Dergi Ara >>
Yıl:1999; Cilt: 6; Sayı: 3>> Özet
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 1999;6(3):165-171
Borderline Kişilik Bozuklukları: Örselenme (Travma)
C Odağ
Düsseldof Psikanaliz Enstitüsü, Almanya.\r\n\r\n
Çocuklukta yaşanılan bedensel ve cinsel taciz, başkalarına yapılan bedensel ve cinsel tacize tanıklık, aşırı çekingenlik ve ihmal nesne ilişkileri kuramcılarına göre Borderline kişilik bozukluğunun ortaya çıkmasında etkili örselenmelerdir. Bu bunlara yakınların yitimi, koruyucu nesnelerin sık sık değişmesi, çocuğun istenci dışında aileden uzaklaştırılması, ebeveynin biri tarafından istenmediği duygusu, aile içinde sıcaklık ve sevgi veren (libidinal yatırımlı) kişilerin eksikliği gibi acı deneyimleri de katıyoruz.

Nesne ilişkileri kuramına göre akut travmaların işlenişini benliğin (ego) gücüyle kendiliğin (self) yapısı belirler. Bize göre güncel travmanın işlenişinde daha önce geçirilmiş örselenmelerin şiddeti de belirleyici bir etmendir. Borderline hastalar en erken çocukluk dönemlerinde karşılaştıkları ve işleyemedikleri şiddetli travmalar yaşam boyu birlikte olmak konumundadırlar. Bu onlara travmalara karşı belirli bir duyarlılık ama aynı zamanda bir dayanıklılık da kazandırmaktadır. Önemsiz gibi görünen bir travmaya şiddetle verilen tepki duyarlılığın, çok şiddetli bir travmaya karşın ruhsal yapısal bütünlüğün korunabilmesi dayanıklılığın, kanıtlarıdır.

Ayrıca akut güncel travmalara verilen tepki borderline hastaların yapısal ve işlevsel özgül sorunlarının da etkisindedir. Tıpkı dismorfofobi, anoreksiya nervosa, şizofreni gibi ergen dönemine özgü hastalıkların, dönemin çözülmesi gerekli temel sorunlarının etkisi altında olması gibi.

Borderline Personality Disorder and Trauma
Childhood traumas are important factors in the development of Borderline Personality Disorder (BPD). Patients with BPD have difficulty in working through the childhood traumas and have to live with them lifelong. Their reactions to acute daily traumas are affected by their specific structural and functional problems.

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