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Tijdschrift voor Psychiatrie 51 (2009) 4, 239 - 248

Review article

Bodily aspects of mentalization: a therapeutic focus in the treatment of patients with severe medically unexplained symptoms

J.A. Spaans, L. Veselka, P. Luyten, M.E.F. Bühring

summary
background
Our knowledge about medically unexplained symptoms (mus) is increasing, but translating this knowledge into more effective treatment, particularly if symptoms are severe, continues to be problematical.
aim
To clarify the physical aspect of mentalisation (body-mentalisation) and to outline a theoretical perspective of body-mentalisation, starting from theories such as the attachment theory and the mentalisation theory, and to describe the diagnostic and therapeutic value of this approach.
methods Clinical experience with body-mentalisation led to a systematic literature search (via PsycInfo and Medline).
results Body-mentalisation is the ability to detect the signals of our own and of other, to respond to them and perceive the links with underlying mental states. Poor body-mentalisation occurs frequently in patients with severe mus and can be treated successfully by means of intensive residential or day-therapy programmes.
conclusion Body-mentalisation may turn out to be a useful concept in connection with the treatment of persons with severe mus. More research is needed to test the diagnostic validity and therapeutic relevance of this concept.

keywords body-mentalisation, medically unexplained symptoms, mentalisation, unexplained physical symptoms