Integrative Psychotherapy for Patients with Borderline Personality Disorder: A Description of a Management Model in Taiwan

描述台灣之一種邊緣型人格障礙整合式心理治療模式

10.29478/TJP.200912.0004

周勵志(Lih-Chih Jou)

邊緣型人格障礙 ； 整合式心理治療模式 ； 精神動力 ； borderline personality disorder ； integrative psychotherapy ； psychodynamic

台灣精神醫學

23卷4期（2009 / 12 / 01）

275 - 283

英文

本文是要描述自2001年5月起，在台北某醫學中心所逐步發展的，一個以邊緣型人格障礙病人為主要對象的整合式心理治療模式。基於客體關係理論，並參考辯證行為治療模式的辯證策略，本心理治療模式包括三成份：支持－精神動力個別心理治療，長期精神動力－人際－存在團體心理治療，及諮商－督導團體。以質性分析方式討論與本心理治療模式發展有關的一些重要團體現象，例如，反映或平行過程、團體主題與療效因子、界線問題、反團體力量、循環治療與發展螺旋等。當提供邊緣型人格障礙病人的心理治療時，下列諸點值得深思：(1)心理治療是一種持續的辯證性互動，(2)心理治療技巧的應用要兼顧整合性與折衷性，(3)心理治療是一種存在性的交會，(4)心理治療講究技巧性的型態配對。

This overview is to discuss a management model of integrative psychotherapy for patients with DSM-IV-TX Borderline Personality Disorder (BPD), developed at a medical center in northern Taipei, Taiwan since May 2001. Based on Object relations, and Linehen's dialectic strategy, this model is composed of supportive-psychodynamic outpatient individual psychotherapy, long-term outpatient psychodynamic-interpersonal-existential group therapy for patients, and a consultation-supervision group for therapists. Group phenomena such as reflection process or parallel process, group themes and therapeutic factors, boundary issues, anti-group force, cyclotherapy and developmental spiral, acknowledged during the development of the model were discussed. In providing psychotherapy for BPD patients, the following suggestions may be considered: (A) Psychotherapy as continuous dialectic interaction, (B) Psychotherapeutic managements being integrative and eclectic, (C) Psychotherapy as an existential encounter, (D) Skillful pattern matching in psychotherapy.

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