Abstract
Objective: The aim of this study was to explore how patients with personality disorder (PD) and substance use disorder (SUD) experience mentalization-based treatment (MBT), in particular what they consider useful and less useful elements of the therapy.Method: Semi-structured qualitative interviews with 13 participants were conducted. Participants were interviewed on their experience of the different elements of MBT, their experience of working in the transference, and their view on MBT as a whole. Thematic analyses were performed within a hermeneutical-phenomenological epistemology, with an emphasis on researcher reflexivity.Results: The following themes were found in the material: “I am not alone,” “Taking blinders off,” “Just say it,” “The paradox of trust,” and “Follow me closely.” Three of these themes concerned therapist interventions; these involved addressing the relationship with the patients, addressing negative or unspoken feelings in the sessions, and validating and tolerating patients’ affect. Two themes concerned group therapy experiences; these were the experience of sameness with co-patients in group and the experience of discovering different perspectives in group.Conclusions: Patients’ experiences of useful elements in MBT resonate with theoretical tenets of (borderline) personality pathology, in particular attachment disturbances and emotional dysregulation. Patients highlight what we would label working in the therapeutic relationship, addressing transferential and counter-transferential processes explicitly, emotional validation, and enhancing mentalizing in its own right.
Highlights
Mentalization-based treatment (MBT) with patients who suffer from both personality disorder (PD) and substance use disorder (SUD) is an area where we still lack sufficient empirical evidence
In this study, we found five themes describing from the patients perspective, therapeutic processes in MBT
Patients highlight what we would label working in the therapeutic relationship, addressing transferential and counter-transferential processes explicitly, emotional validation, and enhancing mentalizing in its own right
Summary
Mentalization-based treatment (MBT) with patients who suffer from both personality disorder (PD) and substance use disorder (SUD) is an area where we still lack sufficient empirical evidence. In our pilot trial with 18 female PD\SUD patients, Patient Experience of Mentalization-Based Therapy we investigated both feasibility and experiences of the treatment (Morken et al, 2017a,b). In the explorative qualitative study, 13 female patients were interviewed on their experiences of change, with a special reference to mental states and feelings (Morken et al, 2017a). In this study with the same patients, we focus on how they experienced the actual MBT treatment. We already know they experienced meaningful change, and we investigate what elements of MBT they highlight for their change
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