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Psychodynamic treatment for borderline personality disorder and mood disorders: A mentalizing perspective

Luyten, P; Fonagy, P; (2015) Psychodynamic treatment for borderline personality disorder and mood disorders: A mentalizing perspective. In: Choi-Kain, L and Gunderson, J, (eds.) Borderline Personality and Mood Disorders Comorbidity and Controversy. (pp. 223-251). Springer: Cham, Switzerland. Green open access

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Abstract

Borderline personality disorder (BPD) and mood disorders are highly comorbid, and both disorders share important developmental pathways and underlying neurobiological features. This chapter reviews evidence for the overlap between BPD and mood disorders and presents an attachment and mentalizing approach to the conceptualization and treatment of depressed patients and without marked BPD features. We propose that patients with BPD and mood disorders can be situated on a continuum, with four related features distinguishing individuals with depression with, versus without, marked BPD features: (a) the nature of their depressive experiences; (b) the nature of their mentalizing impairments; (c) the presence of insecure, but organized, attachment in response to stress and arousal versus disorganized attachment; and (d) problems with epistemic trust versus epistemic hypervigilance. We outline the therapeutic implications of these views, arguing that treatments that combine a mental representation and mental process (i.e., mentalizing) focus may be most appropriate for patients with mood problems without marked BPD features. Yet, for patients with more marked BPD features, these treatments may be iatrogenic, as these patients may have serious problems in establishing a therapeutic alliance and lack the reflective capacities needed for such treatments. For these patients, a mental process approach that focuses on restoring the capacity for mentalizing might be more appropriate. Preliminary empirical evidence supporting these assumptions is presented.

Type: Book chapter
Title: Psychodynamic treatment for borderline personality disorder and mood disorders: A mentalizing perspective
ISBN-13: 9781493913138
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/978-1-4939-1314-5_13
Publisher version: https://doi.org/10.1007/978-1-4939-1314-5_13
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: attachment, mentalizing, social cognition, early adversity, psychodynamic, stress Psychodynamic Treatment for BPD and Mood Disorders
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/1478152
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