Hingley S M
Psychology Service, Lobley Hill Clinic, Gateshead, UK.
Br J Med Psychol. 2001 Mar;74(Pt 1):57-72.
An introductory overview of central psychodynamic theories relevant to narcissistically related personality problems and disorders of the self is provided, focusing on the central role of the child's relationship with primary care givers in the development of the self. A psychodynamic formulation is described for a 45-year-old woman experiencing depression, anxiety and despair following a severe rift in her previously enmeshed/merged relationship with her teenage daughter. The subsequent two and a half years of therapy were monitored using the Brief Symptom Inventory (BSI), the Dysfunctional Attitudes Scale (DAS) and the Object Relations Technique (ORT), producing data supportive of psychodynamic theory and therapy. A pattern of depression emerged during therapy which was in keeping with the concept of abandonment depression, as the client came to experience herself as more separate from her daughter and others. Changes in the functioning of primitive defences were also illustrated, plus the expression of previously denied anger, and increased abilities to be assertive, set limits and take care of herself.
本文提供了与自恋相关的人格问题和自我障碍相关的核心心理动力学理论的介绍性概述，重点关注儿童与主要照顾者的关系在自我发展中的核心作用。描述了一位45岁女性的心理动力学构想，她在与十几岁女儿先前紧密交织/融合的关系出现严重裂痕后，经历了抑郁、焦虑和绝望。随后两年半的治疗使用简明症状量表（BSI）、功能失调性态度量表（DAS）和客体关系技术（ORT）进行监测，得出的数据支持心理动力学理论和治疗。治疗过程中出现了一种抑郁模式，这与被抛弃抑郁的概念相符，因为来访者开始体验到自己与女儿及他人更加分离。还阐述了原始防御功能的变化，以及先前被否认的愤怒的表达，以及在 assertiveness（此处可能是“自信”之意，原文有误，应为“assertiveness”）、设定界限和照顾自己方面能力的增强。
