Kuyini Ukuzicwasa Futhi Kungani Kubuhlungu?

URamya Ramadurai, oyi-Ph.D. owenza iziqu kwi-psychology yomtholampilo e-American University, unikele kulokhu okuthunyelwe.

Inhlamba ichazwa njengophawu lwamahloni noma lokuhlambalaza. Ngomqondo wokulebula wezenhlalo singakwazi ukucabanga ukucwaswa kwezempilo yengqondo njengophawu lwehlazo noma ukuhlazeka okusetshenziswa kulabo abahlangabezana nokuphazamiseka kwemizwa, ababizwa ngamagama, babekwe eceleni, futhi babandlululwe.

Kuyaziwa ukuthi ukucwaswa kwezempilo yengqondo kuyinkinga esabalele yomphakathi. Izimo zengqondo ezibekiwe kanye nokubandlululwa okugcinwe ngumphakathi (iRüsch, Angermeyer, & Corrigan, 2005) kubizwa ngenhlamba emphakathini futhi kungaholela ekulahlekelweni ngamathuba ezomnotho noma omsebenzi, impilo yomuntu uqobo kanye nokungabi nampumelelo kwezemfundo, ukuthola indawo encane yezindlu noma ukunakekelwa okufanele kwezempilo ngokomzimba izimo, nokucwaswa kabanzi, kulabo abahlangabezana nezinkinga zempilo yengqondo.

Mhlawumbe okungaziwa kangako ukuthi kwenzekani lapho lobandlululo kanye nemibono eyeqisayo yafakwa ngaphakathi ngendlela umuntu azibona ngayo?

Ukwamukelwa komuntu uqobo nokuvumelana nezinkolelo-ze nezinkolelo zobandlululo ezibhekiswe kuwe, kubizwa ngokuthi yi-self-stigma (Corrigan, Watson, & Barr, 2006) noma ukucwaswa ngaphakathi (Watson et al., 2007). Kumodeli esetshenziswa kabanzi yengcosana (Meyer, 2003), ukuzenyeza noma ukucwaswa kwangaphakathi kungumphumela wokuqina wokucindezeleka obangelwa yisiphetho sehlazo. Uhlaka lokulamula ngokwengqondo (uHatzenbuehler, 2009) luyavuma ukuthi imiphumela eyi-proximal efana nokuzicwasa ingachaza ukuhlangana phakathi kwemiphumela ekude yenhlamba yomphakathi kanye ne-psychopathology.

Ukucwaswa kwangaphakathi kuhlotshaniswa nokucindezeleka okuhlukile ngokomzwelo, ukungazethembi, imizwa yokuzenyeza, ukulahleka kokuzikhandla, futhi ekugcineni nezinkinga zezempilo yengqondo. Ukuzicwasa kubuye kube nezindleko zokusebenza. Isibonelo, ukucwaswa okwenziwe ngaphakathi kungaholela umuntu ekutheni angaze afake isicelo somsebenzi ngoba bakholelwa ukuthi abakwazi.

Iziguli eziseMcLean Hospital's Behavioral Health Partial Hospital program zivame ukukhuluma ngesihlamba sempilo yengqondo. Senze ucwaningo eminyakeni embalwa edlule ukuqonda ukuthi ukucwaswa ngaphakathi kungathinta kanjani umphumela wokwelashwa. Nakhu esikutholile:

• Abantu abanamazinga aphezulu okucwaswa ngaphakathi ekwamukelweni babenobunzima obukhulu bezimpawu futhi behlisa izinga lokuphila elibikiwe, ukusebenza, kanye nempilo yomzimba lapho ikhululwa (Pearl et al., 2016).
• Ngesikhathi sokwelashwa, ababambiqhaza babhekana nokwehliswa ngokuphelele kwenhlamba engaphakathi.
• Labo abahlangabezane nenqubo yenguquko ethembekile ekucwaswa ngaphakathi bahlangabezana nokuthuthuka okukhulu emiphumeleni eminingi yezimpawu.
• Imiphumela ibingaguquguquki kuzo zonke izici zabahlanganyeli ezinjengobuhlanga, ubulili, ubudala, ukuxilongwa, nomlando wokuzibulala.

Asinasiqiniseko sokuthi yiziphi izingxenye zokwelashwa kwethu ezisize ekwehliseni ukucwaswa kweziguli ngaphakathi. Kungaba yizinto eziningi, futhi kuyehluka kuye ngomuntu nomuntu. Ngingabikezela ukuthi ukuxhumana okusekelayo nokuqinisekisayo nezinye iziguli nabasebenzi kusizile. Mhlawumbe imfundo ye-psychoeducation etholwe ngezikhathi zethu ezahlukahlukene zokwelashwa kweqembu nayo isize ukuqeda izinkolelo zabanye abantu mayelana nezimpawu zempilo yengqondo.

Yinye into eqinisekile - inqobo nje uma ukucwaswa kwezempilo yengqondo kusalokhu kuyinkinga yomphakathi, kunesidingo sokungenelela okusiza abantu ngokwezinga ngalinye ngolwazi lwabo lokucwaswa ngaphakathi. Izazi zokusebenza kwengqondo seziqalile ukuthuthukisa nokuhlola ukungenelela okuhlose ukusiza abantu ukuthi baphathe kangcono futhi baqonde ukucindezeleka okuyingqayizivele okuhlobene nokucwaswa abangakuthola. Okuningi kwalokhu kungenelela kube nemiphumela yokuqala ethembisayo, kokubili ekwehliseni ukucwaswa kwangaphakathi kwengqondo, kanye nokuqinisa izindlela ezihambisanayo njengokuzethemba nethemba.

Ukubuyekezwa okuhlelekile kwakamuva kutholakale ukuthi izindlela eziningi zokuzicwaswa zisuselwa eqenjini, zinciphisa ngempumelelo ukucwaswa ngaphakathi, futhi zibandakanya ukufundwa kwengqondo, imfundiso yokuziphatha kwengqondo, ukungenelela okugxile ekudaluleni, noma inhlanganisela ethile yalaba abathathu (Alonso et al., 2019).

Isibonelo, i-Coming Out Proud (i-Corrigan et al., I-2013) yiprothokholi ebhukwe yinqwaba yamaqembu ama-3 eholwa ngontanga (abantu abanolwazi lokuphila ngokugula kwengqondo). Kugcizelelwa kakhulu ekuhloleni nasekukhuthazeni isimo sokuguquguquka ekuvezeni ukugula kwengqondo, njengendlela yokulwisana nokuzicwaswa. Basikisela ukuthi kunesikhathi nendawo yokufihla nesikhathi nendawo yokudalula, futhi isifundo senzelwe ukunika amandla abantu ukuthi benze izinqumo benalokho engqondweni. Le protocol ingaba namandla kakhulu ekulweni nokucwaswa ngoba iholwa ontanga.

Esinye isibonelo yi-Narrative Enhancement and Cognitive Therapy (NECT; i-Yanos et al., 2011), umthetho olandelwayo weqembu elisebenza ngamaqembu angama-20 eliholwa ngumelaphi. Kusekelwe emcabangweni wokuthi abantu abaningi abanesifo sengqondo basizwa isidingo sokuphinda bathole futhi baphinde bathole ubunikazi babo kanye namagugu abo, okungenzeka ukuthi kungcoliswe ngumbono womphakathi wokuxilongwa kwabo. Le ndlela yokwelashwa ifaka ukuhlanganyela okuhlangenwe nakho okuhlobene nokugula kwengqondo, impendulo evela kumalungu eqembu, i-psychoeducation ezungeze ukuzenyeza, ukuhlela kabusha ukuqonda, futhi ekugcineni "ukuthuthukisa ukulandisa" lapho abantu bekhuthazwa ukwakha, ukuhlanganyela, nokubona ukulandisa kwabo ngelensi entsha.

Amandla wokungenelela kwe-self-stigma eqenjini acacile- enza kube lula ukuxhumana kontanga futhi avule izingxoxo zamaqembu ezingahle zixazulule futhi ziqede izinkolelo-ze ezabiwe ezabiwe. Kodwa-ke, njengoba ukwesaba ukucwaswa, kanye nokufakwa ngaphakathi kwenhlamba kukhonjisiwe njengezithiyo ekufuneni ukunakekelwa kwezempilo yengqondo, le ndlela ingahle ibe inselele ekufinyeleleni kokungenelela.Ukulethwa kokungenelela kokuzicwilisa ngezinye izindlela, njengama-smartphones, kungasiza ekufinyeleleni abantu abazizwa benqena ukufuna izinsizakalo noma abahlala ezindaweni lapho amaqembu engatholakali khona. Akunandaba ukuthi iyiphi indlela yokulethwa, kuyacaca ukuthi ukwakha umphakathi oqinile nabantu ababelana ngokuhlangenwe nakho kokuphila ngokugula kwengqondo, kungaba ukwelashwa.

ICorrigan, P.W, Kosyluk, K. A., & Rüsch, N. (2013). Ukunciphisa isithunzi sakho ngokuphuma uziqhenya. Ijenali yaseMelika Yezempilo Yomphakathi, 103 (5), 794-800. https://doi.org/10.2105/AJPH.2012.301037

ICorrigan, P.W, Watson, A. C., & Barr, L. (2006). Ukuzicwaswa kokugula kwengqondo: Imiphumela yokuzethemba nokuzikhandla. Ijenali Yezengqondo Nezenhlalo, 25 (8), 875-884. https://doi.org/10.1521/jscp.2006.25.8.875

UHatzenbuehler, M. L. (2009). Ukucwaswa kwabantu abancane kwezocansi "kungena kanjani ngaphansi kwesikhumba"? Uhlaka lokulamula kwengqondo. I-Psychological Bulletin, 135 (5), 707. https://doi.org/10.1037/a0016441

UMeyer, u-H.H. (2003). Ubandlululo, ingcindezi yezenhlalo, kanye nempilo yengqondo kubantu abathandana nabobulili obufanayo, abesilisa abathandana nabobulili obubili: izingqinamba zomqondo kanye nobufakazi bokucwaninga. I-Psychological Bulletin, 129 (5), 674. https://doi.org/10.1037/0033-2909.129.5.674

UPearl, R. L., Forgeard, M. J. C., Rifkin, L., Beard, C., & Björgvinsson, T. (2016, Ephreli 14). Ukucwaswa Kwangaphakathi Kwesifo Sengqondo: Izinguquko Nezinhlangano Ezinemiphumela Yokwelapha. Ukucwaswa Nempilo. 2 (1), 2–15. http://dx.doi.org/10.1037/sah0000036

URüsch, N., Angermeyer, M. C., & Corrigan, P. W. (2005). Inhlamba yokugula ngengqondo: Imiqondo, imiphumela, kanye nezinhlelo zokunciphisa ukucwaswa. I-European Psychiatry, 20 (8), 529-539. https://doi.org/10.1016/j.eurpsy.2005.04.004

UPhilip T. Yanos, uDavid Roe, noPaul H. Lysaker (2011). Ukuthuthuka okulandisayo kanye nokwelashwa kwengqondo Ijenali Yomhlaba Wonke Yeqembu I-Psychotherapy Yeqembu: Umq. 61, No. 4, amakhasi 576-595. https://doi.org/10.1521/ijgp.2011.61.4.576

UWatson, A. C., Corrigan, P., Larson, J. E., & Sells, M. (2007). Ukuzicwasa kubantu abagula ngengqondo. ISchizophrenia Bulletin, 33 (6), 1312-1318. https://doi.org/10.1093/schbul/sbl076