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精神病性人格与边缘型人格

Psychotic character versus borderline.

作者信息

Frosch J

出版信息

Int J Psychoanal. 1988;69 ( Pt 4):445-56.

PMID:3220673
Abstract

The clinical syndrome designated by the diagnostic term borderline, exists. However, the diagnosis borderline as such gives no clue about the clinical or psychodynamic feature in this syndrome. Furthermore, the use of the concept borderline by its very vagueness and diffuseness deprives us of a means of understanding these conditions clinically and dynamically. It thereby makes it more difficult to treat these patients with appropriate understanding. I therefore believe it should be abandoned. The diagnosis psychotic character has previously been proposed by the author for this syndrome. It relates more appropriately to the clinical and psychodynamic features and is more consonant with an understanding of the syndrome. The diagnosis suggests, among other frames of reference, the underlying psychotic process which typifies these patients. It provides frames of reference which facilitate understanding these conditions psychodynamically and genetically. Out of this understanding a more meaningful therapeutic approach may evolve. We therefore feel that the term and concept borderline should be abandoned.

摘要

由诊断术语“边缘型”所指的临床综合征是存在的。然而,“边缘型”这一诊断本身并未提供关于该综合征临床或心理动力学特征的线索。此外,“边缘型”这一概念因其极度模糊和宽泛,使我们无法从临床和动力学角度理解这些病症。这进而使得以恰当理解来治疗这些患者变得更加困难。因此,我认为它应该被摒弃。作者此前曾针对该综合征提出“精神病性人格”这一诊断。它与临床和心理动力学特征的关联更为恰当,也更符合对该综合征的理解。该诊断在其他参照框架中暗示了这些患者所具有的潜在精神病性过程。它提供了有助于从心理动力学和发生学角度理解这些病症的参照框架。基于这种理解,可能会发展出更有意义的治疗方法。所以我们认为“边缘型”这一术语和概念应该被摒弃。

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