LaFarge L
Columbia University College of Physicians and Surgeons.
J Am Psychoanal Assoc. 1989;37(4):965-95. doi: 10.1177/000306518903700405.
This paper examines the empty states experienced by severely ill borderline patients. At times of stressful regression, these patients use complaints of emptiness to describe profound disturbances of affect, cognition, object relations, and bodily experience. Empty states may be seen as complex defensive configurations which protect a borderline level of psychic structure from the impact of aggressively charged object relations, and ward off further regression to states of fragmentation or fusion. Severely ill borderline patients consolidate an empty screen by means of a characteristic repertoire of primitive defenses consisting of various forms of projective identification, including bitriangulation and projective identification of psychic agencies, somatization, acting out, and specific alterations in cognition. The author describes the highly deviant organizations of the object world seen in empty states, and the complex and disturbing countertransferences which these states evoke.
本文探讨了重症边缘型人格障碍患者所经历的空虚状态。在压力性退行时期，这些患者用空虚感来描述情感、认知、客体关系和身体体验方面的深刻紊乱。空虚状态可被视为复杂的防御结构，它保护着边缘水平的心理结构免受充满攻击性的客体关系的影响，并防止进一步退行至破碎或融合状态。重症边缘型人格障碍患者通过一系列由各种形式的投射性认同组成的原始防御机制来巩固一个空虚的表象，这些防御机制包括三角化、心理机构的投射性认同、躯体化、付诸行动以及认知方面的特定改变。作者描述了在空虚状态中所见到的客体世界的高度异常组织，以及这些状态所引发的复杂且令人不安的反移情。
