Introduction to the mentalization-based treatment for borderline personality disorder

Abstract

Mentalization based treatment (MBT) for Borderline Personality Disorder (BPD) has been developed mainly by Anthony Bateman and Peter Fonagy. Mentalization is the process by which we understand others and ourselves in terms of subjective states (wishes, thoughts, feelings) and the close link between these and our behaviors. Such ability is not innate: it must develop in a secure attachment context. According to this model, the BPD symptoms result from the re-emergence of pre-mentalizing modes of psychic functioning, after a partial and specific suppression of mentalizing in a context of hyperactivation of the attachment system. In Hallwick Unit (Hospital St. Ann, London), conducted by Bateman, treatment is structured in three phases, keeping focus on enhancing mentalization. It has been proved effective in reducing borderline symptoms in randomized controlled trials, which support its usage.