Mini psychosis

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The term mini-psychosis is used in the psychoanalytically oriented theory of borderline disorder (BPS) to describe dissociative states .

definition

Patients with borderline personality disorder often have generalized dissociative states. This means that some borderline patients perceive themselves poorly over a longer period of time, do not recognize their own emotional states, perceive the "here and now" in a distorted way, have a pronounced feeling of alienation and experience an increasing loss of control over reality . If flashbacks also occur in such phases (a scenic reliving of traumatizing experiences), then such states act on third parties like a psychotic experience. In the psychoanalytic literature, such states are therefore referred to as mini-psychoses or micro-psychotic experience.

Demarcation

It is important to emphasize that such dissociative states are not regarded as psychosis in accordance with the behavioral therapeutic orientation of the treatment of borderline personality disorder and the efforts of the authors of the ICD-10 to present diseases free of theory . In this sense, the term mini-psychosis can be misunderstood if it is understood according to everyday language usage.

Historical

The term borderline was first used by Adolph Stern in 1938 .

Fundamental works by Hoch and John B. Catell appeared in the 1950s , who tried to grasp the disorder using three terms and are still valid today: the term pan-neurosis was used to describe the variety of neurotic symptoms, the term pan-anxiety should point to the generalized fear and the term pan-sexuality describe the strongly inhibited sexual behavior of the patient, which is mainly shown in the tendency to excessive sexual fantasies.

As a result, there were two main areas of research: the psychiatric research mainly dealt with the marginal phenomena in the border area to schizophrenia . This resulted in the concept of schizotypic personality disorder. In contrast, the psychoanalytic research direction emphasized the concept of an independent disorder group in the transition between neurosis and schizophrenia.

This resulted in the term emotionally unstable personality disorder of the borderline type according to the ICD and, from 1980, also in the inclusion of the disorder as borderline personality disorder in the DSM-III. With the distinction between schizotypic disorder and borderline disorder and the insight that patients with borderline disorder primarily have a consistent disorder pattern in the area of ​​mood and affect control , the original assumption that borderline disorder was a borderline case in the transition from neurosis became invalid to represent psychosis. This change in the conceptualization of borderline disorder is an expression of a process in the understanding of this disorder that has evolved over several decades. The constant observation that patients with a borderline disorder are always able to test reality, and the concentration on the affective aspects of the disorder have led to the dissociative modes of experience described above not primarily being understood under the aspect of the “psychotic” experience should.

swell

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