「孤獨」與「連結」－青年男同志的憂鬱敘事

Abstract

本研究呈現五位經歷憂鬱症的青年男同志的生命故事，研究者以病痛的觀點來理解青年男同志的憂鬱症，試圖了解男同志在青年生命階段因為憂鬱症所帶來的病痛經驗，以及憂鬱症的病痛於其生命中所展現出的意義，並爬梳這樣的意義所鑲嵌的社會文化脈絡。 本研究採取質性研究中的敘事研究方法進行，五位研究參與者為透過網路進行公開招募而得，而在敘事訪談過後，研究者會邀請參與者閱讀研究者依據訪談內容所撰寫的生命故事與詮釋，並一同討論不同看法或考量之處，此外，研究者也會邀請指導教授與同儕閱讀，並請其提供意見，因此最後的故事呈現是揉雜了研究者、研究參與者與閱讀者的理解。 透過五位青年男同志的故事，本研究發現青年男同志的憂鬱症經驗，在他們生命世界中所反映出的意義是他們所承受的「孤獨」之苦，而孤獨作為一種社會經驗，形塑青年男同志受苦於孤獨的文化與結構性力量則在於社會對於男同志以及憂鬱症者的汙名與不理解、加諸於男性的性別規範、在華人家庭文化下作為兒子的角色期待。不過，檢視青年男同志目前的生活狀態，可見他們於目前的生活中發展出新的平衡，這是因為他們與重要他人、自我、過往生命歷程產生的「連結」，緩衝或療癒了處於孤獨之中的苦痛。 依據研究發現，本研究針對助人實務、服務與政策規劃、未來研究方向提出提醒。助人工作者應花更多的心力傾聽與看見案主的情緒與想法，以期與案主建立連結；面對男同志案主，應協助其建立對於少數族群壓力的因應能力與支持系統；同時也有責任去多了解不同多元文化的知識以及建立自身文化能力。針對服務與政策規劃的提醒是，男同志的憂鬱症往往不僅只是單一的身心問題，背後可能是交織著不同議題，因此服務體系在面對有著身心議題的男同志案主時，應更全面性的進行評估，進而提供多面向的服務內容或建立網絡間的合作以回應案主的需求；此外，如何透過政策投注更多資源或是透過公私協力的方式，使得有需求者更能負擔心理社會服務的成本，並在需求出現時能及時取得服務，也是應持續考量的。在後續研究上，助人工作者所處的處境值得繼續探索，以了解為什麼青年男同志在使用服務的過程中會面對到負向經驗，期待透過雙邊的理解來促進對話與改變體制的可能；而敘事研究的執行確實有其可貴之處，但研究過程中對於研究參與者曝光或是身心上的風險仍是往後研究者應持續留意的。此外，敘事研究者在研究執行過程中，也要準備好自己的支持系統，以因應研究歷程中自身狀態的變動。

This research introduces a qualitative-narrative study that explores the life stories of five young gay men who have experienced depression. The study aims to examine the participants' illness experiences, the meanings of depression in their lives, and the social and cultural contexts in which these meanings are embedded. The participants were recruited online, and each of them was interviewed one to two times. With the data collected from interviews, the researcher wrote the participants’ life stories separately. The participants were given the opportunity to review and discuss the content with the researcher to ensure that their stories aligned with their experiences. The study reveals that depression is linked to a sense of "loneliness" in the lives of young gay men. Moreover, the “loneliness”, which is a form of social suffering, was shaped by the cultural and structural factors such as the stigma toward gay and mental disorders, the gender norms imposed on men, the expectation on the role of son in Chinese family culture and a lack of understanding gay men’s narratives within formal service systems. However, the study also indicates that the young gay men have developed a new life balance through “connectedness” with significant others, self and life experience. The research findings provide recommendations for mental health workers, policymakers, and researchers. Mental health workers should prioritize active listening and cultural competence to connect with LGBT+ clients and help them establish coping skills and supportive systems to reduce the impact of minority stress. The study shows that it’s highly possible that depression may co-occur with other psychological and social conditions/disorders in gay men’s life. Therefore, it is necessary to conduct more comprehensive assessments for gay men in mental health service. Considering the complicated needs of gay men, establishing diverse services networks for gay men is also essential. In addition, the policymaker should allocate more resources for affordable and accessible psychosocial services. Narrative research is empowering for the participants, but researchers must be mindful of the risks involved, such as identity exposure and trauma reactions. Coping skills and support groups for researchers are suggested to manage emotional reactions to participants' conditions and stories. Future research could focus on the relationships between gay men and mental health professionals to better understand why negative experiences arise when accessing services. In summary, this study provides valuable insights into depression in young gay men’s life and underscores the need for more understanding and supportive services.