Chlebowski Susan M
Division of Child & Adolescent Psychiatry ,Upstate Medical University, State University of New York, Syracuse, NY 13210, USA.
Am J Psychother. 2013;67(2):153-64. doi: 10.1176/appi.psychotherapy.2013.67.2.153.
The child whose mother is diagnosed with borderline personality disorder (BPD) is at risk for developing this disorder. The mother with BPD may be limited in her ability to negotiate a secure attachment with her baby. Mothers with BPD may have difficulties with bonding, internalization, affect attunement, and attachment. Because it is through mirroring and mentalization that a child can learn emotional regulation and master the early stages of development, the child may fail to develop object constancy and master the tasks of separation and individuation. The authors present two cases of patients with BPD. The first case is of a patient with BPD who, after surrendering custody of her two children to their father, participated in weekly Dynamic Deconstructive Psychotherapy sessions for two years. The second case is a mother with BPD who presents for dyadic therapy with her three-month-old daughter. In each case the mother developed insight regarding her relationship with her mother and how that relationship affected the relationship with her own child. The author concludes that psychiatry should consider prepartum screening for BPD and if necessary, early dyadic intervention.
母亲被诊断为边缘型人格障碍（BPD）的孩子有患该障碍的风险。患有BPD的母亲与婴儿建立安全依恋关系的能力可能有限。患有BPD的母亲在情感联结、内化、情感协调和依恋方面可能存在困难。由于孩子是通过镜像和心理化来学习情绪调节并掌握早期发展阶段的，因此孩子可能无法发展客体恒常性，也无法完成分离和个体化任务。作者介绍了两例BPD患者的病例。第一个病例是一名患有BPD的患者，在将两个孩子的监护权交给孩子父亲后，参加了为期两年的每周一次的动态解构心理治疗。第二个病例是一位患有BPD的母亲，她带着三个月大的女儿前来接受二元治疗。在每个病例中，母亲都对自己与母亲的关系以及这种关系如何影响她与自己孩子的关系有了深刻认识。作者得出结论，精神病学应考虑对BPD进行产前筛查，如有必要，进行早期二元干预。
