邊緣性人格障礙者愛情分手之心理調適歷程研究

愛情分手後的復原過程往往需要良好的調適技巧並耗費極大的內在資源，本研究目的為瞭解邊緣性人格障礙者面對分手經驗時的調適歷程及相關因素。研究方法採立意取樣，由高雄地區兩位精神科醫師轉介六名年齡介於二十至四十歲之邊緣性人格障礙者為研究對象，以深度訪談蒐集資料，訪談過程全程錄音，再謄錄為逐字稿，進行資料整理、編碼，採敘事分析之「整體－內容」分析每位個案的生命故事、「類別－內容」分析跨個案的重要議題，並請受訪者檢核相關資料以確保研究的有效性。研究結果顯示：（1）過去的創傷經驗、家庭功能不健全與不安全依附對愛情關係的發展有負向影響；（2）在認知、情緒及行為上的反應大致與一般族群相同，主要差異在於其認知缺乏彈性、出現極端的負向認知、情緒強度較高且頻繁出現自殺、自殘等衝動行為；（3）使用不適當的調適策略導致惡性循環，復原程度低；（4）關係的結束加深對於自我、人際與愛情的負向概念，無法賦予分手經驗正向意義；（5）願意尋求醫療協助但難維持規律藥物或心理治療。最後根據上述結果進行討論，並對未來相關研究及臨床工作者提出建議。

關鍵字

邊緣性人格障礙；分手；心理調適；質性研究

並列摘要

Recovering from a breakup usually takes good adjustment skills and consumes great inner resources. The purpose of this study is to understand the rehabilitation process and to find out relevant factors affecting individuals with borderline personality disorder (BPD) when they’re facing with breakup. There were 6 patients with BPD aged 20 to 40 referred to be research subjects by 2 psychiatrists in Kaohsiung. For collecting data, purposive sampling and in-depth interviews are chosen in this study. The entire interview was audio-recorded, and the recordings were converted into transcripts. This study performed the “holistic-content” and “categorical-content” approach of narrative research to analyze the life story and the important issues across subjects. The results indicated that (a) previous traumatic experiences, dysfunctional family, and insecure attachment negatively affect the development of romantic relationship; (b) the patients are generally the same as general population in cognitive, emotional, and behavioral responses, but the main differences are that patients are lack in cognitive flexibility, performing extremely negative cognition, higher emotional intensity, frequent occurrence of suicide attempts, and self-injury; and (c) both emotional and behavioral dysregulation will lead to vicious circle and low level of recovery; (d) termination of relationship reinforces the negative concepts of self, interpersonal relationship, and love; (e) patients with BPD are willing to seek medical assistance, but it is difficult for them to maintain regular medication or psychotherapy. Based on these findings, implications for practice and further research were addressed as well.