剎那間消失，疼愛的親人瞬間離散，熟悉的環境猛然面目全非。全國傾力援助中，家園重建會很快，但這些兒童默默承受的心靈創傷若不救助，潛隱的心理損害，在他們一生中，將遠遠超過災難本身。Facing the sudden earthquake disaster, the childrens heart suffers attack

6、 fiercely. The stable space disappears instantly, the family separates and the familiar environment becomes strange suddenly. After earthquake, the homeland can be constructed quickly with the great effort of help of the people all the country; however, if the heart hurt fails to be healed for these

7、 children in disaster-hit area, the hidden metal wound will be more serious than the disaster itself in their life.兒童生活視域窄，抗壓能力弱，心理干預所必備的溝通與交流能力，表達與接受的能力，都遠低于成人。晤談的治療的實施效果相對有限。同時，他們處于“學語期”，心理危機一般數月才達到高峰。所以，成人與兒童的語言交流溝通，很難達到治療所需維度。尤其災難發生兩個月內，晤談式干預治療甚至很危險。即便兒童主動述說，也盡量謹慎維持處理。The children live in the na

8、rrow space with the weak pressure resistance skill, the communication skill required for mental intervention and ability of expression as well as acceptance for children are much lower than the adults, thus, the therapy via talking with them can reach the relatively limited effect. In the meantime,

9、they are in language study stage and the mental crisis can be the peak within several months. Therefore, it is hard to reach the therapy effect via the language communication between the adults and children, especially within two months after earthquake. The intervention therapy via talking with chi

10、ldren is even hazardous. It should keep cautious to childrens active narration. 目前針對災后兒童的大量溫情慰問或熱情鼓勵，也許反而加深了對象內心殘酷記憶與美好場景間的矛盾，或許強化了兒童對心靈的鎖閉性防護。At present, a lot of tender comfort or passionate encouragement given to the children suffered from the earthquake may increase the contradiction between the

11、 cruel memory of inner heart and the sound scene of the objects, or strengthen the childrens mental blocking protection 聯合國兒童基金會專家杰弗里-基爾說，大多數兒童都有與生俱來的“韌性”，雖然災難帶來創傷，但只要針對性提供藝術治療等心理修復，兒童會很快掃除災難的心理陰影。Jeffrey Gere, an expert from UNCF, says that most of children have the instinctive tenacity. The mental

12、 relief such as the proper art therapy can heal the childrens mental wound quickly though they suffer in the disaster. 但是，單一的愉悅穩定型的藝術療法，如歡快樂曲、抒情兒歌、效果類似單邊式鼓勵語言的誤區。科學審慎對待這類特殊群體，就必須嚴格遵循心理學和音樂治療的專業原則，把救助方案調整到多元化視角。However, the single joviality and stable-based art therapies such as the joyous music and

13、lyric childrens song are similar to the effect of unilateral language encouragement. It must comply with the discipline principle of psychics and music therapy, and adjust the relief scheme to the multi-aspect of view when treating these special groups scientifically and carefully. 大腦科學的研究表明：音樂的波動，對

14、兒童影響最大，因為，音樂以生物電的形式最易于影響兒童相對空白的記憶神經元，使大腦神經元上的突觸數增加，軸突變粗，改善進行信息交換和加強思維能力的物質基礎，短期內優化兒童的性情、心態和智力。The cerebra science study indicates that the undulation of music influences the children mostly, because the music with form of bioelectricity can influence the relative blank memory nerve cell of children

15、easily, increase the number of synapse on the cerebra nerve cell and enlarge the axons, improve the information exchange and strengthen the material base of ideation to optimize the childrens temper, attitude and intellect in a short period. 因此，采用國際第四代心理治療流派艾倫艾維的多元文化咨詢與治療方案，應該是當務之急。務必細致廓清兒童的年齡特征、地域文

16、化、家族背景等多元視域，以此為坐標，擬定個性音樂治療方案，才可能伴隨兒童步入其心靈，燭照她自己去體會、再現、表達、并接受悲哀。促動他們自我喚醒、自我激發對未來的熱情。Consequently, it is urgent to adopt the multi-cultural consultation and therapy scheme of international 4th generation of psychological therapy school with head of Alan Ivy. It must make clear the diverse view such as

17、 childrens age character, regional culture and family background, with which as the coordinates to establish the unique music therapy scheme, so the music can affect the childrens heart and help them experience, recur and accept the sadness, making them self awaken and encourage the passion to the f

18、uture. 多元化視角音樂治療的準星Multi-aspect of View, the Goal of Music Therapy 在督導寇覺中老師指導下，我針對川陜甘兒童，遵循多元化視域，既針對兒童的文化特點，家族背景，年齡階段。同時，也融合中國音樂單音深邃特點和西方古典音樂復調優勢，搜集了82首三地兒歌、童謠。擷選出中國民樂改編的交響樂、管弦樂等樂曲，因人而異地多元化貫穿執行接觸期、認同期、感受期、促動期、輔導期。Under the instruction of teacher Kou Juezhong, aiming at the children in Sichuan, Shaanx

19、i and Gansu disaster-hit province and complying with the multi-aspect of view, I have searched 82 pieces of childrens songs and nursery rhyme in three provinces, which not only corresponds to the childrens culture character, family background and age feature, but also fuses the uni-phone profound Ch

20、inese music and the advantage of western classical music polyphone. The symphony adapted by China folk music and orchestral music are selected carefully to execute the acquaintance, recognition, awareness, motivation and instruction stages. 一位四歲陜西寶雞地區的女童，地震中失去了父親，母女二人都受傷入院。初識時，她在病床上表情漠然、動作刻板，主動語言極少，

21、甚至不與我目光對視。面對床頭慰問品，她顯然處于災難過后的心理休克冷漠期。A 4-year girl from Baoji, Shaanxi province lost her father in the earthquake; the girl and her mother were injured in hospital. When I met her at first, she was listless with unmeaning action and few words, even she saw me reluctantly. Obviously, she was in the of

22、fish status of mentality after the disaster facing the relief items on the bed. 我遵循督導的共情設計，開始和她一同唱童謠、唱兒歌、玩游戲。三次以后，她漸漸和我目光對視。我接著補充性的和她伴隨音樂做分果果等游戲。我深知，對兒童過早的脫敏，往往導致情緒惡性激化。Complying with the mutual feeling design composed by the supervisor, I began singing the nursery rhyme, childrens song and playing

23、games with her. After three times, she gradually looked at me with her eyes. Then I played the games of dividing the fruits accompanying with the music. I knew deeply that too early desensitization for the children would cause the deteriorating emotion.下來就要謹慎進入實質性的穩定支持、回溯再現、表達宣泄、接受悲哀的過程。聚焦多元音樂手段，溫暖僵

24、化的心，軟化她以悲哀支撐的心靈盔甲，釋放有害液體，激活她內心世界被封凍的鮮活童趣。Next, I entered into the process of stable support, tracing reoccurrence, expression of catharsis and acceptance of sadness prudently. Focusing on the instrument of diverse music, I began warming her heart and comforting her sadness to active the lively inter

25、est that is hampered by the disaster. 首先，我選擇了中央樂團合唱團舒緩輕柔的天籟童聲合唱、小白船等幾個曲目，由抒情向快樂遞進，牽引她進入親近音樂的狀態。因為，自從六年前在西安陽光智障兒童學校的干預案例開始，我日益總結到，越小的兒童，越能迅速接受音樂感染，也越喜歡節奏感強的柔和音樂。經過一段音樂初始化接觸，感覺她表情開始軟化，情緒明顯活躍，心態有所穩定，我開始搭設干預架構。Firstly, I chose several pieces of music such as the gentle and slow chorus with natural child

26、s voice and “Little White Boat” sang by glee club of Central Music Performing Group, which led her into hobnobbing with the music from the lyric to the upbeat rhythm. Since the intervention case in Xian Sunny Mental Retarded Childrens School six years ago, I have concluded that the younger the child

27、ren are, the more quickly they are edified by the music, and love the finger-popping gentle music. After a periods of initial acquaintance of music, I found out that her expression become better, the emotion shown more active and the attitude was more stable, so I began designing the intervention fr

28、amework.適度催眠后，我選用了鋼琴曲集童謠中的小白菜，從樂曲呈現凄風殘雨中搖曳的孤獨小鳥，我暗示了失去爸爸的孤獨小鳥，但絕不提及她失去親人。緊閉的雙眼間，她長長睫毛終于沒能留住一顆顆不斷溢出的淚珠。緊閉的幼小心靈打開了一條縫。After the proper hypnosis, I chose the “Little Cabbage” in piano music collection “Nursery Rhyme”, with the lonely bird in the cold wind playing in the music, I hinted her that the lon

29、ely bird lost its father instead of mentioning her losing her own father. Drops of tear rushed out of the closed eye and the long eyelash, the crack shown in her childish and younger heart.下來，我繼續用賀藝先生改編的陜西民歌蘭花花管弦樂第二樂章入手。隨著療程，進而用幾個樂曲片段過度到柴可夫斯基的第六交響曲。其間，我極度審慎地暗示她回憶一些瞬間，不料，昔日重現，她開始斷斷續續主動泣訴極端壓抑的痛楚片段回憶：她

30、在房屋倒塌時跑向院子，媽媽撕裂般的哭喊、找爸爸時挖的雙手鮮血淋淋村里人一片混亂，幾個叔叔滿身塵土在她家廢墟中尋找到了爸爸她嗚咽哽塞哭述著當時的孤立無援、悲苦、恐懼。After that, I chose the second movement of orchestral music, Lanhuahua, Shaanxi folk song adapted by Mr. He Yi, with several music segment to the 6th Symphony composed by Tschaikovsky. Meanwhile, I tried to hint her to

31、 memorize some instant scene. Unfortunately, she began crying to pour the miserable scene in which she rushed to the yard when the house collapsed, her mother cried painful, and the gory hands of excavating her father. The mess occurred suddenly in her village, several uncles found her father in the

32、 ruin of house. She wept sorrowfully to pour out the isolation, sadness and terror at that time. 兒童對悲哀的釋放維度，比成人相對易于提升，六次治療后，脫敏進入關鍵環節，我啟動了重點樂曲：趙季平先生大漠孤煙直組曲中的第四樂章悼歌。繼續支持她對悲哀的痛述反應，鼓勵她對細節回憶，當樂章最后的四聲管鐘響起，她幾乎淚雨滂沱。我任由她反復哭泣、重復訴說場景片段。Expression of the sadness for a child is prone to rise comparing with the a

33、dults. After six times therapy, the desensitization goes to the crucial link. I played the key music, namely the forth movement “Mourning Music” in the “Straight Plume of Smoke Group Music” composed by Zhao Jiping, to support the painful response to the sadness continuously and encourage her recolle

34、ction of the details. When the tubular bell at the end of movement played, she cried more painfully to pour the miserable scene repeatedly with drops of tear.此時，我和她保持適當的心理距離，不強求她勇敢或鎮靜，只盼望她用音樂和另一個世界的爸爸溝通,接受樂曲對幼小靈魂一瀉千里的洗禮。同時，我也密切注視著她情緒的細微波動，設置了調控防御，準備了撫慰柔情類音樂，以備隨時介入，避免她滑向凄楚絕望或過分依賴。At that time, we kep

35、t the proper psychological distance instead of encouraging her braveness or calmness, the only hope is that she can communicate with her deceased father via the music in the heaven and accept the music therapy for the babyish spirit. I watched her gentle undulated emotion and prepared the gentle mus

36、ic for intervention, avoiding the desperation or too much dependence. 我明白，這不是軟弱，我欣慰看到，一雙柔嫩的小手，開始對自己的心理黑洞探底。I knew it was not the frailty, and I was glad to see the tender hands begin the exploration of the wounded heart.治療進入實質階段后，由于多年鋼琴學習鉆研，我深感民族樂曲多屬缺乏和聲的單聲音樂，很難勝任對人心靈干預的深度、強度和調諧力。而西方多聲音樂的和聲，則立體化了旋律，

37、細分化了層次，客觀化了二次創造，最易達成作者與聽眾行為共振。所以，我國民族音樂的魅力，能給人沁入心靈的陶醉，而很少給人付諸行為的震撼或沖動。若實施多元化音樂治療方案，必須根植民族文化認知和價值體系基礎，對民族性素材給予世界化表現技法的改良性發掘和再現。于是，我采用沃爾塔瓦河的同時，擷選了和平頌、春光燦爛睡蓮等片段，幫她縱深拓寬疏泄渠道，激化意識流淌中的積極元素，提振她從認可喪失階段向適應喪失階段緩緩過度，從回避或試圖繞過災難的恐懼中自然的走出來。When the music therapy went to the essential stage, I felt the monaural mus

38、ic lack of stereo in the national music due to several years study of piano, which is incompetent to affect the heart in terms of depth, strength and tune. Instead, the western stereo music synthesizes the cantus, separates the level and realizes the second creation, which is easy to reach the reson

39、ance between the composer and the listener. Therefore, China national music has the charm to infiltrate into the inner heart instead of encouraging the people for convulsion or action. If the diverse music therapy scheme is adopted, it should be based on the national cultural recognition and value s

40、ystem to develop and recur the expression skill for the national materials. So I played pieces of the music such as “Ode to the Peace”, “Sunny Spring” and “Pond Lily” while playing the “Vltava”, with which I helped her open the heart, activate the happy emotion and encourage to adapt the reality fro

41、m knowing that her father was killed in the earthquake, and come out the disaster naturally, instead of avoiding or attempting to escape from the terrible disaster.平靜下來后，她小臉上開始泛出不易察覺的微笑。和我過家家游戲時，也間或有了撒嬌。護士反映，兒童夜間不再出現以往的驚叫了。因為畢竟面對的是一顆幼小而柔弱的心，我始終小心翼翼的嘗試、呵護都如履薄冰，此刻，揪著的心才放了下來。The smile began showing on

42、the childish face after calming down. She played the games with me, sometimes showing childish. The nurse told met that childrens screaming phenomena in the evening disappeared. I tried to care for the young heart prudently and finally I relaxed. 立足民族、地域、年齡多元文化背景的音樂干預Music Intervention based on Mult

43、i-cultural Background of Nation, Region and Age 中國音樂治療研究所主任高天先生說：“若及時把消極情緒充分宣泄出去，再嚴重的創傷也會逐漸治愈當消極情緒發泄到一定程度，人內心深處的積極力量就會抬頭”。Mr. Gao Tian, the director of China Music Therapy Institute, says “if the negative emotion is abreacted thoroughly in time, can any serious wound be gradually healed. When the ne

44、gative emotion is abreacted in a certain degree, the positive emotion in the inner heart will show”. 確認她情緒疏導效果顯后，我謹慎著手促動她對悲哀的漸次接受。I motivated her to accept the sorrow carefully after confirming of the evident therapy effect for her emotion.鑒于兒童閱歷和閱讀面的局限，我在和她一起做音樂游戲小老鼠、找朋友時，講述了一些兒童在災難中失去雙親的實例，一步步暗示，地

45、震和很多災難，都是很難避免的自然現象。同時，我開始注入了何占豪的交響詩龍華塔。同步監聽觀察，當夢幻般豎琴導引下，樂曲進入第二主題，二胡如凄如述地奏出對逝者的回憶時，她已經淚如泉涌。當再現部清越的豎琴又把思緒從深度回憶慢慢帶回現實化解悲痛時，我讓她休息。In light of the limit of experience and reading for the children, I told her the example that some children also lost her parents in the disaster when we played the music gam

46、es such as “Mini Mouse” and “Seeking for Friend”, and hinted her that earthquake and many disasters are the natural phenomena that cannot be avoided. Then I played the “Longhua Tower”, the symphonic poem composed by He Zhanhao. With the guide of gentle harp, the music went to the second theme, the d

47、ismal Erhu music seemed to make her recall her deceased father, she cried heartrendingly. When the music played with harp led her scatter the sadness in the reality from the deep memories gradually, she rested. 此時的狀態，正如中國音樂治療學會會長張鴻懿先生的精確表述：“音樂治療像一把鑰匙，打開了孤獨兒童緊閉的心扉。內心世界通過音樂治療找到了釋放、發泄和表達的特定的渠道”。 The si

48、tuation at this time is as if the accurate statement by Mr. Zhang Hongyi, the president of China Academy of Music Therapy, “the music therapy seems to be a key to a childs closed heart. Her or his inner heart can be opened, abreacted and expressed via the music therapy”.許多深刻的成長，是由傷口開始的。我開始激化她自身的對決潛力

49、。當她聆聽趙季平先生交響樂太陽鳥片段時，隨著管弦樂組以高音區密集的和弦，奏出清亮明朗的翱翔弧線尤其進行到孔雀精靈，隨著鼓樂撞擊開緊閉的陰霾，綻放出飛向天籟間清新的燦爛時看她緊繃著的小臉上，木然克制漸漸松展，綻露出松快的愜意。當天，我給她講故事講到：瓦缸破成了一堆碎片，他還扭回頭去一片片撿回來，你說他是不是個傻瓜呀？她笑著說：“大傻瓜”！太陽鳥呼喚太陽照亮了兩顆心，我們頭一次不約而同的哈哈大笑。Much deep experience during growing up begins the wound. I began motivating her own potential to chall

50、enge the sadness. When she listened to the “Sunbird”, a symphony composed by Mr. Zhao Jiping, with the concentrated chord in alt played with the orchestral instrument, the haze in her inner heart disappeared gradually, especially when the Peacock Eidolon was playing, her closed heart opened little b

51、y little and the relieved smile shown on her tightened face. On that day, I told her the story, I told her that when the jar was broken into the fragment, and a boy collected the fragment one by one, and asked if he was a fool. She smiled and admitted the fool boy. The “Sunbird” music gives the suns

52、hine to the two hearts and we laughed happily at the same time使人潦倒的，往往不是災難，而是人面對災難的心態。我開始評估她內心對厄運的接受程度，殘而不廢的萌芽，怎樣自己認可厄運、接受喪失、激發希望、自我修復？It is the attitudes towards the disaster that always makes people disappear instead of the disaster itself. I began assessing her acceptance capacity for the doom, and how does the young girl accepts the misfortune, inspires the hope and self encourages? 我日益感到，只要立足文化背景、年齡特色的和中西音樂結合的多元視域，對兒童的音樂治療，不難獲得理想的利導效果，年齡越小，利導補償和激發的作用就越大。 I gradually feel that it is easy to obtain the ideal effect with the music therapy for the children based on the