Citation

Vinet C, Rahioui H, Louppe F. Ann. Med. Psychol. (Paris) 2018; 176(5): 456-461.

Copyright

(Copyright © 2018, Societe Medico-Psychologique, Publisher Elsevier Publishing)

DOI

10.1016/j.amp.2017.06.008

PMID

unavailable

Abstract

Borderline personality disorders concern clinicians and caregivers because of the violent and impulsive nature of their behavioral and affective reactions, which often confronts them to a feeling of helplessness and incomprehension. Indeed, it may be difficult to deal with self-harm, massive anxiety, intense affects and interpersonal ruptures, which are often present in the life course of the borderline patients. Their distress is particularly difficult to accept as it takes place in the therapeutic link, which reveals the core of the patient's attachment problematic. This paper aims to draw up an overview of borderline personality disorders, in light of attachment theory, which could help to clarify the involved mechanisms and gather the described behaviors in a coherent unit. Many studies relating to borderline personality disorder and attachment theory highlight what constitutes the specificity of these disorders through an integrative approach. Thus, the combination of an insecure attachment style, biological vulnerabilities and environmental stressors like traumatisms may induce the establishment of many defensive mechanisms, such as attachment system hyperactivation, emotional dysregulation or mentalization's failure. People suffering of borderline personality disorder activate these mechanisms as soon as they have to deal with real or imagined abandonments related to one of their attachment figures. However, in view of the massive anxiety and the severe disruption, those inefficient mechanisms cannot enable a good resolution of stressful situations. Consequently, borderline patients are likely to resort to new kind of emotional regulation such as suicidal, destructive and impulsive behaviors. Attachment based theories focus on these defensive mechanisms and inadequate attempts of emotional regulation, in order to propose an appropriate treatment for borderline personality disorder. © 2017 Elsevier Masson SAS

Language: en

Keywords

Trauma; human; suicide; Emotion; Emotional dysregulation; Borderline personality disorder; Psychotherapy; automutilation; impulsiveness; borderline state; emotionality; psychological theory; Article; environmental stress; Attachment theory; attachment theory; Mentalization