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2011, vol. 43, br. 1, str. 65-82
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Modifikovana psihodinamska psihoterapija poremećaja ličnosti - dileme i izazovi
Modified psychodynamic psychotherapy of personality disorders: Dilemmas and challenges
aUniverzitet u Beogradu, Medicinski fakultet + Univerzitet u Beogradu, Medicinski fakultet, Institut za mentalno zdravlje bUniverzitet Singidunum, Fakultet za medije i komunikacije - FMK, Beograd
e-adresa: dusica.lecictosevski@eunet.rs
Projekat: Temperament i struktura simptoma poremećaja ličnosti (MPNTR - 175013)
Sažetak
Poremećaji ličnosti predstavljaju dijagnostički i terapijski izazov za stručnjake. I dok je strukturalna dijagnostika relativno jednostavna (longitudinalna procena, primitivni mehanizmi odbrane, ego-sintoni i aloplastični simptomi), lečenje ovih poremećaja neretko je praćeno pesimizmom i nihilizmom. Terapija poremećaja ličnosti treba da bude multidimenzionalna, kontinuirana, multimodalna i integrativna. Najčešći modaliteti su individualna, grupna, porodična, kombinovana i partnerska terapija (uz čestu primenu medikacije). Iako nas psihoterapija poremećaja ličnosti suočava sa ograničenjima naše veštine, daje malo gratifikacija, odvija se sporo, često sa prekidima, i predstavlja poseban izazov za kontratransferna osećanja, ona daje mogućnost neprekidnog učenja i individuacije ne samo pacijentu već i terapeutu. U ovom radu prikazana je modifikovana psihodinamska psihoterapija poremećaja ličnosti sa vinjetama nekoliko slučajeva.
Abstract
Personality disorders represent diagnostic and therapeutic challenge to experts. While structural diagnostics is relatively simple (longitudinal evaluation, primitive defense mechanisms, ego-syntonic and alloplastic symptoms), the treatment of these disorders is frequently connected with pessimism and nihilism. The treatment of personality disorders should be multidimensional, continuous, multimodal and integrative. The most frequent modalities are individual, group, family, combined and partner therapy (with medication in decompensation phases). Even though psychotherapy of personality disorders confronts us with the limitations of our skill, offers little gratification, unfolds slowly, often in intervals, and poses a particular challenge in terms of counter-transference feelings, it provides the possibility of learning and individuation, not only to the patient but to the therapist as well. The article presents modified psychodynamic psychotherapy of personality disorders, with several case vignettes.
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