, Corso San Gottardo 15, 20136, Milan, Italy.
Am J Psychoanal. 2021 Mar;81(1):82-111. doi: 10.1057/s11231-021-09279-x.
Recent research on trauma, attachment and neuroscience point at a clear divide in psychopathology between disorders based on repression, (as in Freud's repression model) and psychopathologies structured on dissociative mechanisms, a response to severe interpersonal trauma. Pathologies based on repression are typical of a neurotic structure, (with better developmental outcome), while pathologies based on dissociation are of more severe, often borderline nature, as in Otto Kernberg's borderline organization (1975). Neurobiology of attachment and affect regulation theory (Allan Schore), developmental psychopathology (Giovanni Liotti) and contemporary relational psychoanalysis (Philip Bromberg), all provide clinical evidence that the most severe psychopathology is of dissociative structure. This paper clarifies the after-effects of first level of traumatization of human agency (i.e., lack of attunement) and of the second level as in cases with actual abuse, maltreatment or incest (Mucci, 2013), with the internalization of a dyad victim/persecutor within the self of the survivor, as seen in borderline psychopathology (Mucci, 2018).
最近的创伤、依恋和神经科学研究表明，在以压抑为基础的精神病理学障碍（如弗洛伊德的压抑模型）和基于分离机制的精神病理学障碍之间存在明显的区别，这是对严重人际创伤的反应。基于压抑的病理学是神经症结构的典型特征（具有更好的发展结果），而基于分离的病理学则更为严重，通常是边缘性的，如奥托·克恩伯格的边缘性组织（1975）。依恋的神经生物学和情感调节理论（Allan Schore）、发展心理病理学（Giovanni Liotti）和当代关系精神分析（Philip Bromberg）都提供了临床证据，表明最严重的精神病理学是分离性结构。本文澄清了人类机构的第一级创伤化（即缺乏协调）和第二级创伤化的后果，如实际虐待、虐待或乱伦（Mucci，2013），在幸存者的自我内部内化了一对受害者/迫害者，如边缘性精神病理学所见（Mucci，2018）。
