Fonagy, P;
Luyten, P;
(2018)
Attachment, mentalization, and the self.
In: Livesley, WJ and Larstone, R, (eds.)
Handbook of personality disorders.
Guilford Press: New York, NY, USA.
(In press).
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Abstract
Mentalizing is often simplistically understood as synonymous with the capacity of empathy toward other people. In fact, mentalizing comprises a spectrum of capacities that critically involve the ability to see one’s own behavior as coherently organized by mental states, and to differentiate oneself psychologically from others. It is these capacities that tend to be noticeably absent in individuals with a personality disorder (PD), particularly at moments of interpersonal stress. In this chapter, we will attempt to demonstrate that such impairments in mentalizing are at the heart of our explanatory framework for conceptualizing PDs. The foundations of our thinking lie in attachment theory, but, according to our most recent formulation, the heart of the relationship between mentalizing and personality pathology lies in the capacity of engaging productively in communication, and more specifically, in the quality of epistemic trust the individual possesses in relationships and, formatively, in the relationship between the child and his/her primary caregivers. Epistemic trust is defined in terms of an individual’s experience of communication from others, specifically, the ability to receive and treat new knowledge from others as personally relevant and therefore capable of modifying durable representational structures pertaining to self, others, and interpersonal relationships. Underpinning this capability is the consideration of the informant as a “trustworthy” source likely to communicate information that is generalizable and relevant to the self.
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