Chapter

Using the mentalization model to understand severe personality disorder

Anthony W. Bateman and Peter Fonagy

in Mentalization-based Treatment for Borderline Personality Disorder

Published on behalf of Oxford University Press

Published in print September 2006 | ISBN: 9780198570905
Published online February 2013 | e-ISBN: 9780191754456 | DOI: http://dx.doi.org/10.1093/med/9780198570905.003.002

Series: International Perspectives in Philosophy & Psychiatry

Using the mentalization model to understand severe personality disorder

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The attachment–mentalization framework outlined in Chapter 1 is helpful in providing a developmental model of the emergence of BPD. The key components of the model are: (1) an early disorganization of primary attachment relationships; (2) the consequent enfeeblement of essential social-cognitive capacities further weakening the individual’s capacity to create secure relationships with caregivers; (3) the disorganization of the self- structure consequent on disorganized attachment relationships and maltreatment; and (4) liability to temporary failures of mentalization associated with the intensification of attachment and arousal. The failure of mentalization prompts the re-emergence of pre-mentalistic modes of representing subjective states and these, in combination with failed mentalization, generate the common symptoms of BPD. The understanding of these manifestations in terms of limited mentalizing capacities is a useful heuristic because of relatively clear suggestions entailed about both helpful and unhelpful psychotherapeutic approaches to handling the problems.

Chapter.  6604 words. 

Subjects: Psychiatry

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