바로가기메뉴

본문 바로가기 주메뉴 바로가기

ACOMS+ 및 학술지 리포지터리 설명회

  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
  • 2024년 07월 03일(수) 13:30
 

logo

정신화(mentalization) 개념을 통한애착 이론과 정신 분석의 재조명: 정신화의 경험적 기반과 측정의 임상적 함의

Revisiting Attachment Theory and Psychoanalysis: Clinical Implications of Empirical Findings and Measurement of Mentalization

한국심리학회지: 일반 / Korean Journal of Psychology: General, (P)1229-067X; (E)2734-1127
2016, v.35 no.1, pp.167-190
https://doi.org/10.22257/kjp.2016.03.35.1.167
차혜명 (경북대학교)
김은영 (경북대학교)
  • 다운로드 수
  • 조회수

초록

정신분석과의 관계에서 볼 때, 애착이론의 시작과 발전은 그 자체로 역설적이라 할 수 있다. Bowlby의 애착이론은 ‘정신 내적 세계’와 ‘표상으로서의 어머니’에 집중하고 있던 Kleinian 정신분석학적 전통에서 잉태되었지만, 이러한 전통에서 떨어져 나와 또 다른 경험과학, 즉 ‘외부 세계’와 ‘실제 어머니’에 주목하는 발달심리학의 주요한 하나의 거점으로 자리잡았고, 나아가 작금의 경험 과학(empiricism)적 심리학의 풍토에 성공적으로 안착하였다. 그러나 흥미롭게도, 현대 애착 이론을 대표하는 Fonagy는 ‘실제 현실’의 경로를 추적하던 애착이론의 경험적 연구들이 거듭된 수정과 재수정을 통해 ‘표상으로서의 내적 세계’에 접근하고 있음을 지적한다. 이와 같이 정신분석적 시각에서 애착 연구의 성과를 재해석하고, 결별한 두 이론적 흐름을 재결합시키는 Fonagy의 이론적 시도는 정신화 개념에서 극명하게 드러난다. 본 논문은 먼저 Fonagy의 정신화 개념 및 애착이론의 수정된 가정인 상호조절(mutual regulation) 개념을 정신분석적 전통과의 대비선상에서 조명하고, 정신화 개념을 뒷받침하는 신경생물학적 연구들을 개관한다. 마지막으로 본 논문은 정신화의 조작적 측정 도구로서의 성찰 기능 척도를 개관하고, 근거 기반 치료(evidence-based treatment)라는 최근 흐름에서의 임상적 함의와 국내 상황에서의 시사점을 탐색한다.

keywords
Mentalization, Reflective Function, Attachment Theory, Psychoanalysis, Mentalization-based Treatment, 정신화, 애착이론, 정신 분석, 성찰 기능, 성찰 기능 척도, 정신화 기반 치료

Abstract

From the perspectives of psychoanalysis, the development of the attachment theory has been paradoxical in itself. Bowlby’s theory of attachment has been initially derived from the Kleinian psychoanalytic tradition focused on ‘internal world’ and ‘mother as a representation.’ However, it has been detached from its origin and found its place within empirical tradition of social science with developmental psychology concentrating on ‘external world’ and ‘real mother,’ and further developed into more empirical tradition in the field of psychology. Interestingly enough though, Fanagy representing modern attachment theory stresses the fact that the series of empirical studies on attachment have been reversed its academic trajectory, through rounds of revisions, back to ‘internal world.’ Fonagy’s attempt to reestablish ties between the two academic trends shows its effort clearly in his concept mentalization stemming from the idea of evolution. This study looks into ‘mutual regulation’ that is a revised hypothesis of mentalization and attachment theory in relation to the psychoanalytic tradition, and reviews current neurobiological finding on attachment and mentalization. Lastly, this study covers various operational measurement schemes of mentalization and discusses clinical implications of mentalization in the contexts of evidence-based treatment and of South Korean.

keywords
Mentalization, Reflective Function, Attachment Theory, Psychoanalysis, Mentalization-based Treatment, 정신화, 애착이론, 정신 분석, 성찰 기능, 성찰 기능 척도, 정신화 기반 치료

참고문헌

1.

심영숙 (2010). 성찰기능과 정신병리의 관계: 외상과 악몽을 중심으로. 카톨릭대학교 대학원 박사학위 논문.

2.

오소영, 문수진, 이원혜, 홍민하, 민정원, 김봉석, 황준원, 우이혁, 반건호 (2012). 단축형청소년 정신화 프로그램의 학생정신건강증진효과 평가, 대한소아청소년 정신의학회, 23(3), 117-126.

3.

오미애, 박찬민, 이연정, 홍민하, 한주희, 오수현, 박준헌, 반건호 (2014). 정신화 이론에 근거한 청소년기 자해행동의 분석:‘캐주얼베이컨시’의 Sukhvinder 중심으로,Psychoanalysis, 25(1), 24-32.

4.

Allen, J. G., Fonagy, P., & Bateman, A. W. (2008). Mentalizing in clinical practice. Arlington: American Psychiatric Publishing.

5.

Arnsten, A. F. T. (1998). The biology of being frazzled. Science, 280, 1711-1712.

6.

Baron-Cohen, S., Wheelwright, S., & Hill, J. (2001). The ‘Reading the Mind in the Eyes’ test revised version: A study with normal adults, and adults with Asperges syndrome or high-functioning Autism. Journal of Child Psychology and Psychiatry, 42, 241-252.

7.

Bateman, A., & Fonagy, P. (2006). Mentalizationbased treatment for Borderline personality disorder: A practical guide. Oxford: Oxford University Press.

8.

Beebe, B., Jaffe, J., Markese, S., Buck, K., Chen, H., Cohen, P., et al. (2010). The origins of 12-month attachment: A microanalysis of 4-month mother-infant interaction. Attachment & Human Development, 12, 1-135.

9.

Beeghly, M., & Tronick, E. (1994). Effects of prenatal exposure to cocaine in early infancy: Toxic effects on the process of mutual regulation. Infant Mental Health Journal, 15(2), 158-175.

10.

Blakemore, S. J., Winston, J., & Frith, U. (2004). Social cognitive neuroscience: Where are we heading? Trends in Cognitive Sciences, 8, 216-222.

11.

Blatt, S. J., Ford, R. Q., Berman, W., Cook, B., & Meyer, R. (1988). The assessment of change during the intensive treatment of Borderline and Schizophrenic young adults. Psychoanalytic Psychology, 5, 127-158.

12.

Buck, R. (2010). Emotion is an entity at both biological and ecological levels: The ghost in the machine is language, Emotion Review, 2(3), 286-287.

13.

Buhle, J. T., Silvers, J. A., Wager, T. D., Lopez, R., Onyemekwu, C., Kober, H., et al. (2014). Cognitive reappraisal of emotion: A metaanalysis of human neuroimaging studies. Cerebral Cortex, 24, 2981-2990.

14.

Cartes, C. S. (1998). Neuroendocrine perspectives on social attachment and love. Psycho Neuroendocrinology, 23(8), 779-818.

15.

Caldwell, H. K., Lee, H. J., Macbeth, A. H., & Young, W. S. (2008). Vasopressin: Behavioral roles of an “original” neuropeptide. Progress in Neurobiology, 84(1), 1-24.

16.

Choi-Kain, L., & Gunderson, J. (2008). Mentalization: Ontogeny, assessment, and application in the treatment of Borderline personality disorder, American Journal of Psychiatry, 165(9), 1127-1135.

17.

Crick, N. R., Murray-Close, D., & Woods, K. (2005). Borderline personality features in childhood: A short-term longitudinal study. Developmental Psychopathology, 17, 1051-1070.

18.

Dziobek, I., Fleck, S., Kalbe, E., Rogers, K., Hassenstab, J., Brand, M., et al. (2006). Introducing MASC: :A movie for the assessment of social cognition, Journal of Autism and Developmental Disorders, 36(5), 623- 636.

19.

Ensink, K., Target, M., & Oandasan, C. (2013). Child reflective functioning scale scoring manual: For application to the child attachment interview. Unpublished manuscript, Anna Freud Centre/ University College London, London, UK,

20.

Fonagy, P. (1991). Thinking about thinking: Some clinical and theoretical considerations in the treatment of a Borderline patient, The International Journal of Psychoanalysis, 72(4), 639-656.

21.

Fonagy, P. (2001). Attachment theory and psychoanalysis. New York: Other Press.

22.

Fonagy, P. (2015). Mutual regulation, mentalization, and therapeutic action: A reflection on the contributions of Ed Tronick to developmental and psychotherapeutic thinking. Psychoanalytic Inquiry, 35(4), 355-369.

23.

Fonagy, P., & Bateman, A. (2004). Psychotherapy for Borderline personality disorder: Mentalization based treatment. Oxford: Oxford University Press.

24.

Fonagy P., & Bateman, A. (2006). Mechanisms of change in mentalization-based treatment of BPD. Journal of Clinical Psychology, 62 (4), 411-30.

25.

Fonagy P., & Campbell C. (2015). Bad blood revisited: Attachment and psychoanalysis, British Journal of Psychotherapy, 31(2), 229-250

26.

Fonagy, P., Gergely, G., Jurist, E., & Target, M. (2002). Affect regulation, mentalization, and the development of the Self. New York: Other Press.

27.

Fonagy, P., Luyten, P., & Strathearn, L. (2011). Borderline personality disorder, mentalization, and the neurobiology of attachment. Infant Mental Health Journal, 32(1), 47-69.

28.

Fonagy, Steele, Steele, & Target (1998). Parental development interview, addendum to reflective functioning scoring manual. Unpublished manuscript, City College of New York, New York, NY.

29.

Fonagy, P., & Target, M. (1996). Playing with reality: I. Theory of mind and the normal development of psychic reality. International Journal of Psycho-Analysis, 77, 217-234

30.

Fonagy, P. & Target, M. (1997). Attachment and reflective function: Their Role in self organization. Development and Psychopathology, 9(4), 679-700.

31.

Fosse, X., Monestes, J. L., & Bakhache, B. (2008). Disorganized attachment and genetics in the development of Borderline personality disorder. European Psychiatry, 23, S94-S94.

32.

Frankfurt, H. (2005). On bullshit. Princeton: Princeton University.

33.

Frith, U., & Frith, C. D. (2003). Development and neurophysiology of mentalising. Biological Sciences, 365(1522), 1345-1350.

34.

Gallagher, H. L., Happe, F., Brunswick, N., Fletcher, P. C., Frith, U., & Frith, C. D. (2000). Reading the mind in cartoons and stories: An fMRI study of “Theory of Mind” in verbal and nonverbal tasks. Neuropsychologia 38, 11-21.

35.

Gallagher, H. L., & Frith, C. D. (2003). Functional imaging of “Theory of Mind.” Trends in Cognitive. Science, 7, 77-83.

36.

George, C., Kaplan, N., & Main, M. (1985). The adult attachment interview. Unpublished protocol (3rd eds.), University of California, Berkeley, CA.

37.

Gergely, G., & Watson, J. S. (1996). The social biofeedback theory of parental affect-mirroring: The development of emotional self-awareness and self-control in infancy. International Journal of Pyscho-analysis, 77, 1181-1212.

38.

Giedd, Jay N. (2003). The anatomy of mentalization: A view from developmental Neuroimaging. Bulletin of the Menninger Clinic, 67, 132-142.

39.

Gordon, I., Zagoory-Sharon, O., Schneiderman, I., Leckman, J. F., Weller, A., & Feldman, R. (2008). Oxytocin and cortisol in romantically unattached young adults: Associations with bonding and psychological distress. Psychophysiology, 45(3), 349-352.

40.

Grewen, K. M., Girdler, S. S., Amico, J., & Light, K. C. (2005). Effects of partner support on resting oxytocin, cortisol, norepinephrine, and blood pressure before and after warm partner contact. Psychosomatic Medicine, 67(4), 531-538.

41.

Gunderson, J. G. (1996). The borderline patient’'s intolerance of aloneness: Insecure attachments and therapist availability. American Journal of Psychiatry, 153(6), 752-758.

42.

Holmes, J. (2004). Disorganized attachment and Borderline personality disorder: A clinical perspective. Attachment & Human Development, 6(2), 181-190.

43.

Jolliffe, D., & Farrington, D. P. (2006). Development and validation of the basic empathy scale. Journal of Adolescence, 29(4), 589-611.

44.

Kim, E. Y. (2010). An activating mechanism of aggressive behaviour in disorganised attachment: A moment-to-moment case analysis of a three-year-old. Journal of Child Psychotherapy, 36(2), 152-167.

45.

Klein, M. (1946). Envy, gratitude, and other works. New York: The Free Press.

46.

Kohn, N., Eickhoff, S. B., Scheller, M., Laird, A. R., Fox, P. T., & Habel, U. (2014). Neural network of cognitive emotion regulation: An ALE meta-analysis and MACM analysis. Neuroimage, 87, 345-355.

47.

Main, M., & Goldwyn, R. (1998). Adult attachment rating and classification system . Unpublished manual, University of California, Berkeley, CA.

48.

Mitchell, S. A., & Black, M. J. (1995). Freud and beyond. New York: Basic Books.

49.

Mosquera, D., Gonzalez, A., & Leeds, A. M. (2014). Early experience, structural dissociation, and emotional dysregulation in Borderline personality disorder: The role of insecure and disorganized attachment. Borderline Personality Disorder and Emotion Dysregulation, 1, 1-8.

50.

Pedersen, A., Koelkebeck, K., Brandt, M., Wee, M., Kueppers, K. A., & Kugel, H. (2012). Theory of mind in patients with Schizophrenia: Is mentalizing delayed? Schizophrenia Research, 137, 224-229.

51.

Rogers, R. D., Everitt, B. J., & Baldacchino, A. (1999). Dissociable deficits in the decisionmaking cognition of chronic amphetamine abusers, opiate abusers, patients with focal damage to prefrontal cortex, and tryptophandepleted normal volunteers: Evidence for monoaminergic mechanisms. Neuropsychopharmacology, 20, 322-339.

52.

Rossouw, T. I., & Fonagy, P. (2012). Mentalization-based treatment for self-harm in adolescents: A randomized controlled trial. Journal of American Academy of Child & Adolescent Psychiatry, 51(12), 1304-1313.

53.

Rudden, M. G., Milrod, B., & Target, M. (2005). The brief reflective functioning interview. New York: Weill Cornell Medical College.

54.

Ryan, E. R., & Bell, M. D. (1984). Changes in object relations from psychosis to recovery. Journal of Abnormal Psychology, 93, 209-215.

55.

Sharp, C., Williams, L. L., Ha, C., Baumgardner, J., Michonski, J., & Seals, R. (2009). The development of a mentalization-based outcomes and research protocol for an adolescent inpatient unit. Bulletin of the Menninger Clinic, 73(4), 311-338.

56.

Shmueli-Goetz, Y., Target, M., Fonagy, P., & Datta, A. (2008). The child attachment interview: A psychometric study of reliability and discriminant validity. Developmental Psychology, 44, 939-356.

57.

Smith, J. D., Shields, W. E., & Washburn, D. A. (2003). The comparative psychology of uncertainty monitoring and metacognition. Behavior and Brain Sciences, 26, 317-373.

58.

Stern, D. N. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. New York: Basic Books.

59.

Strathearn, L., Mamun, A. A., Najman, J. M., & O’Callaghan, M. J. (2009). Does breastfeeding protect against substantiated child abuse and neglect? A 15-year cohort study. Pediatrics, 123(2), 483-493.

60.

Target, M., Oandasan, C., & Ensink, K. (2001). Child reflective functioning scale scoring manual: For application to the child attachment interview. Unpublished manuscript, Anna Freud Centre/ University College London, London, UK.

61.

Tronick, E., & Reck, C. (2009). Infants of depressed mothers. Harvard Review of Psychiatry, 17(2), 147-156.

62.

Twemlow, S. W., Fonagy, P., & Sacco, F. C. (2005). A developmental approach to mentalizing communities: II. The peaceful Schools project. Bulletin of the Menninger Clinic, 69(4), 282-304.

63.

Winnicott, D. W. (1971). Playing and reality. London: Routledge..

한국심리학회지: 일반