Mentalization within Intensive Analysis with a Borderline Patient

Abstract

The author discusses whether the concepts of mentalization are helpful within intensive, individual analytic work with a personality disordered patient. Child and adult technique within the widening scope of psychopathology can be thought of as building on developmental help, studied at the Anna Freud Centre from the sixties to reach ‘atypical’ children who could not use classical analysis. The first two years of work with Jenny, a young borderline woman, were anchored by developmental research on attachment and early parent–infant relating. Later, when her capacity to symbolize, tolerate and communicate affect had greatly improved, she could accept and use interpretations, and working in the transference was gradually able to be accepted as thinking and not only as action. The infantile modes of experiencing psychic reality hypothesized in mentalization theory are illustrated from the material, and the status of attachment within psychoanalytic theory is reconsidered. In the last section, how each psychotherapist specifically shapes the process of change will be discussed, building on the concept of ‘marked mirroring’.