TY - JOUR
T1 - The developmental roots of borderline personality disorder in early attachment relationships
T2 - A theory and some evidence
AU - Fonagy, Peter
AU - Target, Mary
AU - Gergely, George
AU - Allen, Jon G.
AU - Bateman, Anthony W.
PY - 2003
Y1 - 2003
N2 - The paper suggests a way of understanding borderline personality disorder in terms of the failure of a secure base. We begin with an account of optimal self-development in a secure attachment context, highlighting the importance of the caregiver's ability to help the small child think about his own and others' minds. This optimal self-development is crucial in developing the child's capacity for mentalization, which can enhance his resilience in the face of later trauma. We discuss the impact of attachment trauma in later development, arguing that the extent of this impact depends on how well early attachment relationships facilitated the capacity for mentalization. We identify some of the consequences for the representations of the internal world of a failure of mentalization that may follow trauma in individuals made vulnerable by genetic predisposition or disorganized early attachment. We link these features to the clinical presentation associated with borderline personality organization. Finally, some of the necessary characteristics of successful psychotherapeutic treatment of borderline personality disorder are briefly considered.
AB - The paper suggests a way of understanding borderline personality disorder in terms of the failure of a secure base. We begin with an account of optimal self-development in a secure attachment context, highlighting the importance of the caregiver's ability to help the small child think about his own and others' minds. This optimal self-development is crucial in developing the child's capacity for mentalization, which can enhance his resilience in the face of later trauma. We discuss the impact of attachment trauma in later development, arguing that the extent of this impact depends on how well early attachment relationships facilitated the capacity for mentalization. We identify some of the consequences for the representations of the internal world of a failure of mentalization that may follow trauma in individuals made vulnerable by genetic predisposition or disorganized early attachment. We link these features to the clinical presentation associated with borderline personality organization. Finally, some of the necessary characteristics of successful psychotherapeutic treatment of borderline personality disorder are briefly considered.
UR - http://www.scopus.com/inward/record.url?scp=0042265586&partnerID=8YFLogxK
U2 - 10.1080/07351692309349042
DO - 10.1080/07351692309349042
M3 - Review Article
AN - SCOPUS:0042265586
SN - 0735-1690
VL - 23
SP - 412
EP - 459
JO - Psychoanalytic Inquiry
JF - Psychoanalytic Inquiry
IS - 3
ER -