《How to Talk to a Borderline》中Joan Lachkar介绍了边缘型人格障碍（BPD），并概述了它给临床医生带来的挑战和困难。
《How to Talk to a Borderline》中Joan Lachkar介绍了边缘型人格障碍（BPD），并概述了它给临床医生带来的挑战和困难。她通过概述八种不同类型的边缘人格障碍以及每种边缘人格障碍如何需要特定的沟通技巧和方法来扩展目前对BPD的理解。全文中提供了案例示例，在某些情况下还描述了边界线吸引的合作伙伴类型。这本书提供了沟通，工作和治疗边缘人格障碍的新方法，同时整合了更现代的治疗方法。
Joan Lachkar博士是一名心理医生和精神历史学家，在加利福尼亚州泰山的私人诊所工作。她是许多有关婚姻和政治冲突的出版物的作者，也是一本成功的书《如何与自恋者交谈》的作者。Joan Lachkar是新的精神分析中心的会员和讲师，是《心理历史杂志》、《FrontPage杂志》和《家庭安全问题》的特约撰稿人。
Living in Borderland. Overview of the Borderline Personality. The Pathological Borderline. The Malignant Borderline. The Depressive Borderline. The Obsessive-Compulsive Borderline. The Antisocial Borderline. The Passive-Aggressive Borderline. The Histrionic Borderline. The Cross-cultural Borderline. Closing Thoughts.
Unfortunately, many challenges exist whentreating mentally ill patients, particularly criminal offenders. Theseoffenders might be resistant to treatment, mental health professionals might beafraid to treat them, and the offenders might perceive the helpingprofessionals as an extension of the jus- tice system and not as theiradvocates (Lamb, Weinberger, & Gross, 1999). However, these challenges canbe overcome by identifying a sound treatment philosophy and clear treatmentgoals. This chapter is useful for forensic psychologists and people in thecriminal justice system. It also has applicability for the family, friends,spouses, partners, co-workers, and acquaintances of these offenders, who oftenhave difficulty dealing with the guilt and shame of having been involved withsuch immoral people. Mentally ill offenders cause difficulty for the criminaljustice system, which needs to put in place comprehensive programs based on atreatment philosophy that balances individual rights and public safety andincludes clear treatment goals (Lamb, Weinberger, & Gross, 2004).
不幸的是，在治疗精神疾病患者时存在许多挑战，特别是罪犯。这些罪犯可能会抗拒治疗，心理健康专家可能害怕治疗他们，罪犯可能会把帮助他们的专业人士视为司法体系的延伸，而不是他们的拥护者(Lamb, Weinberger， & Gross, 1999)。然而，这些挑战可以通过确定一个健全的治疗理念和明确的治疗目标来克服。这一章对司法心理学家和刑事司法系统中的人们都很有用。它也适用于这些罪犯的家庭、朋友、配偶、伴侣、同事和熟人，这些人往往难以处理与这些不道德的人有牵连的罪恶感和羞耻感。精神疾病罪犯给刑事司法系统带来了困难，这需要建立在治疗哲学基础上的综合项目，平衡个人权利和公共安全，包括明确的治疗目标(Lamb, Weinberger， & Gross, 2004)。
Not all people treating criminals andpeople with deviant behavior are analytically trained, but those who are canappreciate Melanie Klein’s work (1927) and will find it invaluable. Ofparticular interest is her take on how criminals ward off anxiety by blockingout guilt emanating from the superego—the conscience missing in the mind of anantisocial. Klein further explains how the pathological self meets and matchesthe criminality of a persecutory superego only to be absorbed by an ego inharmony and synchronicity with the false self. “nothing wrong with knocking offthis guy; he deserved it!” Within the venue of the language of dialectics thisoffers us another opportunity to communicate with these two worlds (thefalse/denying/delusional self vis à vis a world of morality and values).
It is amazing how people with thesepathologies, people who live in a Judeo-Christian-based society, believe theycan get away with their sociopathy. Here we retrieve the “false self,” mainlyof the borderline, the self that belies the true self and creates an entirepersona to fit the crime. These are the charmers, fixers, caretakers, all-encompassinggivers, the charismatic types that can dupe even the most seasoned therapist.“Oh, Dr. Analyst, I have been to so many therapists and they were all terrible.So glad I found you. You are amazing!”
I met the nicest guy. He was so loving andthoughtful, would take me to the nicest places, bring me gifts, flowers. Andthen gradually it stopped. He claimed it was because he was in debt and neededmoney. So I loaned him $50,000.00, which he promised to pay back. When I firstmentioned getting back my money, I got the cold shoulder, silence. Every time Imentioned it later, his response kept getting more violent. He would slap me orbang me against the wall. I was afraid to call the police because then I knew Iwould never get my money back. Suddenly he disappeared, and I never heard fromhim again.
Many people are caught in this dilemma.They fear reporting the violence because, if they do, their partners may losetheir capacity to work or, as in the case above, never pay back the victim.Laws should be revised to find a middle ground for dealing with antisocialborderlines that includes special workshops, anger management seminars, couplescounseling, assigned monitors, and so forth.
Profile of an Extreme AntisocialBorderline
In 1978, Ted Bundy was found guilty in themurders of two Chi Omega Sorority sisters at Florida State University inTallahassee, as well as that of Kimberly Leach. He was also charged, but nottried in a number of northwest states, including Washington, Oregon, Utah, andColorado, for approximately 40+ (the actual number is unknown, and Bundy tookthat information to the grave) murders of women from 1974 through his capturein Florida in 1978. Bundy was executed in Florida in 1989. His basic symptomswere those of an antisocial personality, with an extreme disregard for therights of other people.
1978年，特德·邦迪(Ted Bundy)被判谋杀塔拉哈西佛罗里达州立大学(Florida StateUniversity)的两名Chi Omega姐妹会成员，以及金伯利·里奇(Kimberly Leach)。从1974年到1978年在佛罗里达被捕，他还被控谋杀妇女，但没有在包括华盛顿、俄勒冈、犹他和科罗拉多在内的几个西北州接受审判(实际数字不详，邦迪将这一信息带入了坟墓)。邦迪于1989年在佛罗里达州被处决。他的基本症状是反社会人格，极度漠视他人的权利。
Background on Ted Bundy
Evidence of serial killers’dysfunctionality can often be tracked to incidents that occurred in earlychildhood. In many cases, their backgrounds reveal deviant behaviors such ascruelty to animals and small children, vandalism, as well as a fascination withknives, guns, and fire. Personally, many of these murderers outwardly appear tobe immensely charming, with a persona that can fool people with their falseinnocence. A major clue is the absence of conscience, guilt, and loyalty toothers. One patient reveals how a child would steal family silver or aneighborhood dog and sell them for a profit. Others would throw rocks or eventerrorize the people closest to them or forge checks and embezzle funds fromtheir own family members. What would a therapist do if she/he knew then whateveryone knows now? What follows are some early clues and red flags concerningTed Bundy’s childhood background and some responses that a therapist might havemade in retrospect.
Theodore Bundy was born on november 24,1946, and was executed on January 24, 1989. His birth took place in a home forunwed mothers. In addition to the shame of illegitimacy, Bundy grew up with aconfused identity, thinking his mother was his sister and his grandfather washis father. Along the way, there were several name changes, which left Bundywith no clear identity of who he was. He was never even sure who his biologicalfather was. When he was only three years of age, his aunt caught him smilingwhile arranging knives around her neck while she was napping. He also saw hisgrandfather (who he thought was his father) torturing animals. Bundy himselfwould mutilate animals, which fascinated him to no end. Bundy was a loner and,in his isolation, could not understand why people had attachments to oneanother. He was a habitual liar; he compulsively stole and shoplifted. He laterclaimed that he was also involved in voyeurism at a young age, specifically bypeeping into windows, for which he was arrested twice. He had a girlfriend, towhom he proposed and who subsequently dumped him. Later, she accepted hisproposal, and then he dumped her. After that he began his killing spree.