Peter Fonagy, an internationally renowned clinical psychologist, psychoanalyst and expert in borderline psychopathology and early attachment relationships, and who has produced some of the most influential work relating to this field, has stressed the importance of MENTALISING (or, more precisely, the avoidance of it) in relation to borderline personality disorder (BPD).
What Is Meant By The Term ‘Mentalising’?
The term ‘mentalising’ refers to a person’s ability to perceive, understand and make use of other’s emotional states (and their own).
Why Might Those Suffering From BPD Avoid ‘Mentalising’?
According to Peter Fonagy’s theory, children of cold and rejecting parents avoid mentalising because thinking about their parents’ lack of emotional warmth, rejection, absence of love and, perhaps, even, hatred would be too psychologically distressing and painful.
Prevention Of Recovery :
However, Fonagy also theorizes that this evasion (both conscious and unconscious) of the truth about how one’s parents treated one and felt about one prevents the individual from resolving the trauma and recovering from the emotional mistreatment. He proposes that it is necessary for those suffering from borderline personality disorder (BPD) to confront, and consciously process, the traumatic elements of their childhoods, and, in particular, their difficult, perhaps tortured, childhood relationships with their parents.
The Need For Understanding And Verbal Expression :
Only by understanding what happened to one in childhood, and by learning to express, verbally, this understanding, Fonagy proposes, is recovery possible.
Whilst Fonagy’s theory has been influential, some researchers have criticized it for not placing enough emphasis upon the fundamental problem sufferers of borderline personality disorder (BPD) frequently experience – namely their inability to control intense emotional reactions (often referred to as ’emotional dysregulation.
MENTALIZATION BASED THERAPY
MBT, like DBT, was designed specifically to treat borderline personality disorder. MBT is largely based upon the idea that the core reason why individuals develop BPD is that they EXPERIENCE PROBLEMS EARLY IN LIFE IN CONNECTION WITH HOW THEY BONDED, AND RELATED TO, THEIR PRIMARY CAREGIVERS, which, in turn, leads to them experiencing further DIFFICULTIES WITH FORMING AND MAINTAINING RELATIONSHIPS IN LATER LIFE. MBT seeks to help the individual suffering from BPD empathize with others, ‘put themselves in their shoes, and develop awareness and understanding in relation to how their volatile emotional outbursts affect others (people with BPD tend to have an impaired ability to do this if they do not seek out treatment).
So far research into the effectiveness of MBT has been encouraging. It has been found to:
– reduce hospitalizations
– reduce suicidal behaviours
– improve day-to-day functioning
David Hosier BSc Hons; MSc; PGDE(FAHE).