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I LIVING LIKE A FOOL~
我又糟蹋了我自己~
有一天~你们像我一样~你们会怎么做~？
谁能告诉我~？
有一天~当我真的承受不了这一切~
我会彻底离开~
离开那些城市~离开那些所有人~
就那样抛弃一切~毫不犹豫~
决绝~
彻底~
我过了怎样一段的黑暗时光啊~
黑洞状态：逐渐连成一片
你常常会冒出很多个爱情想法，幻想各种爱情情节发生在自己身上。这样的你，却是个不会轻易相信爱情，不敢轻易涉及感情，也很难投入真心的人。习惯于压抑自己的感情，总是无法对感情现状满意，使得你对于一段充满激情的爱情的幻想日益强烈。你觉得即使一生只有一次也好，即使日后要面对痛苦也好，希望自己能够经历一段刻骨铭心的爱情，希望真的遇到一个自己真心爱着的，让自己一生不忘的恋爱对象。
你是一个很现实的人，很难真心相信一个人。并且你是一个能够忍受寂寞的人，总是显得比较独立和冷静，不会依赖别人。在你看来，真的能够一辈子陪着你的、能够让你信任的，或许只有跟你有着血缘关系的家人。因此，你对于家人会很在意，觉得无论遇到什么事情，只要还有家人的支持就可以坚持和忍受下去。对于父母，你会想要尽力孝顺，兄弟姐妹或是其他亲戚，也会是你关心和在意的对象。这样的你，很可能为了家人而放弃一些自己的理想甚至爱情，为了家人而做出牺牲，因为在你看来家人是能够让自己安心和支持自己的最重要的安全绳。
以下是典型的症状，如符合5条以上，即可诊断BPD：
1）极其依赖关系，非常惧怕真正的或自己想像出来的被遗弃，为了避免被遗弃，会作出种种疯狂的努力。
2）对依赖对象的评价很容易走极端，因依赖对象的一点好，会将其极端理想化，但一发现依赖对象的一点缺点，又会将其极端贬低。并且，极端理想化和极端贬低经常发生，且一直飘忽不定。
3）缺乏稳定的自我形象或自我意象，通俗的说法即“不知道自己是谁”或“感受不到自己是谁”。
标准六：在自我认同上持续有著明显的困扰，以下项目中至少有两项自我定位不明确：自我形象、性别取向、长期目标或职业选择、喜好交往的朋友类型、价值偏好。边缘人格者缺乏一贯的自我认同感，就像他们对他人也没有一致的观感一样。边缘人格者不认为自己具有某种程度的聪明、魅力、敏感等特质，反而觉得这些特质是相对的，是必须不断与他人比较之下赢得的。比方说，患者可能只有在参加了正式的智商测验後，才会根据成绩认定自己是聪明的，但到了第二天，当他犯了一件「傻瓜才会犯的错」，他便会改变看法，认为自己很「愚蠢」。又比方说，女性边缘人格者可能认为自己很有吸引力，直到患者看到了一位她认为比自己更漂亮的女性，那时她又会觉得自己很丑。对边缘人格者而言，身份定位的等级可连成一条曲线，个人的价值是以自己今天的角色（以及做了什么）来决定的，与之前自己的一切没什么关联。
4）至少有两种以上的自毁行为，如奢侈、乱性、药物滥用、鲁莽驾驶、狂吞滥饮。
患者不容许自己在获得某项荣誉之後有所休息，就像希腊神话中的薛西弗斯（Sisyphus）一样，得一而再、再而三地将巨石滚上山坡、一次又一次地证明自己。不切实际地想达到完美，也是边缘人格模式的一部份。举例来说，有厌食症状的边缘人格者可能想尽办法保持体重轻盈，如果体重小小地变动了一磅也会惊慌不已，却不认为自己对维持体重的期望不切实际。患者认为自己是不变的，并不是处在不断改变的动态之中；所以当僵固的自我形象有了任何改变时，患者都会觉得事态严重。然而，边缘人格者也可能以完全相反的方式获得满足，包括经常换工作、职业、目标、朋友，有时甚至经常转换性别或性向。患者希望藉由改变外在的环境，或是彻底改变生活方式，来获得内心的满足。
5）经常发生自伤行为，容易闹自杀，或以自杀、自伤威胁重要的依赖对象。
自我加诸於肉体的痛苦，可能反映出边缘人格者需要有所感觉，想要从麻木的束缚中挣脱。边缘人格者把自己放在一个与外界隔绝的透明罩?，不仅要保护自己的情绪不受外界影响而痛苦，也把自己对真实世界的感知给阻绝了，肉体的疼痛在此时成了与自己的存在唯一的连结。然而，加诸於自己的疼痛，常常不足以强烈到能跨越这道阻隔（虽然流出的血与形成的伤口，能让患者著了迷似地观察许久），这时候，患者的挫折感将驱使自己更频繁地去感受肉体的痛楚。加诸於肉体的疼痛，也可以转移患者的注意力，不去理会自己受到的其他型式的折磨。
自我伤害的行为也被当成是为自己的罪恶赎罪。
边缘人格者可能认为自己的某些举动有失控的危险，便以疼痛和有害自己的方式来制止这些举动。
冲动下采取伤害自己的行为（或威胁要伤害自己），可能其实是要惩罚别人，且通常是亲近的人。
许多边缘人格者表示，自伤时并不会感到疼痛，甚至说在自残之後产生了平静而愉悦的感觉。要伤害自己之前，他们情绪上也许有极大的压力，或是无法承受的忧伤，但事後则有焦虑解除後的解脱感。之所以产生解脱的感受，可能有心理上或生理上的原因。内科医师很早就发现，在受到严重的生理创伤如战争受伤後，伤者可能意外地平静，尽管尚未进行医疗，却好像自然而然被麻醉了。有些专家推论，身体在这段期间，会释放出如脑内啡（endorphins）的天然物质，有助於自行治疗疼痛
标准二：冲动下作出可能有害自己的行为；例如药物滥用、性滥交、赌博、偷窃、过度花费、过量饮食、厌食症或暴食症等。边缘人格患者的行为可能出其不意并且互相矛盾，这是因为他们的行为通常导因於短暂而强烈的感受──反映的是独立而互不连结的瞬间经验。当下这一刻是独立存在的，与过去的经验无关，也与未来的展望无关。对患者来说，没有所谓的历史模式、一贯性或可预测性这类的概念，因此他们会一再地重蹈覆辙。
6）情绪不稳定，易激惹、焦虑或严重抑郁，但持续时间较短，一般是数小时，很少会超过几天。
7）长期的空虚感。
8）不合适的强烈愤怒，或难以控制的发怒。
9）如遭遇创伤事件，可能会短暂地出现偏执观念，或严重的分离性症状。后者譬如，严重遗忘了刚遭遇的普通创伤事件的细节。
最关键的两点症状，或许是频频的自伤行为，以及情绪变化无常。
边缘型人格障碍患者情绪之所以很容易失控，可能与他们主动遗忘了自己太多事情有关。
他们主动遗忘，是因为遭遇了太多痛苦。痛苦谁也不愿意面对，如果经常遭遇痛苦，主动遗忘就可能会发生。把他们都忘记，那样意识上就好受多了。
只不过，忘记只是意味着把心理内容从意识上驱赶进潜意识。这导致潜意识过于庞大。
Borderline personality
disorder 边缘型人格障碍
Overview
Borderline personality disorder (BPD) is a serious emotional disturbance that's characterized by disappointing and unstable personal relationships, intense anger, feelings of emptiness, and fears of abandonment — real or imagined.
It's one of several types of personality disorders, all of which reflect an inability to accept the demands and the limitations of the outside world. These disorders may regularly interfere with your behavior and your interactions with family, friends or co-workers. Among the other personality disorders are paranoid personality disorder, antisocial personality disorder, histrionic personality disorder and narcissistic personality disorder.
People with BPD have an enormous need for love and a terrible fear of closeness. They have disturbed thinking and are constantly in a state of emotional turmoil. They're calm and rational at times, but they may explode into inappropriate anger or rage at some perceived rejection or criticism.
Borderline personality disorder is more common than other perhaps better-known mental illnesses, such as schizophrenia and bipolar disorder. BPD is most common in young women. Treatment consists of psychotherapy and medications.
Signs and symptoms 体征和症状
Signs and symptoms of borderline personality disorder may include:
- Difficulty controlling emotions or impulses 难以控制情绪和冲动
- Frequent emotional ups and downs 情绪经常大幅波动
- Impulsive actions 有冲动行为
- Mood swings 心境飘忽
- Stormy relationships 暴风骤雨般强烈的人际关系
- Intense anger, possibly involving physical fights 怒气冲天，可能还会打架
- Casting others in terms of good or bad 把人规类为：要么好人，要么坏人
- Feeling of emptiness inside 空虚感
- Fear of being alone 害怕孤独
Unlike the mood changes in disorders such as depression and bipolar disorder, which may last for weeks or months, the mood swings in BPD generally last just hours.
People affected with BPD are terrified of being alone, yet they push others away with their erratic behavior. They often get into repetitive, rather predictable crises often related to the fear of abandonment, while in reality their behaviors often lead to just that.
Common occurrences, such as a spouse being a few minutes late, may prompt sudden fury or despair. People with BPD are likely to believe this "abandonment" implies that their partners don't love them anymore or that they're "bad." When a loved one is perceived as uncaring, a person with BPD may react with extreme sarcasm, lingering bitterness or verbal abuse. These outbursts may be followed by feelings of guilt.
People with BPD may idolize a new lover and demand lots of time together. This switches quickly to devaluing that person and feeling that the person doesn't care enough or isn't dependable. As a result, relationships often are stormy and unstable.
Affected people may also experience sudden and dramatic shifts in their self-image, which can be expressed in a shift of their goals and values. They may quickly change their opinions and plans about their career, sexual identity and types of friends.
Causes 原因
The term borderline comes from the thinking of psychiatrists in the 1940s and 1950s that the disorder bordered on and shared features of psychotic and neurotic disorders. But that view doesn't reflect current thinking.
Doctors don't know for sure what causes borderline personality disorder, but there are clues. Most likely, no single factor explains its development. Instead, it may be a combination of:
- Hereditary predisposition. You may be at a higher risk of BPD if a close family member — mother, father or sibling — has it. 遗传倾向
- Childhood abuse. Some people with BPD may have been physically or sexually abused as children. 儿童时期遭虐待
- Neglect. Some people with BPD describe severe deprivation, neglect and abandonment during childhood. 儿童时期遭忽视，遭抛弃，遭严重剥夺
- Neurologic injury in early childhood. There appears to be a high prevalence of childhood head injuries in people with BPD. 儿童时期有神经损伤
When to seek medical advice
If you feel like hurting yourself, seek help at the emergency room. If you're abusing drugs or alcohol or have an eating disorder, see your doctor to find the underlying cause and to seek treatment.
If a friend or family member exhibits intense mood swings and unstable relationships with others, consider suggesting that the person see a doctor to discuss how to deal with his or her emotions.
Screening and diagnosis
Doctors look for at least five of the following signs and symptoms to determine if a person has borderline personality disorder:
- Intense fears of abandonment
- A pattern of unstable relationships
- A precarious self-image
- Impulsive and self-damaging behaviors, such as overspending and substance abuse
- A tendency toward suicide or self-mutilation
- Wide mood swings
- Chronic feelings of emptiness
- Intense anger, violent outbursts
- Periods of paranoia and loss of contact with reality
Doctors regard diagnosis of borderline personality disorder in adolescents as premature. That's because what appear to be signs or symptoms of BPD in adolescents often disappear as adolescents grow older, and these people may do well as adults.
Complications
Borderline personality disorder may occur along with depression and other mental health conditions and behaviors such as:
- Substance abuse
- Anxiety disorders
- Eating disorders
- Bipolar disorder
- Other personality disorders
- Excessive gambling
- Excessive spending
- Risky sex
- Suicidal tendencies
- Attempts at self-mutilation
Treatment
Treatment for BPD can be difficult and long-term, lasting years in many cases. People who have the best chance for success seek out treatment for themselves and find a therapist experienced in BPD. Success depends on sticking to the therapy and taking responsibility for your own problems.
Treatment for BPD usually involves a combination of:
- Psychotherapy. The most effective types of counseling appear to be long-term therapy and dialectical behavior therapy (DBT). Long-term therapy focuses on internal experiences, relationships and self-destructive behaviors. DBT is a form of cognitive behavior therapy that focuses on coping skills — learning how to take better control of behaviors and emotions.
- Medications. Doctors use a
variety of medications to treat borderline personality disorder.
The choice of a medication may depend on your particular symptoms
and whether medications you try initially work for you. Medications
aren't cure-alls, nor are they intended to take the place of
psychotherapy. Doctors may first prescribe antidepressant
medications such as the selective serotonin reuptake inhibitors
(SSRIs) fluoxetine (Prozac, Sarafem) and sertraline (Zoloft) or the
related antidepressant venlafaxine (Effexor). For severe behavior
problems, doctors may prescribe the neuroleptic medication
haloperidol (Haldol).
Other medications that doctors may use include monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) and tranylcypromine (Parnate); the mood stabilizer lithium (Eskalith, Lithobid); the anticonvulsants carbamazepine (Carbatrol, Tegretol) and divalproex (Depakote); and the benzodiazepines alprazolam (Xanax) and clonazepam (Klonopin)
There's no one path to recovery from BPD. The condition appears to be worse in young adulthood and may gradually diminish with age. Many people with BPD attain greater stability in their lives during their 30s and 40s.
Today, psychotherapy combined with medications can be effective at reducing or eliminating many of the most troublesome signs and symptoms of BPD. Many people once in psychic misery now feel good about themselves and are able to sustain loving relationships and enjoy meaningful careers.
Coping skills
It's not easy to help someone who has borderline personality disorder, but you may find these suggestions useful:
- Be patient. You can't force your friend or family member to get counseling. As obvious as it seems to you that your friend or family member needs help, it's best if the initiative comes from him or her.
- Don't take it personally. When your friend or family member thinks you're the best, enjoy the compliments. But when he or she verbally attacks you, don't take it to heart.
- Acknowledge abandonment fears. It's easier to step back from an angry outburst if you understand where it's coming from.
- Set limits to what you'll tolerate. No one should endure constant verbal or emotional abuse.
- Be supportive. Don't take responsibility for someone else's behavior or become his or her therapist. You can't fix someone else's problems. However, you can be supportive in his or her efforts to get well.
- Build up your own self-esteem. Although you may treasure your friendship, your ego may have sustained blows over the years. Take time to participate in activities that make you proud of yourself. Set goals for yourself and meet them.
- Make time for your own happiness. Start making plans with other people you haven't seen in a while. Nurture new relationships.
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