The author outlines his concept of reflective function or mentalization, which is defined as the capacity to think about mental states in oneself and in others. He presents evidence to suggest that the capacity for reflective awareness in a child's caregiver increases the likelihood of the child's secure attachment, which in turn facilitates the development of mentalization in the child. He proposes that a secure attachment relationship offers the child a chance to explore the mind of the caregiver, and in this way to learn about minds; he formulates this model of the birth of the psychological self as a variation on the Cartesian cogito: `My caregiver thinks of me as thinking and therefore I exist as a thinker.` This model is then applied to provide insight into some personality-disordered individuals who were victims of childhood abuse. The author proposes (1) that individuals who experience early trauma may defensively inhibit their capacity to mentalize to avoid having to think about their caregiver's wish to harm them; and (2) that some characteristics of severe borderline personality disorder may be rooted in developmental pathology associated with this inhibition. He offers evidence for and some qualifications of this model, and argues that the therapeutic effect of psychoanalysis depends on its capacity to activate patients' ability to evolve an awareness of mental states and thus find meaning in their own and other people's behavior.
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References
1.
Alessandri, S.M. (1992). Mother-child interactional correlates of maltreated and nonmaltreated children's play behavior. Development and Psychopathology4:257—270.
2.
Astington, J. (1996). What is theoretical about the child's theory of mind?: A Vygotskian view of its development. In Theories of Theories of Mind, ed. P. Carruthers & P.K. Smith.Cambridge : Cambridge University Press, pp. 184—199.
3.
Barach, P. (1991). Multiple personality disorder as an attachment disorder. Dissociation Progress in the Dissociative Disorders4:117—123.
4.
Beeghly, M., & Cicchetti, D. (1994). Child maltreatment, attachment, and the self system: Emergence of an internal state lexicon in toddlers at high social risk. Development and Psychopathology6:5—30.
5.
Benjamin, L., & Benjamin, R. (1994). Application of contextual therapy to the treatment of multiple personality disorder. Dissociation Progress in the Dissociative Disorders7:12—22.
6.
Bretherton, I. (1991). Intentional communication and the development of an understanding of mind. In Children's Theories of Mind: Mental States and Social Understanding, ed. D. Frye & C. Moore.Hilldale, NJ: Erlbaum, pp. 271—289.
7.
Carlson, E., & Sroufe, L.A. (1995). Contribution of attachment theory to developmental psychopathology. In Developmental Psychopathology, vol. 1: Theory and Methods, ed. D. Cicchetti & D.J. Cohen.New York : Wiley, pp. 581—617.
8.
Clements, W.A., & Perner, J. (1994). Implicit understanding of belief. Cognitive Development9:377—395.
9.
Dennett, D. (1987). The Intentional Stance. Cambridge : MIT Press.
10.
Fischer, K.W., Kenny, S.L., & Pipp, S.L. (1990). How cognitive process and environmental conditions organize discontinuities in the development of abstractions. In Higher Stages of Development, ed. C.N. Alexander , E.J. Langer, & R.M. Oetzel.New York: Oxford University Press, pp. 162—187.
11.
Fisher, L., Ames, E.W., Chisholm, K., & Savoie, L. (1997). Problems reported by parents of Romanian orphans adopted to British Columbia. International Journal of Behavioral Development20:67—82.
12.
Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., Target, M., & Gerber, A. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology64:22—31.
13.
——— Steele, H., Moran, G., Steele, M., & Higgitt, A. (1991). The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal13:200—217.
14.
——— Steele, M., Steele, H., Higgitt, A., & Target, M. (1994). Theory and practice of resilience. Journal of Child Psychology and Psychiatry35:231—257.
15.
——— ——— ——— Leigh, T., Kennedy, R., Mattoon, G., & Target, M. (1995). Attachment, the reflective self, and borderline states: The predictive specificity of the Adult Attachment Interview and pathological emotional development. In Attachment Theory: Social, Developmental and Clinical Perspectives, ed. S. Goldberg , R. Muir, & J. Kerr.New York: Analytic Press, pp. 233—278.
16.
——— & Target, M. (1996). Playing with reality: I. Theory of mind and the normal development of psychic reality. International Journal of Psycho-Analysis77:217—233.
17.
Frith, C. (1996). Neuropsychology of schizophrenia: What are the implications of intellectual and experiential abnormalities for the neurobiology of schizophrenia? In Biological Psychiatry, ed. E.C. Johnstone.London: Royal Society of Medicine Press.
18.
Gergely, G. (1997). Margaret Mahler's developmental theory reconsidered in the light of current empirical research on infant development. Paper presented at the Mahler Centennial Conference, Sopron, Hungary.
19.
——— & Csibra, G. (1997). Teleological reasoning in infancy: The infant's naive theory of rational action. A reply to Premack and Premack. Cognition63:227—233.
20.
——— Nádasdy, Z., Csibra, G., & Biró, S. (1995). Taking the intentional stance at 12 months of age. Cognition56:165—193.
21.
——— & Watson, J. (1996). The social biofeedback model of parental affect-mirroring . International Journal of Psycho-Analysis. 77:1181—1212.
22.
Hegel, G. (1807). The Phenomenology of Spirit. Oxford: Oxford University Press.
23.
Levinson, A., & Fonagy, P. (IN PREPARATION). Attachment classification in prisoners and psychiatric patients.
24.
Lyons-Ruth, K., Bronfman, E., & Parsons, E. (IN PRESS). Maternal disrupted affective communication, maternal frightened or frightening behaviour and disorganized infant attachment strategies. In Typical Patterns of Infant Attachment: Theory, Research and Current Directions, ed. J. Vondra & D. Barnett. Monographs of the Society for Research in Child Development.
25.
Main, M. (1991). Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) models of attachment: Findings and directions for future research. In Attachment Across the Life Cycle, ed. C.M. Parkes, J. Stevenson-Hinde, & P. Marris.London: Tavistock /Routledge, pp. 127—159.
26.
——— & Hesse, E. (1991). The insecure disorganized/disoriented attachment pattern in infancy: Precursors and sequelae. In Attachment in the Preschool Years: Theory, Research and Intervention, ed. M.T. Greenberg, D. Cicchetti , & E.M. Cummings.Chicago: University of Chicago Press.
27.
Mayes, L., & Cohen, D. (1993). Playing and therapeutic action in child analysis . International Journal of Psycho-Analysis74:1235—1244.
28.
——— ——— & Klin, A. (1991). Experiencing self and others: A psychoanalytic perspective on theory of mind and autism. In Understanding Other Minds: Perspectives from Autism, ed. H.T.S. Baron-Cohen & D. Cohen.Oxford: Oxford University Press, pp. 450—465.
29.
Patrick, M., Hobson, R.P., Castle, D., Howard, R., & Maughan, B. (1994). Personality disorder and the mental representation of early social experience. Developmental Psychopathology6:375—388.
30.
Perry, B. (1997). Incubated in terror: Neurodevelopmental factors in the “cycle of violence.” In Children in a Violent Society, ed. J. Osofsky.New York: Guilford Press, pp. 124—149.
31.
Schneider-Rosen, K., & Cicchetti, D. (1984). The relationship between affect and cognition in maltreated infants: Quality of attachment and the development of visual self-recognition. Child Development55:648—658.
32.
——— ——— (1991). Early self-knowledge and emotional development: Visual self-recognition and affective reactions to mirror self-image in maltreated and non-maltreated toddlers. Developmental Psychology27:481—488.
33.
Slade, A., Belsky, J., Aber, L., & Phelps, J.L. (1999). Mothers' representations of their relationships with their toddlers: Links to adult attachment and observed mothering. Developmental Psychology35:611—619.
34.
Spangler, G., & Grossman, K.E. (1993). Biobehavioral organization in securely and insecurely attached infants. Child Development64:1439—1450.
35.
Target, M., & Fonagy, P. (1996). Playing with reality II: The development of psychic reality from a theoretical perspective. International Journal of Psycho-Analysis77:459—479.
