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Towards a learning stance in teams: Developing a community of practice to capture and disseminate what works for whom
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
The reason for introducing this apparently unconnected term here is that much of what follows draws on the theory and science behind it and the expanding field of practice that its emergence has triggered. Mentalisation (Fonagy et al., 2002) has rapidly gained acceptance as a useful framework for understanding the relational basis of human experience and behaviour (and a useful basis for evidence-based therapeutic practice). This began with its application in the evidence-based Mentalization-Based Treatment (MBT) for adult borderline personality disorder, but, latterly, there has been increasing interest in developing applications of mentalising earlier in the developmental lifecycle (e.g., MBT-A for adolescents who self-harm; Rossouw and Fonagy, 2012; MBT-F for families; Keaveny et al., 2012) and across broader complex systems in AMBIT (Bevington et al., 2017). A recent study has shown a reduction in suicide attempts in (adult) patients with Borderline Personality Disorder and concurrent SUD that approaches statistical significance (p = 0.06, Philips et al., 2018).
Principles of treatment for the mentally disordered offender
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
Pamela J Taylor, Peter F Buckley, Gill McGauley, Jen Clarke, Estelle Moore, Elena Carmen Nichita, Paul Rogers, Pamela J Taylor, Fred Browne, Gisli Gudjonsson, John Gunn, Gary Rix, Leslie Sohn, Pamela J Taylor
The two quotations just cited allow for discussion of the concept of mentalization, its relationship to both personality disorder and violence and the development of mentalization based treatment (MBT) as a promising, psychodynamically derived intervention for those with borderline and possibly antisocial personality disorders. Although these interviewees may not have been aware of it, both remarks contain insight. It is not so much that the first patient cannot ‘read minds’ but in all likelihood has a diminished capacity to mentalize and may be unable to envision the mental states of others, or may do so inaccurately. Mentalization refers to the ability to interpret the actions of oneself and others as meaningful on the basis of intentional mental states and of an understanding of the feelings, beliefs, thoughts and intentions of oneself and others (Baron-Cohen et al., 2000). The second quotation points towards the aetiology of this deficit, namely that the capacity to mentalize develops through a process of having experienced oneself in the mind of another during childhood, in the context of a secure attachment relationship (Fonagy et al., 1997).
Suicide
Published in John R. Cutcliffe, José Carlos Santos, Paul S. Links, Juveria Zaheer, Henry G. Harder, Frank Campbell, Rod McCormick, Kari Harder, Yvonne Bergmans, Rahel Eynan, Routledge International Handbook of Clinical Suicide Research, 2013
More recently new theories and therapies have been presented to fight depression and suicidal ideation, some of them originating in cognitive-behaviorist therapy, such as the Mindfulness-based Cognitive Therapy (Segal, Williams, & Teasdale, 2002), and others of dynamic inspiration, exemplified in the Mentalization-based Treatment of Borderline Personality Disorders (Bateman & Fonagy, 2004) and in the Goal-directed Action Therapy (Valach, Michel, Young, & Dey, 2006). Another curious theory is the Interpersonal-Psychological Theory of Thomas Joiner (2005), which is particularly interesting because it revives some of Roy Baumeister's concepts (1990), such as guilt and identity. According to this theory there is a disconnection and isolation of the suicidal, a form of social alienation, which essentially results from three constructs: (1) the feeling of not belonging; (2) a feeling of being a burden to the family; and (3) the loss of the fear of death.
Vulnerability of personality disorder during the Covid-19 crises – a multicenter survey of treatment experiences among patients referred to treatment
Published in Nordic Journal of Psychiatry, 2022
Elfrida Hartveit Kvarstein, Kjell-Einar Zahl, Line Indrevoll Stänicke, Mona Skjeklesaether Pettersen, Åse-Line Baltzersen, Merete Selsbakk Johansen, Ingeborg Ulltveit-Moe Eikenaes, Espen Ajo Arnevik, Benjamin Hummelen, Theresa Wilberg, Geir Pedersen
The reciprocal process between patients and therapists is frequently emphasized in psychotherapy. Balancing processes through difficult emotional situations requires skilled therapists [66]. Therapists’ negative countertransference feelings are commonly encountered in treatment of patients with PD [67–70] and in the extraordinary, pandemic situation, such complicated reactions involving both patient and therapist would be understandable. A recent publication addresses the dialogue between therapists and patients in mentalization-based treatment during the pandemic [26]. The case vignettes illustrate the importance of therapist attunement to the current situation where patients’ personality problems were activated by the pandemic. Accommodating attitudes and conditional satisfaction in our study may be linked to an early experience that the therapist made a convincing effort to keep up contact.
Mediators in the Association Between Affective Temperaments and Suicide Risk Among Psychiatric Inpatients
Published in Psychiatry, 2018
Denise Erbuto, Marco Innamorati, Dorian A. Lamis, Isabella Berardelli, Alberto Forte, Eleonora De Pisa, Monica Migliorati, Gianluca Serafini, Xenia Gonda, Zoltan Rihmer, Andrea Fiorillo, Mario Amore, Paolo Girardi, Maurizio Pompili
All items were controlled for formulation and plausibility by an expert in psychological diagnostics and experts in the field of mentalization-based treatment (MBT). Respondents were asked to rate each item on a 5-point Likert scale, from I disagree to I agree. A confirmatory factor analysis (CFA) supported a four-factor solution: refusing self-reflection, emotional awareness, psychic equivalence mode, and regulation of affect (Hausberg et al., 2012). Total scores can vary between 0 and 60, with higher scores indicating less mentalizing ability. Specific cutoff scores are not available for this instrument (Hausberg et al., 2012). We translated and adapted the Italian version of the MZQ from an English version provided from the authors of the measure. Information and further details of the procedure are reported in Innamorati et al. (2017). In the present sample, the Cronbach’s alpha was 0.78.
Art as Relational Encounter: An Ostensive Communication Theory of Art Therapy
Published in Art Therapy, 2018
Throughout her childhood, Kitty's mother suffered recurring episodes of psychosis and was frequently hospitalized. From a young age Kitty recalled needing to help her mother with basic tasks such as bathing, medication, eating, and going to bed. She also tried to help her by banging saucepans to chase away the ghosts that her mother believed were keeping her prisoner in the room. Kitty's father struggled to accept this reality. Whenever the subject was raised, he would attribute the mother's distress to her children being stressful and he forbade them from talking about it. Kitty's older sister spent 3 years in a psychiatric institution from the age of 16 and her loss in the family was traumatic. With these experiences, Kitty learned that talking was damaging. She coped through self-harm, substance misuse, and self-administered painkillers. Kitty was keen to progress in her life and always enjoyed helping people. She attempted nurse training, but had to stop because the training course left her with crippling anxiety and depression. Kitty was offered 18 months of mentalization-based treatment (Bateman & Fonagy, 2006), which included a group art therapy component.