A Multilevel Perspective on the Development of Borderline Personality Disorder

Abstract

This chapter provides an update of the mentalizing approach to borderline personality disorder ( BPD ). We present a multilevel approach to BPD from a developmental psychopathology life‐span perspective, discussing developmental pathways involved in the emergence of BPD from infancy to adolescence and (young) adulthood, locating the origins of the social cognition or mentalizing impairments typical of BPD patients in attachment disruptions. We also discuss in this context emerging findings stressing the importance of gene–environment transactions in BPD , and research findings concerning the neurobiology of impairments in mentalizing and attachment in these patients. Finally, we outline mentalization‐based treatment for BPD and we present a new view on the mechanisms of change in the treatment of BPD rooted in extant theories concerning the intergenerational transmission of social knowledge and social learning, suggesting that this mechanism may be the missing link that connects and is shared by all effective treatments of BPD .

Mentalizing, Attachment, and Epistemic Trust in Group Therapy

“…But a further possible impact will be that -owing to the importance of mentalizing as an ostensive cue -the child's naturally occurring epistemic vigilance will not be replaced by the development of epistemic trust that opens the child to taking on the social knowledge that will guide her through the social environment (Fonagy & Luyten, 2016). We all seek social knowledge, but without the reassurance and support of trusted caregivers, family or peers, the content of communication can be confusing and it may be rejected due to perceived hostile intent.…”

“…Secure attachment relationships, in which caregivers are interested in and attribute agency to the infant's mind, create a safe environment in which the infant can start exploring other people's minds (Fonagy & Luyten, 2016). The capacity for balanced mentalizing first emerges in these early interactional experiences, in which the infant finds himself reasonably accurately represented by the other as an intentional being with separate thoughts and feelings (Fonagy, Gergely, Jurist, & Target, 2002).…”

Using Aesthetic Response - A Poetic Inquiry to Expand Knowing, Part I: The Rx6-Method

“…The method is grounded on a theoretical framework (Creswell, 2009) of inter-subjectivity and implicit processing based on attachment research and contemporary neuroscience. These innate processes are seen as interwoven with our narrating potential, and thus constructing our capacity to mentalize (Fonagy & Luyten, 2015), and coming close, paraphrasing the words of Stern (2004) "one can not get to the lived experience and stay there while talking about it. But that does not stop me from thinking about it and approaching as close as I can" (p. xiii).…”

Using Aesthetic Response - A Poetic Inquiry to Expand Knowing, Part II: Theoretical Perspectives on Arts-based Research

“…Research on attachment points to the role of shared interconnectivity described by (Gallese & Ferri, 2014;Bowlby, 1968;Gaensbauer, 2016;Schore, 2003dSchore, , 2009Siegel, 1999) as a prerequisite for development, empathy, and mentalization (Fonagy & Luyten, 2015). Kenny (1989Kenny ( , 2006 described an intuitive level of togetherness that encompasses therapist and client in clinical work.…”