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たとえ治らなくても

 相変わらずPTSDの治療は続いています。
EMDRという治療法を一言で言い表すのは難しいです。眼球の左右あるいは垂直方向への動きを人工的に起こさせるか、あるいは音、タッピングなどの体への刺激を交互に与え、それと同時に、過去の出来事の中で最も辛かった場面を思い出しながら進んでいきます。

 ビデオを見ているように、時間順に思い出すとは限りませんし、こんなこと忘れていたのに…という事を思い出したり、やっている最中は何が起こるか分かりません。

 しかも、出来事だけでなく、それに伴う感情や体の感覚も出てきます。ちょうどおもちゃ箱をひっくり返したような感じで一度にど~んと出てくるので、その後が少々大変です。しかし、出てきても、ずっとそのままというわけではなく、次第にそれが落ち着いて、あるいはなくなっていくので不思議です。

 この一連の作業を「記憶の再処理」という呼び方をします。再処理のスピードは非常に速く、再処理が終わったいやな記憶は、思い出しても再処理前のような、こころや体の反応はなくなっています。人によっては、鮮明で圧倒されそうな記憶がぼやけた感じになったり、詳細に思い出せなくなることもあるようです。

 なぜそういう事が起こるのかがよく分からない、不思議な治療法です。

 私は2年前からこのEMDRの使い手でもあり、今は自分が治療をやってもらっているという微妙な立場で仕事をしています。何故EMDRなの?と聞かれても、うまく答えることができません。ただ、私の中には、こういう仕事をしている人間がいつまでもPTSDの症状を引きずっているのは良くない、という思いがあって、どうにかして治したい、そのためにいろんな文献を調べたりして最後に行き着いたのがEMDRだったというわけです。

 では、私がEMDRを体験してどうだったのかというと、まだその結果は出ていません。いくらスピードの速い治療法と言っても、実際の回復はゆっくりだからです。昨日あたりからようやく眠れるようになったかな、と言う程度ですから、まだまだ道のりは長いです。

 EMDRの中では、時々「あっ、そうか」と何かに気付く瞬間があります。それが、変化のきっかけというか、単に症状を軽くするだけでなく、時々はものの見方や考え方ががらりと変わる時があります。

 おとといはそういう日でした。

 PTSDであることがはっきり分かってから、すでに5年が経ちました。2年前に一度EMDRの治療を試験的に半年間受け、その後症状は大分落ち着いていました。今年になって前回の治療者に頼み込んで治療を再開しましたが、再発がなければ今回のことはなかったはずです。

 「どうして再発したんだろう?」と考えない日はありませんでした。もちろん、思い出させるものがあるからなんですが、以前は実家に行っても全然平気だったのに…突然の予想外の事に私は内心動揺していました。私自身が多くのPTSDに苦しんでいる患者さんを援助する立場にいるので、彼らには迷惑をかけられない、早く治さないといけない、という焦りもありました。

 治療の始まる前から、無理と精神的疲労からうつがひどくなっていて、その状態で治療を再開したので、辛い記憶と感情が一度に出てきたときに辛くてもうだめかと思うくらいでした。家族がこういう状況を理解してくれると期待はできないので、誰にも相談できないまま、悶々とした毎日を送っていました(それでも仕事は休めないし)。

 それでも苦しい感じは、先週にピークを越えました。今は先週ほどは辛いとは思わなくなりました。そして3日前に治療を終えて帰ってきてから、ふと考えたことが。
 
もし私がPTSDでなかったら、今頃私はどうなっていたのだろうか?

 多分、そのまま会社のOLを続けていたはずです。仕事がおもしろくて仕方なかったから。M先生にも、EMDRにも出会うことはなかっただろうし、ましてや今のような立場になることもなかったでしょう。

 もし、今PTSDがきれいさっぱり治ったとしたら、私はどうなるのだろうか?

 これまで、症状があるのが当たり前のように生きてきて、突然それが全部なくなったら、私は私ではなくなってしまう…と、とまどいを感じるはずです。そう、これ(PTSD)があるのがわたし。これがあるから、わたしはわたしでいられるし治療者としてやっていけるんだ…。

 そう考えると、治ることが目的でないような気がしたのです。多分時間をかければ、大半の症状は落ち着くでしょうが、完全にゼロにならなくてもいいと、始めて思いました。たとえ完全に治らなくても、時々は嫌なことを思い出して涙が止まらなかったり苦しくなったとしても、大切なのは私がそこからどうにかして立ち直る事を選べればいいんです。

 治らなくても弱くないし、自分に負けたことにもならない。

 もし、このPTSDの部分を、ADHDや自閉症スペクトラム障害に置き換えてみたら?…それでも答えは同じはずです。やはり、障害がなくなることが答えではない気がしたのです。

 酒木保著、「自閉症の子供たち」(PHP新書)の中に、次のような言葉があります。


どんなによく練られた治療プログラムであっても、対象になる子供の発達段階や、個々の実際の能力にあったものでなければ何の意味もありません。私たちにとってはいたって簡単だと思える訓練でも、障害を持つ子どもにとっては、とてつもない難解な課題である場合が多々あります。その子の実情を無視した要求水準で行われる訓練は、意味がないどころか、子どもにとっては拷問にも等しいものです。(中略)
 二十数年にわたる治療の日々を通して、いま私は、自閉症が治るかどうかを問うことよりも、子どもたちの育ちを見守っていくことがむしろ重要なことではないのかと思うに至りました。(中略)
 ここで私が治療においてめざしていることは、元来「普通」と呼ばれることとはまったく違った生き方しかできなかった自閉症のこどもたちが、とにかく皆と何とか共存できる程度になること、いわゆる「普通」といわれる生き方を身につけるということにすぎません。

ADHDにも、同じ事が当てはまると思います。彼らを追いつめるような訓練をしても意味がないのです。むしろどうすれば不自由さを少しでも解消できるかということが、援助の中心になる必要があるはずです。

 PTSDの場合、突然の衝撃的な出来事による(あるいは虐待のように長期にわたる苦痛を伴う出来事による)日常生活への様々な障害ですから、PTSDの症状がなくなることは、以前の生活を取り戻すことと思われがちですが、そうではありません。過去は変えられないからです。「安全」に対する考え方、周囲への対応の仕方、どれをとっても、以前と同じ状態に戻るわけではありません。それでも、PTSDの治療をするのは、出来事以前に近い状態まで、何とか回復できるようにするために過ぎず、特に虐待の場合は、出来事以前の状態すら思い描けないので、何を持って回復と呼んでいいのかが、はっきりしているわけではないのです。

 この本の終わりには、こんな言葉が記されています。


 自閉症児にとって本当に必要なのは、「いま」「ここ」に自分が存在することについて抱いている不安や恐怖を克服すること、安心して生き、生きようとする力を彼ら自身が手にするための援助です。そのために、人間と人間とが関わり合って生きていくということは快い体験なのだということを彼らが感じ取ることができる環境を作っていかなければなりません。
 自閉(症)という生き方を余儀なくされている子どもたちも、本当は一人ひとり自分の生き方を主体的に選択していきたいと願っているのだということを私は信じています。そしてそれを実現するためには、自閉症について我々が分かっていることはまだほんの少しであるという謙虚な態度に立ち戻って、「人間の心のあり方」という、このもっとも基本的な問題に、しっかりと向き合わなければなりません

私は私自身の問題と、そして、私が出会う方々が抱える問題とどちらにも向き合うという課題があるわけですね。

 外傷体験後に人として成長する過程を見つめていく事も、大切なことなのかもしれないと思います。(これを専門用語でPosttraumatic Growthといいます) いやむしろ、症状がなくなるより、大事なことなのかも。

 

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