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边缘型人格障碍患者的现实感、现实检验与现实处理

Sense of reality, reality testing and reality processing in borderline patients.

作者信息

Figueiredo Luis Claudio

出版信息

Int J Psychoanal. 2006 Jun;87(Pt 3):769-87. doi: 10.1516/8Q72-R1Q6-N144-H0G6.

Abstract

Although borderline patients are suitable for it, they often undergo repeated testing of fantasies against objective reality without success. A reason for these partial failures is that subjects have not been able to build a solid sense of reality and have found many difficulties for processing reality demands and possibilities. The author puts forward some thoughts on this question, such as the importance of working through the depressive position and the Oedipus complex in the process of building up a solid sense of reality. A sense of reality also favours continuous reality processing. When reality processing becomes as continuous as life itself, the repetition of individual reality tests becomes less frequent and necessary, and more satisfying. The author also presents some recommendations for the psychoanalytic treatment of such patients, stressing the importance and the difficulties of the introduction of the borderline patient into the triangular situation because primitive defences--such as disavowal and denial--are mobilized.

摘要

尽管边缘型患者适合这样做,但他们常常反复将幻想与客观现实进行检验,却未获成功。这些部分失败的一个原因是,主体未能建立起稳固的现实感,并且在处理现实需求和可能性方面遇到了诸多困难。作者针对这个问题提出了一些想法,比如在建立稳固现实感的过程中,修通抑郁位置和俄狄浦斯情结的重要性。现实感也有利于持续的现实处理。当现实处理变得像生活本身一样持续不断时,个体现实检验的重复就会变得不那么频繁和必要,也更令人满意。作者还针对此类患者的精神分析治疗提出了一些建议,强调将边缘型患者引入三角情境的重要性和困难,因为诸如否认和拒绝这样的原始防御会被调动起来。

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