Køster Allan
Department of Communication and Psychology, Aalborg University, Krogh Stræde 3, 9220, Aalborg, Denmark.
Theor Med Bioeth. 2017 Dec;38(6):465-482. doi: 10.1007/s11017-017-9422-z.
It is often emphasised that persons diagnosed with borderline personality disorder (BPD) show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective, BPD can be understood as an existential modality in which the embodied self is profoundly saturated by an alienness regarding the person's own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through, e.g., psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern 'from behind'. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question of personal responsibility in BPD, particularly as this question plays out in psychotherapeutic contexts where a narrative self-appropriation may facilitate an increase in sense of autonomy and reduce emotions of guilt and shame.
人们常强调，被诊断为边缘型人格障碍（BPD）的人在理解自身心理状态方面存在困难。在本文中，我认为从现象学角度来看，边缘型人格障碍可被理解为一种生存模态，在这种模态中，具身自我被关于个体自身情感和反应的一种陌生感深深浸透。然而，熟悉与陌生的平衡并非静止不变，而是可以通过例如心理治疗来培养。顺着这一思路，我提出这样的观点，即对经历进行叙事化在接纳这种具身自我陌生感的过程中可发挥重要作用。重要的是，这里所使用的叙事概念是一种叙事性的标量概念，即叙事性是一种程度不同的、可变的体验特质。从这个角度来看，叙事接纳是一个逐渐将叙事性特质赋予经历的过程，从而使原本“幕后操纵”的情绪、情感和反应变得熟悉起来。最后，我提出具身自我陌生感的叙事接纳这一观点也与边缘型人格障碍中备受争议的个人责任问题相关，尤其是在心理治疗情境中，这种叙事性的自我接纳可能有助于增强自主感，并减少内疚和羞耻情绪时，这一问题就会凸显出来。
