From Attachment Theory to Mentalization Table 1. The elements and the feasibility of the development of attachment according to maternal types Element

Review Article Psychoanalysis 2013;24:9-20 ISSN 1226-7503 Copyright c 2013 Korean Association of Psychoanalysis From Attachment Theory to Mentalization: Historical Background and Clinical Implications Geon Ho Bahn Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea 애착이론으로부터정신화까지 : 배경과임상적의의 반건호 경희대학교의학전문대학원소아정신과학교실 John Bowlby linked the pre-existing psychoanalysis theory with ethology theories and emphasized the mother-baby interaction instead of the individual psychosexual development theory. The attachment which develops in the interaction with the care-giver, can be categorized into secure and insecure attachment types. Insecure attachment can continue throughout the adulthood and influence personal relations and social life. Mostly affect regulation problems occur. Peter Fonagy developed the mentalization theory based on the attachment theory. Mentalization is the ability to understand other people s feelings, emotions and thoughts. Currently various evidence based studies are being carried out. In order to objectively assess attachment and mentalization, Fonagy and other researchers are developing various assessment tools such as brief reflective functioning interviews, mentalizing stories for adolescents and mental state tasks. Recently, by applying mentalization-based treatment techniques on patients with borderline personality disorder, symptomatic improvements can be seen. Psychoanalysis 2013;24:9-20 KEY WORDS: Mentalization Attachment Bowlby Fonagy Transition. Received: March 14, 2013 Revised: April 9, 2013 Accepted: April 10, 2013 Address for correspondence: Geon Ho Bahn, MD, PhD Department of Psychiatry, Kyung Hee University School of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-702, Korea Tel: +82-2-958-8556, Fax: +82-2-957-1997, E-mail: mompeian@khu.ac.kr - -? www.freud.or.kr 9

From Attachment Theory to Mentalization Table 1. The elements and the feasibility of the development of attachment according to maternal types Elements Mental retardation Depression Maternal types Borderline personality disorder Harsh character Bowlby? - Good-enoughmother Sensitivity Good Low Good/low Too much Good Responsibility Good Low Good/low Too much Good Availability Low Low Low Low Good Feasibility of the development Low Too low Too low Low or disguised Good of attachment 10 Psychoanalysis 2013;24:9-20

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From Attachment Theory to Mentalization - -? James Robertson(1911~1988) - - - 12 Psychoanalysis 2013;24:9-20

www.freud.or.kr 13 GH Bahn - - - Mary Ainsworth(1913~1999) - - - - - - - -

From Attachment Theory to Mentalization -? - Table 2. The comparison of the theories between Bowlby and Ainsworth Issues Bowlby Ainsworth Attachment bond Universal, general Universal, individual Nature of attachment Biologically determined instinct Environmental Research objects Thieves, war orphans Modest families, Uganda and Baltimore Trauma Discrete Cumulative Table 3. The comparison between Anna Freud and John Bowlby Issues Anna Freud (1895-1982) John Bowlby (1907-1990) Mentor analyst Sigmund Freud Joan Reviere Beginning of child analysis 1923 1937 Memorable work Hampstead Nursery report 1941-1945 A two-year-old goes to the hospital (1952) Main job Hampstead child therapy course & clinic (1952-1982) WHO mental health consultant, since 1950 Best colleagues Dorothy Tiffany Burlington James Robertson Mary Ainsworth Major difference Psychosexual development Mother-child interaction WHO: World Health Organization 14 Psychoanalysis 2013;24:9-20

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GH Bahn Medial prefrontal cortex Anterior insula Orbitofrontal cortex Superiotemporal gyrus Figure 1. Human brain side view diagram. Fusiform gyrus Amygdala Anterior cingulate Temporal pole Figure 2. A sagittal view (cut in half) of the brain to show the internal structure. - - - www.freud.or.kr 17

From Attachment Theory to Mentalization - - - 18 Psychoanalysis 2013;24:9-20

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