Melges F T, Swartz M S
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
Am J Psychiatry. 1989 Sep;146(9):1115-20. doi: 10.1176/ajp.146.9.1115.
The authors propose that oscillations of attachment in borderline personality disorder stem from a central problem with regulation of interpersonal distance. This problem derives from borderline patients' conflicts between fears of abandonment and domination. When they move closer to others, they fear that they will be dominated; when they move away, they fear that they will be abandoned. Whichever direction they move, they experience negative feedback. This gives rise to recurrent oscillations between attachment to and detachment from others. Because the oscillations are reinforced by the ambivalent reactions of significant others and the involvement of third parties, family therapy is often indicated.
作者提出,边缘型人格障碍中依恋的波动源于人际距离调节的核心问题。这个问题源于边缘型患者在害怕被抛弃和被控制之间的冲突。当他们与他人靠近时,他们担心会被控制;当他们远离时,他们担心会被抛弃。无论朝哪个方向移动,他们都会经历负面反馈。这导致了在与他人依恋和脱离之间反复出现的波动。由于这些波动会因重要他人的矛盾反应和第三方的介入而得到强化,因此家庭治疗往往是必要的。