Citation

Bateman AW. Am. J. Psychother. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Association for the Advancement of Psychotherapy)

DOI

10.1176/appi.psychotherapy.20210023

PMID

34915724

Abstract

Antisocial personality disorder (ASPD) is a common condition associated with interpersonal and social violence, and current treatments are unsatisfactory. Mentalizing, which has developmental roots in attachment processes, offers a framework to reconsider treatment for ASPD, in which dysfunction of the attachment system temporarily inhibits affect regulation and reduces mentalizing abilities, resulting in impulsivity and relational reactivity. Mentalization-based treatment for ASPD (MBT-ASPD), which focuses on the mental and relational processes central to personality disorder rather than on anger management and violent behavior, is a promising intervention. Implemented as a group psychotherapy, MBT-ASPD targets the mentalizing vulnerabilities and attachment patterns of patients by using a semi-structured group process focused on personal formulation and by establishing group values to promote learning from other members and generating "we-ness." The treatment then emphasizes mentalizing in relationships. This article discusses the mentalizing model of ASPD and outlines strategies for MBT-ASPD from a therapy group conducted in Great Britain.

Language: en

Keywords

Violence; Psychotherapy; Mentalization; Personality Disorders; Psychodynamic; Psychosocial Interventions