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Tijdschrift voor Psychiatrie 60 (2018) 10, 717 - 721

Klinische Praktijk

The patient with a personality disorder and the mentalizing capacity of the psychiatrist

H.D. Philipszoon

Contact with patients with a personality disorder can be difficult due to the complicated relationship between them and the psychiatrist. Psychodynamic characteristics of the patient seem to influence this process, such as the use of primitive defence mechanisms and a moderately developed mentalizing capacity. These might temporarily disrupt the mentalizing capacity of the psychiatrist, diminishing the psychiatrist’s ability to solve problems in the therapeutic relationship. This is illustrated using a patient vignette. The process can be corrected by recognizing the temporary lack of mentalizing abilities of the psychiatrist. As a result contact between psychiatrist and patiënt (or between psychiatrist and resident) will be more constructive, and therapeutic interventions can be applied more adequately.

keywords mentalizing, personality disorders, therapeutic relationship