마음헤아리기치료(Mentalization-Based Treatment)의 이론과 실제

Abstract

Mentalization based treatment (MBT) is a treatment program for the patients with borderline personality disorder (BPD) originally devel oped by Peter Fonagi and Anthony Bateman at Anna Freud Center. This treatment was developed based on developmental psychopathol ogy and attachment theory. Theoretical basis is on the pathogenesis associated with attachment instability due to innate emotional sensi tivity and various negative emotional experiences during developmental periods. This attachment instability and dysfunctional mentalization function may cause various interpersonal and mental health problems including personality disorder. The most typical type of personality disorder is BPD. MBT has been developed and applied for patients with BPD, and the first practical guide for therapists was published in 2006. In a repre sentative randomized clinical trial for patients with BPD, a significant decrease in the number of suicide attempts and self-harm attempts, and a decrease in the number of hospitalizations were reported in the MBT group during 18 months of treatment and follow-up period. In MBT, authors suggest prementalistic mode into three categories: ‘psychic equivalence’, ‘pretend mode’, and ‘teleological thinking’ as im mature modes of mentalization. In this article, we would like to introduce and summarize the theory of MBT and introduce some of the results and experiences of our treat ment team that have been piloting since 2013 in Korea. We hope that Korean mental health professionals increase their interest and under standing of MBT and help patients in their clinical field with MBT skills and MBT can be settled as a psychological treatment program for patients with BPD in Korea.