臺灣軍中自殺企圖者停役後生活經驗之探討

Abstract

自殺雖是個人結束生命的行為，卻和社會文化有密切的關係，現今社會的多元化，導致自殺現象變的更為複雜。當兵是我國18歲男子之義務，軍中世界有其特殊文化，役男無法適應部隊生活出現自殺行為，經診斷罹患精神疾患，辦理停役終止軍旅生涯。停役後雖少去軍中壓力，但停役者回歸社會面臨環境的改變，需要更多的努力方能適應新的世界，因此本研究目的在瞭解軍中自殺企圖者停役後的生活經驗。 本研究於北部一所國軍精神專科醫院，針對五位於軍中發生自殺行為，辦理停役的病患，以民族誌研究方法，於民國94年2月到96年2月間，運用半結構式深度訪談及參與式觀察等方式，收集停役者生活之主觀經驗，期間五位停役者共訪談十二次，每次訪談一小時三十分到兩小時之間。研究結果以故事性方式描繪停役者生活，並經由分析與歸納，探討停役對其影響與意義。 研究發現軍中自殺企圖者，停役後深受憂鬱症、自殺與未當完兵等多重烙印之苦。停役者自許為「正常」的精神病患，但是由於擔心他人對精神病的偏見，故以身體疾患掩飾憂鬱症；然而家屬與他人指責停役者是「沒有用的」、「丟臉」、「裝病」、「無法完成男人的使命」，並採取嘲弄與排斥的態度。這些處境讓停役者覺得自己「與眾不同」、「不是個男人」、「不被寄予希望」，工作機會受到限制，於是對外界武裝自己，造成與家人關係變的僵化，與外界關係處於矛盾的狀態。但是因著醫療人員、朋友接納的態度與正向互動的經驗，讓停役者在面對困境之虞，仍然有了改變的契機，因著他人的接納，停役者進而接納自我，並開始在信念與態度上有了轉變。「停役」對於停役者來說成為生命的轉捩點，社會支持力量的介入，促使停役者轉化苦痛的經驗，獲取正向與健全的轉變，習得疾病照護知識、轉而正向看待事物、對於自我角色能更加的掌控，並能與他人建立穩固有意義的關係。 研究結果有助於停役者的家屬與社會大眾，了解軍中自殺企圖者停役後生活之現象，面對停役者採取接納的態度，並提供停役者適切的照護，以期在轉變過程中，停役者能於社會中獲取更多促進與支持的力量。

Although suicide is an action for an individual to end his life, it is closely connected to social culture, and the multi-faceted culture of today causes the phenomenon of suicide to be even more complicated. Military service is mandatory for Taiwanese males at 18 years of age. The military has its own unique culture, and suicides often take place when conscripts cannot adapt to it. When these conscripts are diagnosed with psychiatric diseases, they are separated from the service. However, when they return to society and are free from the pressures of the military, they again have to adapt to a new environment, an adaptation which frequently requires considerable effort. The objective of this study was to understand the life experiences of conscripts who attempted suicide following separation from the military. Five subjects who attempted suicide and were then separated from their uniformed services were selected from a national army psychiatric hospital located in northern Taiwan. An ethnographic method of study was applied. The subjective life experiences of these separated conscripts were collected using semi-structured deep interviews and participatory observations between February 2005 and February 2007. There were a total of 12 interviews and each interview lasted from 90 to 120 minutes. The life experiences of these separated conscripts were narrated as a story and the results were analyzed and compiled in order to study the effect and meaning of separation from conscription on their lives. The study found that life following separation from military service was full of difficulties for conscripts who attempted suicide. In the early stages, the conscripts experienced mockery, rejection, and questioned the existence of their underlying psychiatric diseases. This caused the conscripts to feel isolated, to erect a facade, to feel hopeless about the future, and to be unable to build steady relationships with others. However, after a certain period of experiencing acceptance from mentors, friends, the army, and healthcare workers, the separated conscript began to experience positive interactions and learned to accept themselves. Changes began to occur, the conscript developed new social interactions, and changes in their beliefs and actions were evident. Life after separation from the service was fraught by the social stigma surrounding the separation, depression, and suicide. In addition, one's relationship with their family became strained and distant. Nevertheless, service separation also served as a turning point in their lives. Support from society helped to transform their bitter experiences into a positive and healthy transition, and in the process, obtain knowledge on the medical care they needed, become more optimistic with a positive outlook on life, have better control of their role in life, and to build steady and meaningful relationships. This study will help families of separated conscripts and society to understand the phenomenon of life following separation from the service of those who attempted suicide, and to show acceptance and provide them with proper care. Hopefully, more positive support will be available for the separated conscript in transition.