Contents
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Introduction Introduction
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Mentalizing, failures of mentalizing, and borderline personality disorder Mentalizing, failures of mentalizing, and borderline personality disorder
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Definition Definition
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Historical roots Historical roots
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Mentalizing, self-development, and attachment Mentalizing, self-development, and attachment
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Mentalization and personality disorders Mentalization and personality disorders
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Dimensions of mentalizing Dimensions of mentalizing
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Implicit versus explicit mentalizing Implicit versus explicit mentalizing
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Internal versus external mentalizing Internal versus external mentalizing
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Self versus other mentalizing Self versus other mentalizing
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Cognitive versus affective mentalizing Cognitive versus affective mentalizing
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Mentalization measured as reflective functioning Mentalization measured as reflective functioning
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MBT and mentalization-oriented psychotherapy MBT and mentalization-oriented psychotherapy
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MBT as day hospital treatment MBT as day hospital treatment
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MBT as intensive outpatient treatment MBT as intensive outpatient treatment
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Personality assessments, dynamic formulations, crisis plans, and treatment structure Personality assessments, dynamic formulations, crisis plans, and treatment structure
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Is group therapy good treatment for patients with borderline personality disorder? Is group therapy good treatment for patients with borderline personality disorder?
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Group dynamics and evolution Group dynamics and evolution
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Challenges with borderline patients in groups Challenges with borderline patients in groups
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1 Historical and theoretical background for mentalization-based group therapy
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Published:September 2015
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Abstract
This chapter provides a short account of the theoretical rationale for defining mentalizing failure as being the pathogenic core of borderline personality disorder (BPD). Thereafter follows a sketch of the historical and theoretical background for mentalization-based group therapy. The lack of controlled trials providing evidence for beneficial effects changed around the turn of the millennium when both mentalization-based treatment and dialectical behavioral therapy, which both contained a crucial group component, were shown to be more effective than treatment as usual in several randomized trials. Since therapists have a tendency to underestimate the mentalizing difficulties that BPD patients encounter in group situations, the chapter discusses group dynamics from the perspective of evolution and attachment. BPD patients are likely to oscillate between excessive engagement and withdrawal. The chapter ends by discussing the challenges these themes represent for the BPD patient and for the task of developing and maintaining the group as a good “training ground for mentalizing.”
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