Savov Svetoslav, Atanassov Nikola
Department of Cognitive Science and Psychology, New Bulgarian University, 21 Montevideo Boulevard, 1618 Sofia, Bulgaria.
ISRN Addict. 2013 Nov 11;2013:250751. doi: 10.1155/2013/250751. eCollection 2013.
Traditionally treated with wariness, drug addictions have provoked a serious interest in psychodynamically oriented clinicians in recent decades. This paper discusses the development of contemporary psychodynamic conceptualizations of addictions, focusing specifically on mentalization-based theories. The concept of mentalization refers to a complex form of self-regulation which includes attribution of psychological meaning to one's own behavior and affective states, as well as those of the others. We hypothesize that drug-addicted patients have severe impairments in mentalizing, associated with developmental deficits, characteristic for the borderline personality disorder and psychosomatic conditions. Psychodynamic models of mentalization and their corresponding research operationalizations are reviewed, and implications for a contemporary understanding of drug addictions and psychotherapy are drawn. The authors propose that mentalization-oriented theories provide an adequate conceptualization, which is open to empirical testing and has clear and pragmatic guidelines for treatment.
传统上，药物成瘾一直受到谨慎对待，但近几十年来，它引起了心理动力学取向临床医生的严重关注。本文讨论了当代成瘾心理动力学概念的发展，特别关注基于心理化的理论。心理化的概念指的是一种复杂的自我调节形式，包括将心理意义归因于自己以及他人的行为和情感状态。我们假设药物成瘾患者在心理化方面存在严重损害，这与发育缺陷有关，这些缺陷是边缘性人格障碍和身心疾病的特征。本文回顾了心理化的心理动力学模型及其相应的研究操作化，并得出了对当代药物成瘾理解和心理治疗的启示。作者提出，以心理化为导向的理论提供了一种适当的概念化，这种概念化易于进行实证检验，并且有明确且实用的治疗指南。
