本研究旨在探討確診為「邊緣型人格障礙症」（Borderline Personality Disorder, BPD）經驗者的生活經驗。透過訪談，探究經驗者從症狀初發至被診斷為BPD，以及被診斷BPD之後，歷經長期治療後而逐漸穩定的狀態；其中涵括BPD如何在經驗者身上呈現與被經驗、如何影響經驗者與外界的互動，以及經驗者與醫療體系的互動等生活經驗。本研究採用現象學方法論對經驗文本進行分析。研究結果發現，對BPD經驗者而言，當缺乏「被照顧者身份的存在份量感」，需要向外展開行動以換取「我」存在的份量感。然而，在沒有「被照顧者身份的存在份量」作為「我」的保護時，經驗者的「我」容易在遭遇挫折時全面崩垮。透過醫療協助，經驗者的「我」漸趨穩定；然而，當其投入外界尋找存在價值時，再次面臨相同困局。本研究結果有別於以往的研究，離開了「病理」的框架，呈現一種對BPD經驗本質的認識。

The purpose of this study is to explore the lived experience of cases diagnosed with "Borderline Personality Disorder" (BPD). Through interviews, the researcher explored the interviewees’ lived experiences from the onset of symptoms to the diagnosis of BPD and to the state gradually stabilized after long-term treatment, including how BPD is presented and experienced in interviewees, how it affects the interviewees’ interactions with the world and with the medical system, and other lived experiences. The study used phenomenological method to analyze the text of experience. The results of the study found that for the interviewees with BPD experience, when they lack the "identity of the care recipient", they need to take actions to obtain the identity of the "self". However, in the absence of the "identity of care recipient" as the protection of the "self", their "self" are prone to have a nervous breakdown when feeling frustrated. Through medical assistance, the interviewee's "self" has gradually stabilized; however, when he or she seeks for the value of existence from the world, he or she faces the same dilemma again. The results of this study are different from those of previous studies, presented an understanding of the nature of BPD experience without the framework of "pathology".

摘要 III
Abstract VII
目錄 VIII
第一章 緒論 1
第二章 文獻探討 3
第一節 BPD在臨床診斷標準的演變與爭議 3
一、BPD概念的起源與發展 3
二、從診斷準則看BPD——從DSM-IV-TR、DSM-5對比ICD-10、ICD-11的異同 5
四、小結 12
第二節 病理生理學及心理學對BPD的認識 13
一、病理生理學對BPD的認識 14
二、心理學對BPD的認識 15
第三節 現有之探討BPD的經驗研究 23
第四節 現象學對BPD的認識 28
一、情緒的不同狀態與特性 29
二、活在「不安的生活世界」的經驗 31
三、活在「憤怒的生活世界」的經驗 33
四、敘事自我的碎片化 34
第三章 研究問題與方法 39
第一節 研究對象與受訪者保護 39
第二節 研究問題 40
第三節 研究方法 40
第四章 研究結果 45
第一節 四位受訪者的置身結構 45
第二節 普遍結構 77
一、未具有「被照顧者身份份量感」的存在經驗 78
二、需要「有所作為」以感受到自身「我」存在的份量感 79
三、 在沒有「殼」的保護下，自身「我」在挫折之下呈現與外界的連結「全面崩垮」 79
四、在「全面崩垮」後經驗到自身「我」進入與停留在「沒有週遭」的整體感 80
五、自身「我」的正向經驗難以在時間裡被累加 81
六、自身「我」之狀態在進入精神醫療體系裡的漸趨穩定 82
第五章 討論與建議 85
第一節 研究結果摘述 85
第二節 「保護殼」作為個體與世界的中介：與BPD的心理學理論對話 86
一、「沒有具備被照顧者份量感的存在」反映了「被照顧者的情感性需求」被忽略 87
二、作用在自身「我」的「保護殼」功能 88
三、「保護殼」的發展路徑與意涵 89
四、「保護殼」與自我價值的關聯性 91
五、在缺乏「保護殼」之下，面對自身「我」與外界的經驗是「非完整」的 92
六、沒有「保護殼」之下的「非完整」經驗方式是危險的 96
七、在精神醫療體系獲得「保護殼」 96
八、堅固的「保護殼」需要在「脆弱但有存在份量感」的經驗下被建立起來 97
第三節 「保護殼」作為個體與世界的中介：與BPD的精神病理現象學對話 98
一、「特殊的對話形式」呈現了「沒有具備被照顧者份量感的存在」 98
二、沒有「保護殼」之下經驗到的日常生活 99
二、從沒有「保護殼」來看經驗者面對生活變動的經驗 100
四、在精神醫療體系獲得「保護殼」 103
第四節 與BPD診斷準則的對話 104
第五節 研究展望 109
第六節 研究限制 109
第六章 研究結論 111
參考文獻 113

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