First object relations, psychological processes and emotion regulation in borderline personality disorder

Aim: Borderline Personality Disorder; It is a disorder dominated by a common and persistent imbalance in the individual's sense of identity, relationships and affection. The borderline patient grows in a relationship where the lack of coverage and satisfaction requirements expected by the individual's parents, who are their first object, comes to the fore. It is seen that the first objects of the borderline patient are not able to provide sufficient positive care, and stable internal representations of patients are not created. Difficulty in emotion regulation means that one do not knows his own emotions and has difficulty in defining goals and strategies to regulate these emotions or fails to demonstrate these competencies. In this study, where the Rorschach Test, which is a projective test, used to eliminate the manipulative qualities that borderline patients exhibit in projective tests, which negatively affects the validity of the test results, it was aimed to determine the appearance of emotional dysfunction in the borderline personality disorder and the appearance of the first object relations and spiritual functioning in the Rorschach Test. Method: Our study group consisted of 37 patients who applied to various psychiatry clinics between February and August 2019, who were diagnosed as borderline personality disorder according to DSM-V diagnostic criteria, and the control group consisted of 37 patients who were evaluated as normal neurotic according to semi-structured interview and test values. The Sociodemoographic Data Form which is developed by the researcher, Rorschach Test and The Difficulties in Emotion Regulation Scale (DERS) were applied to the participants. The data obtained by data collection tools were entered into the computer as a numerical expression and these data were statistically analyzed using the statistical package program (SPSS 25) for social sciences. Results: In the Borderline Personality Disorder group, the total score of The Difficulties in Emotion Regulation Scale and all the sub-dimensions of the Emotion Regulation Scale (awareness, openness, disagreement, strategies, impulse, goals) differ significantly from the control group (p <0.05). In the Rosrchach Test of Borderline Personality Disorder Group; difficulties in holistic perception of identity and intense use of splitting defense mechanism (F-, Hd), inadequate and unsatisfactory responses of first object relations (Deformation, Clobf, FClob, Anatomy), sensitivity to space (Gbl, Dbl, Ddbl), impulsivity responses (Kob, FCI), boundary problematic responses (Contamination, Confabulation, (H), Anatomy) differ significantly from the responses of the control group (p <0.05). In the Rorschach Test, a significant relationship was found between the responses that the first object relations were not inclusive and satisfying enough and The Difficulties in Emotion Regulation Scale . In the Rorschach Test, a significant relationship was found between the responses on borderline personality disorder and The Difficulties in Emotion Regulation Scale (p <0.05). It was determined that clobf, fclob, kop, dd, dbl, ddbl, ef, ban, which are the answers of the Rorschcah Test, predicted the emotion regulation difficulty scale and that said variables together constituted 60% of the variance of emotion regulation difficulty (p <0.05). Also Clobf, fclob, kop, dd, dbl, ddbl, ef, ban responses which has given by the borderline personality disorder group constitute 50% of the variance difficulty variance (p <0.05). Conclusion: As a result of our study, it has been determined that there is a significant relationship between Borderline personality disorder and emotion difficulties. Keywords: Borderline Personality Disorder, Emotion Regulation Difficulty, First Object, Rorschach Test.