Borderline identity diseases: Meaning, differential prognosis, scientific contexts, and therapeutic tips
Ranging from the overall notion of “borderline”, the current performs focuses primarily on many regions of character disease that define this new clinical and you will symptomatic contexts, putting the newest fundamentals getting the correct differential prognosis, instead of forgetting the new neural properties produced by the new scientific community. A special group model of borderline personality disorder, centered on five levels, try recommended. The new conversation ends up towards top ideal therapeutic steps.
Definition, differential prognosis and you will medical perspective out of borderline identification problems
Definition, introduction and you will epidemiological profile: The phrase “borderline” came to be because a label aimed at outlining sugar daddy Maryland a whole show regarding functions and you may behaviors that are hard to identify. Migone (1990) draws up a listing of the fresh new significance various authors, and that send practically straight to the borderline area, less than specific: “borderline neurosis” (Clark, 1919), “parataxies in some borderline intellectual states” (Moore, 1921), “impulsive profile”, “incipient schizophrenia” (Glover, 1932), “atypical schizophrenia” otherwise “affective schizophrenia” (Kasanin, 1933), “outpatient schizophrenia” (Zilboorg, 1941), “character because if” (Deutsch, 1942), “latent psychosis” (Federn, 1947), “pseudonevrotic schizophrenia” (Hoch & Polatin, 1949), “latent schizophrenia” (Bychowsky, 1953), “psychotic character” (Frosch, 1954, 1960), “attenuated schizophrenia” (Ekstein, 1955), “histeroids” (Easser & Less, 1965), “atypical psychosis”, “borderline schizophrenia” (Kety, ainsi que al. 1968), “hysteroid dysphoria” (Klein & Davis, 1969; Klein, 1977), “borderline psychosis”, “indescribable clients” (Welner, ainsi que al. 1973), “subaffective diseases” (Akiskal, 1981) .
Belongings in the fresh new manuscript
The application of the expression “borderline”, as you may know they, have sources one lay in the early attempts to codify diagnostic classifications on psychiatric setting. In fact, on the 50s of one’s history millennium, a team of dynamic psychotherapists and psychiatrists tried to would a great symptomatic group for some rational conditions one did not meet the criteria proper so you can neuroses or psychoses, starting from the concept created by Strict inside 1938 toward cystic towards the edging anywhere between neurosis and psychosis. This type of clients endured big feeling instability, significant problems during the target relationships, and you can first off consolidation dilemmas during the community. The fresh new malfunction of your symptomatic habits composed of several nosographic perplexities because these clients presented a far more dramatic scientific image of this new neuroses however, with no typical properties to the analysis regarding psychosis (especially regarding the disconnected experience of reality).
Because months, for this reason, special classifications for it types of disease flourished, for instance the “pre-schizophrenia” regarding Rapaport and Gill or the “states/personalities at the maximum” of Rangell. All the suggestive hypotheses one unsealed the doorway on most ranged issues. On this reputation, regarding 60s of the same millennium, Kernberg, doctor and you may psychoanalyst, set up a good psychoanalytic model of such issues based on Klein’s “Concept off target relationships” as well as on the “Therapy of the Ego” regarding A. Freud and you will Hartmann. Kernberg, in particular, ways various episodes, including 100 % free and you will changing stress, several fears, dissociative responses, hypochondriac concerns, perverse polymorphic sex, and you will substance abuse. Trusting, not, the analysis might be dependent not really much towards the periods found however, much more about the clear presence of some architectural attributes that dictate the company away from character, prepared the term “Borderline Providers out-of Identity”, different from neurotic communities and you may psychotic teams already codified of the scientific community, stating this particular company is described as this new systematic access to a particular gang of defense mechanisms hence Kernberg sensed way more “primitive” as opposed to those of one’s neurotic types of, such as splitting, devaluation, idealization, and you can projective identification, through which anyone classified differing people in his ecosystem just like the “totally a good” otherwise “entirely crappy”, even if the view on a person you will definitely consist of day to-day if you don’t on a daily basis.