边缘型人格障碍患者父母的群体心理治疗:Βasic假设与群体包容功能。

Q3 Medicine Psychiatrike = Psychiatriki Pub Date : 2023-03-28 DOI:10.22365/jpsych.2022.080
Pentagiotissa Stefanatou
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引用次数: 1

摘要

边缘型人格障碍(BPD)患者在人际关系方面存在很大困难。他们在人际关系上的极端困难体现在心理家庭互动中。父母成为冲突和患者攻击行为的接受者,而家庭压力则因自杀倾向、自残和药物滥用而增加。目前的报告介绍了对年轻成年BPD患者的父母进行团体心理治疗的介绍,这些患者在埃基辛医院的一个特殊的人格障碍单元接受治疗。目的是通过患者和家长的平行团体治疗,为患者建立持续治疗的条件,维持治疗效果,并建立一个有利于家庭心理痛苦、焦虑、愤怒、羞耻、内疚和悲伤的环境。本文介绍了一个由13名成员组成的父母小组的第一次会议的临床资料,以说明在与父母的治疗工作中发展的抵抗,原始防御和依赖和战斗-逃跑的基本假设。此外,还讨论了小组分裂和敌对的移情沟通以及治疗师的反移情反应。Τhe群体的包容功能被描述为原始焦虑和投射性认同转化的治疗过程,这是通过治疗师对他们的反移情反应和对敌意和困惑的容忍的阐述而逐渐建立起来的。遏制有助于建立一种群体文化,对父母无意识的抵抗、对疾病的否认以及对孩子和治疗师的负面投射进行共情理解,从而逐渐抑制抵抗,改变陈旧的投射。因此,该团体被期望作为一个安全的空间,允许表现和缓解破坏焦虑,以及表达无法表达和无法忍受的情绪。最后,作为母亲对象的群体有望内化为积极父母关怀的典范,增强父母的移情和反思能力,以便他们可以在修复过程中重复父母的角色。
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Group psychotherapy for parents of patients with borderline personality disorder: Βasic assumptions and group containing function.

Patients with borderline personality disorders (BPD) have great difficulties with interpersonal relations. Their extreme difficulties with interpersonal relations are illustrated in psychic family interaction. Parents become the recipients of conflicts and patient's aggressive behaviour, while family stress increases due to suicidal tendency, self-injuries and substance abuse. The current report presents the introduction of group psychotherapy for parents of young adult patients with BPD, treated in a special unit of personality disorders at Eginition Hospital. The aim is, through the parallel group therapy of patients and their parents, to establish the conditions of continuing therapy for the patients as well as maintaining therapy outcomes and to construct a facilitating environment where the family's mental pain, anxieties, anger, shame, guilt and sadness can be contained. Clinical material from the first sessions of a 13-member parent group is presented to illustrate the resistances, the primitive defenses and the basic assumptions of dependency and fight-flight developing in therapeutic work with parents. Furthermore, the groups' split and hostile transference communications and the therapists' countertransference reactions are discussed. Τhe containing function of the group is described as a therapeutic process of transformation of the primitive anxieties and projective identifications, which is gradually established through the therapists' elaboration of their countertransference reactions and their tolerance to hostility and confusion. Containment facilitates the establishment of a group culture of empathic understanding for parents' unconscious resistances, denial of the illness and negative projections onto their child and the therapists, so that resistances gradually to be curbed and archaic projections to be transformed. Hence, the group is expected to function as a safe space to allow the manifestation and relief of destruction anxieties, and the expression of unuttered and intolerable emotions. Finally, the group as a mother-object is expected to be internalised as a model of positive parental care, enhancing the empathic and reflective ability of the parents so that they may repeat the parental role in a process of reparation.

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来源期刊
Psychiatrike = Psychiatriki
Psychiatrike = Psychiatriki Medicine-Medicine (all)
CiteScore
2.60
自引率
0.00%
发文量
37
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