Dissociation and borderline personality disorder

This article is devoted to dissociation as one of the important aspects of borderline pathology. Here we consider main symptoms of the borderline personality disorder (BPD), including diagnostic criteria for BPD in DSM-V. A brief overview of the development of the concept of dissociation starting with the work of Pierre Janet is suggested. This article presents two approaches to understanding of borderline pathology including dissociative symptoms. The first approach is rooted in the works of Pierre Janet, Morton Prince, and Charles Myers. Modern representatives of this trend are Van der Hart, Nijenhuis, Steele, who have developed the theory of structural dissociation (TSD). According to the TSD BPD belongs to a class of traumatic disorders, i.e. disorders resulting from traumatic experiences. According to this theory dissociation is activated as a defense mechanism during psychic traumatization and is considered as the main mechanism in the pathogenesis of the BPD. We consider here another approach which was initiated in the works of Bowlby, and continued in studies of Main, Solomon, Lyons-Ruth, Howell, Bateman and Fonagy. According to the views of these researchers and clinicians psychic trauma does not play a decisive role in the etiology of BPD. A central fac tor in the complex mechanisms of BPD is disorganized/disoriented attachment and fixation on pre-mentalization modes of psychic functioning. Mechanism of dissociative symptoms is described by the representatives of this trend in terms of segregated internal working models, as well as failure of mentalization.

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