Attachment and borderline personality disorder

The author outlines his concept of reflective function or mentalization, wh ich 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 s ecure attachment, which in turn facilitates the development of mentalizatio n in the child. He proposes that a secure attachment relationship offers th e child a chance to explore the mind of the caregiver. and in this way to l earn about minds; he formulates this model of the birth of the psychologica l self as a variation on the Cartesian cogito: "My caregiver thinks of me a s thinking and therefore I exist as a thinker." This model is then applied to provide insight into some personality-disordered individuals who were vi ctims of childhood abuse. The author proposes (I) that individuals who expe rience early trauma may defensively inhibit their capacity to mentalize to avoid having to think about their caregiver's wish to harm them; and (2) th at some characteristics of severe borderline personality disorder may be ro oted in developmental pathology associated with this inhibition. He offers evidence for and some qualifications of this model, and argues that the the rapeutic effect of psychoanalysis depends on its capacity to activate patie nts' ability to evolve an awareness of mental states and thus find meaning in their own and other people's behavior.