Attachment Theory and Multiple Integrated Treatments of Borderline Patients

Liotti, Giovanni; Cortina, Mauricio; Farina, Benedetto

doi:10.1521/jaap.2008.36.2.295

Cited by 33 publications

(29 citation statements)

References 50 publications

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“…Infants develop an emotional strategy that magnifies their stress signals 1. Liotti, Cortina, and Farina (2008) have proposed a model of multiple integrated treatments that might combine individual and group therapy, individual and couples therapy, or two individual therapists working simultaneously with the same patient in different office settings. This team concept is not new, but what it adds is the idea that by having more than one therapist, the intense activation of the trauma with one of the therapists can be managed better.…”

Section: Emotions and Their Affective Regulationmentioning

confidence: 99%

The Use of Attachment Theory in the Clinical Dialogue with Patients

Cortina¹

2013

Psychodynamic Psychiatry

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Attachment theory specifically addresses the ability to use an attachment figure as a haven of safety and base of exploration. While many other relational issues are important during development, a foundation of trust based on having positive expectations that others will be available when needed is clearly relevant in the practice of psychotherapy. Yet many patients come in with histories of insecure or even disorganized attachment and have suffered different forms of maltreatment. Understanding affect-regulating strategies, defensive processes, and transference and countertransference patterns associated with insecure or disorganized patterns is enormously useful during the clinical exchange. In addition to paying attention to affect regulation strategies, it is important to note that two other motivational systems may become coopted for defensive purposes in order to cope with disorganized attachment: the caregiving system and the ranking system (the latter being the legacy of dominance hierarchies we observe in primates). The other theme in this article is the importance of paying attention to a cooperative and social engagement motivational system (sometimes referred sometimes to as a social or affiliative motive) in building a therapeutic alliance. This prosocial motive is not about safety (attachment) but about sharing and developing positive social relations with others (Cortina & Liotti, 2010). The article explores the significance of building on this cooperative and social engagement system when there is not a foundation of trust based on a secure attachment history.

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Section: Emotions and Their Affective Regulationmentioning

confidence: 99%

The Use of Attachment Theory in the Clinical Dialogue with Patients

Cortina¹

2013

Psychodynamic Psychiatry

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“…We also had a secondary and exploratory aim of comparing the strength of the relationships between metacognitive domains across groups. We hypothesized that the metacognitive capacities of the schizophrenia group would be more closely related given literature suggesting that metacognitive deficits in schizophrenia are more global and trait like in nature, while in Borderline PD, impairments are hypothesized to be context dependent and responsive to interpersonal factors in the moment (Fonagy et al, 2002;Liotti et al, 2008;Brüne et al, 2016;Ghiassi et al, 2010). Regarding the relationship of different elements of metacognition to one another in the substance use group, we made no predictions but considered those results to offer potential preliminary insights into how different metacognitive dimensions may influence one another or covary.…”

Section: Introductionmentioning

confidence: 99%

Contrasting metacognitive, social cognitive and alexithymia profiles in adults with borderline personality disorder, schizophrenia and substance use disorder

Lysaker

George

Chaudoin-Patzoldt

et al. 2017

Psychiatry Research

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Deficits in the ability to recognize and think about mental states are broadly understood to be a root cause of dysfunction in Borderline Personality Disorder (PD). This study compared the magnitude of those deficits relative to other forms of serious mental illness or psychiatric conditions. Assessments were performed using the metacognition assessment scale-abbreviated (MAS-A), emotion recognition using the Bell Lysaker Emotion Recognition Test and alexithymia using the Toronto Alexithymia Scale among adults with schizophrenia (n = 65), Borderline PD (n = 34) and Substance Use disorder without psychosis or significant Borderline traits (n = 32). ANCOVA controlling for age revealed the Borderline PD group had significantly greater levels of metacognitive capacity on the MAS-A than the schizophrenia group and significantly lower levels of metacognitive capacity than the Substance Use group. Multiple comparisons revealed the Borderline PD group had significantly higher self-reflectivity and awareness of the other's mind than the schizophrenia group but lesser mastery and decentration on the MAS-A than substance use group, after controlling for self-report of psychopathology and overall number of PD traits. The Borderline PD and Schizophrenia group had significantly higher levels of alexithymia than the substance use group. No differences were found for emotion recognition. Results suggest metacognitive functioning is differentially affected in different mental disorders.

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“…Also describing optimal approaches for those with borderline personality disorder, Liotti, Cortina, and Farina () highlight the benefits of the participation and close collaboration of at least two therapists (e.g., an individual therapist and a group therapist) working together to prevent or correct the consequences of disorganized attachment emerging in therapeutic relationships. The authors describe how both dialectical behavioural therapy (Linehan, ) and MBT (Bateman & Fonagy, ), which have been used successfully with people with borderline personality disorder, utilize two therapists in two separate but integrated settings.…”

Section: Key Themesmentioning

confidence: 99%

Attachment‐informed therapy for adults: Towards a unifying perspective on practice

Berry

Danquah

2015

Psychol Psychother

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Attachment theory should be used to inform individual psychological therapy in adulthood. From the outset of their careers, therapists should receive training and supervision to enhance their awareness of their own and their clients' attachment experiences and how these play out during therapy. There is a need for greater empirical research to investigate whether the degree to which therapists formulate and meet clients' attachment needs influences outcomes.

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Attachment Theory and Multiple Integrated Treatments of Borderline Patients

Cited by 33 publications

References 50 publications

The Use of Attachment Theory in the Clinical Dialogue with Patients

The Use of Attachment Theory in the Clinical Dialogue with Patients

Contrasting metacognitive, social cognitive and alexithymia profiles in adults with borderline personality disorder, schizophrenia and substance use disorder

Attachment‐informed therapy for adults: Towards a unifying perspective on practice

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