a MBT Team , The Bergen Clinic Foundation , Bergen , Norway.
c Institute for Clinical Psychology , University of Bergen , Bergen , Norway.
Psychother Res. 2019 Feb;29(2):251-266. doi: 10.1080/10503307.2017.1325021. Epub 2017 May 17.
The aim of this study was to explore the experience of central psychological change processes for female patients with borderline symptomology and substance use disorder in mentalization-based treatment.
Semi-structured qualitative interviews on experiences from mentalization-based treatment with 13 participants were conducted. The interview material was analysed within a hermeneutical-phenomenological epistemology, with emphasis on researcher reflexivity.
The following themes regarding central psychological change processes were found: "by feeling the feeling," "by thinking things through," "by walking in your shoes to see myself" and "by stepping outside of own bad feelings in seeing you." Two of these themes dealt with intra-psychic modes of how to relate to own mind-states. First, they had a shift from avoiding emotions into tolerating emotions. Second, they discovered the ability to think mental states through. Two themes dealt with mental stances for dealing with interpersonal situations, where one mode included a self-reflective stance in difficult encounters, and the other mode entailed an empathic reflective stance by exploring others' intentionality.
The findings are in line with theoretical assumptions that increasing mentalizing capacity is a central change process for these patients. Furthermore, the findings demonstrate the complex interaction between different modes of mentalizing. Clinical or methodological significance of this article: The article explores change processes in manualized psychotherapy for patients with comorbid borderline personality disorder and substance use disorder, a focus which is not researched in the clinical literature. We claim that putting attention to this patient group and investigating their potential in psychotherapy is of clinical significance. Methodologically, this article utilizes thematic analyses within an epistemology following a specific procedure that is step based and transparent, thus it is of interest for qualitative researchers who also utilize thematic analyses.
本研究旨在探索边缘症状和物质使用障碍的女性患者在基于心理化的治疗中的中心心理变化过程的体验。
对 13 名参与者进行了基于心理化的治疗经验的半结构化定性访谈。采访材料在解释学-现象学认识论内进行分析，重点是研究人员的反思。
发现了以下关于中心心理变化过程的主题：“通过感受感受”、“通过思考事情”、“通过穿上你的鞋子看到自己”和“通过走出自己的不良情绪看到你”。其中两个主题涉及到如何与自己的心理状态相关的内在心理模式。首先，他们从避免情绪转变为容忍情绪。其次，他们发现了通过思考心理状态的能力。两个主题涉及到处理人际情况的心理立场，其中一种模式包括在困难的情况下进行自我反思的立场，另一种模式则通过探索他人的意图来包含同理心的反思立场。
这些发现与理论假设一致，即增加心理化能力是这些患者的核心变化过程。此外，这些发现还证明了不同心理化模式之间的复杂相互作用。本文对临床或方法学的意义：本文探讨了共病边缘型人格障碍和物质使用障碍患者的规范化心理治疗中的变化过程，这是临床文献中未研究的焦点。我们声称，关注这一患者群体并调查他们在心理治疗中的潜力具有临床意义。在方法论上，本文在遵循特定步骤且透明的认识论内利用主题分析，因此对于也利用主题分析的定性研究人员来说是感兴趣的。
