Résumés
Résumé
Cet article examine la dissociation, un concept psychiatrique controversé qui se rencontre dans le quotidien du clinicien. À partir d’une recherche sur Pubmed/Ovid avec les mots clés dissociation et trouble de personnalité limite et d’autres références, l’auteure décrit le phénomène dissociatif dans ses aspects cliniques chez les sujets atteints du trouble de personnalité limite (TPL). L’article discute des hypothèses psychodynamiques et des données neurophysiologiques pour expliquer la dissociation. Certains validateurs neurophysiologiques et neuro-anatomiques produits grâce à l’imagerie cérébrale, et des études du métabolisme de neurotransmetteurs sont étudiés pour étayer les énoncés hypothétiques. L’auteure conclut sur un modèle de mécanisme de défense dans un contexte de prédisposition biologique, de carence du développement psychologique ou d’une sensibilisation post-traumatique et suggère des pistes thérapeutiques.
Abstract
Dissociation is a disturbing psychiatric concept fraught with controversy. It is however encountered in clinical contexts and has to be understood by clinicians. This article based on a Pubmed/Ovid on line research with key words dissociation and borderline personality disorder and other references, describes the clinical aspects of the dissociative phenomena in patients with borderline personality disorder. Psychodynamic hypotheses and neurophysiological data are examined to explain dissociation. Neurophysiological and neuroanatomical variables provided by cerebral imagery controlled studies support hypotheses brought forward. The article concludes with a defence mechanism developed within a context of biological predisposition, deprived psychological development and in reaction to trauma. In conclusion, emerging psychotherapeutic solutions are summarized.
Resumen
Este artículo examina la disociación, concepto psiquiátrico controversial, con la que el clínico se encuentra cotidianamente. A partir de una búsqueda en Pubmed/Ovid con las palabras clave disociación y trastorno de la personalidad límite y otras referencias, la autora describe el fenómeno disociativo, en sus aspectos clínicos, en las personas que sufren de un trastorno de la personalidad límite (TPL). El artículo discute las hipótesis psicodinámicas y los datos neurofisiológicos para explicar la disociación. Se estudian ciertos validadores neurofisiológicos y neuroanatómicos producidos gracias a neuroimágenes, así como estudios del metabolismo de neurotransmisores, con el fin de apoyar los enunciados hipotéticos. La autora concluye con un modelo de mecanismo de defensa en un contexto de predisposición biológica, de carencia del desarrollo psicológico o de una sensibilización postraumática, y sugiere pistas terapéuticas.
Resumo
Este artigo examina a dissociação, um conceito psiquiátrico controverso que encontra-se no cotidiano do clínico. A partir de uma pesquisa sobre o Pubmed/Ovid com as palavras-chave dissociação e transtorno de personalidade limite e outras referências, a autora descreve o fenômeno dissociativo em seus aspectos clínicos nos pacientes que sofrem de transtorno de personalidade limite (TPL). O artigo discute hipóteses psicodinâmicas e dados neurofisiológicos para explicar a Comprendre la dissociation chez les patients avec un trouble de personnalité limite 241 disso ciação. Alguns validadores neurofisiológicos e neuroanatômicos, produzidos graças à neuroimagem e estudos do metabolismo dos neuro - transmissores, são estudados para apoiar os enunciados hipotéticos. A autora conclui sobre um modelo de mecanismo de defesa em um contexto de predisposição biológica, de carência do desenvolvimento psicológico ou de uma sensibilização pós-traumática e sugere pistas terapêuticas.
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