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Sessions:
Attachment: Session 9
Mentalization: How Attunement Affects Development
Jeffery Smith, MD
jssmith@me.com
Reading: Fonagy, Introduction and chapter 1.
Written Assignment: After each session, please write a 1 page reacton: "What struck you about this reading." Bring your paper to share at the beginning of class.
A Few Key Points--
Look for how attunement affects the child's development of a "theory of mind."
How does Fonagy see poor attunement as the cause of borderline and other severe characther pathology. Specifically, how does a faulty theory of mind cause specific patterns observed in patients?
What do you think of Fonagy's lumping the development of a sense of security in with the development of a theory of mind? Are these so intermingled that they should be seen as one?
What do you think of Fonagy's lumping the development of the Superego in with mentalization, seeing them as the same.
Session Highlight: Experience with DID patients who have had bad mother-child mirroring from the beginning suggests that these people are able to form close and healthy bonds based on minimal healthy experience, such as with a grandparent. It is my impression that the avid need for connection drives development even under very adverse circumstances. The inability to split dissociatively seems to force borderline and narcissistic patients to distort themselves and their object representations in order to maintain equilibrium, rather than being the direct result of poor teaching.