Holm K, Hundevadt E
Br J Med Psychol. 1981 Dec;54(Pt 4):335-40. doi: 10.1111/j.2044-8341.1981.tb02571.x.
In the authors' opinion the borderline concept covers a group of patients difficult to define and to delineate but nevertheless a group different from the conventional diagnostic groups of neurosis and psychosis. During work with a follow-up study of borderline patients it occurred to the authors that the classification of Grinker et al., which makes it possible to divide borderline patients into four groups, can fruitfully be combined with the object relation theory of "the English school" of psychoanalysis. A patient's belonging to one of Grinker's groups is shown to be informative as to how this patient has "solved" what Fairbairn calls "the schizoid dilemma". The conceptual framework thus set up is useful in planning the treatment of borderline patients: each subgroup of borderline patients as described by the authors can be given its own indications and contra-indications as far as working alliance and treatment plan are concerned.
作者认为，边缘性概念涵盖了一组难以界定和区分的患者，但这仍是一个不同于传统神经症和精神病诊断组的群体。在对边缘性患者进行随访研究的过程中，作者们想到，格林克等人的分类法能将边缘性患者分为四组，可卓有成效地与精神分析“英国学派”的客体关系理论相结合。事实表明，患者属于格林克分类中的哪一组，对于了解该患者如何“解决”费尔贝恩所说的“精神分裂困境”具有指导意义。由此建立的概念框架有助于规划边缘性患者的治疗：就工作联盟和治疗计划而言，作者所描述的边缘性患者的每个亚组都可有其自身的适应证和禁忌证。
