Eizirik Mariana, Fonagy Peter
Psychoanalysis Unit, Department of Clinical Health Psychology, University College London, London, UK.
Braz J Psychiatry. 2009 Mar;31(1):72-5. doi: 10.1590/s1516-44462009000100016.
To describe the concept of mentalization, and its application in understanding the development of psychopathology in patients with borderline personality disorder; to give an account of the main features of mentalization-based treatment; to summarise the evidence supporting its effectiveness.
Mentalization is a predominantly preconscious mental activity that enables the individual to understand him/herself and others in terms of subjective states and mental processes. Psychological trauma in childhood is associated with deficits in mentalization and with the development of borderline personality disorder. Mentalization-based treatment is a psychodynamically-oriented manualized psychotherapy for borderline personality disorder that aims to develop a therapeutic process in which the patient's capacity for mentalization becomes the focus of treatment. Randomized controlled trials have demonstrated the effectiveness of this treatment for patients with borderline personality disorder.
The development of a psychodynamically-oriented therapeutic intervention that specifically targets the deficits involved in the psychopathology of borderline personality disorder is a crucial step in increasing the effectiveness of treatment. Mental health professionals should be adequately prepared to deliver effective interventions to their patients, such as mentalization-based treatment.
描述心理化的概念及其在理解边缘型人格障碍患者精神病理学发展中的应用；阐述基于心理化治疗的主要特征；总结支持其有效性的证据。
心理化是一种主要处于前意识的心理活动，它使个体能够依据主观状态和心理过程来理解自己和他人。童年期的心理创伤与心理化缺陷以及边缘型人格障碍的发展相关。基于心理化的治疗是一种针对边缘型人格障碍的、以心理动力学为导向的手册化心理治疗方法，其目的是构建一个治疗过程，在此过程中患者的心理化能力成为治疗的焦点。随机对照试验已证明这种治疗方法对边缘型人格障碍患者有效。
开发一种专门针对边缘型人格障碍精神病理学所涉及缺陷的、以心理动力学为导向的治疗干预措施，是提高治疗效果的关键一步。心理健康专业人员应做好充分准备，以便为患者提供有效的干预措施，如基于心理化的治疗。
