Résumés
Résumé
Le fonctionnement réflexif (FR) est un concept relativement nouveau et renvoie à la capacité d’un individu d’interpréter les comportements humains et les réactions interpersonnelles en termes d’intentions sous-jacentes et d’états mentaux. Il est particulièrement important dans le processus de régulation des affects et de la gestion des relations interpersonnelles difficiles. Comparativement à la thérapie comportementale dialectique (DBT) et les thérapies de soutien, la thérapie focalisée sur le transfert (TFP) a l’unique avantage de produire des changements au niveau du FR des patients limites. Dans le présent article, nous adoptons une perspective développementale pour expliquer les changements au niveau du FR induit par la TFP. Nous proposons un certain nombre de mécanismes d’action thérapeutiques par lesquels la TFP agirait chez des patients limites et plus particulièrement dans l’interprétation du transfert..
Abstract
Reflective functioning is a relatively new concept which broadly speaking, refers to the capacity to interpret human behaviours and interpersonal reactions in terms of underlying intentions and mental state motivations. This capacity is particularly important in the regulation of affects and the management of challenging interpersonal relations. In comparison to dialectical behavioural therapy (DBT) and supportive therapies, transference focused psychotherapy (TFP) has been shown to have unique advantages in terms of producing improvements in RF of borderline patients. In the present article, we propose a developmental perspective for understanding how TFP produces these changes in RF. Using this perspective, we identify a number of therapeutic mechanisms through which TFP facilitate the development of RF and specifically transference interpretations.
Resumen
El funcionamiento reflexivo (FR) es un concepto relativamente nuevo y se refiere a la capacidad de un individuo de interpretar los comportamientos humanos y las reacciones interpersonales en términos de las intenciones subyacentes y los estados mentales. Es particularmente importante en el proceso de regulación de los afectos y la gestión de las relaciones interpersonales difíciles. Comparativamente a la terapia comportamental dialéctica (DBT) y las terapias de apoyo, la terapia centrada en la transferencia (TFP) tiene la única ventaja de producir los cambios a nivel del FR de los pacientes límite. En este artículo, adoptamos una perspectiva de desarrollo para explicar los cambios a nivel del FR inducido por la TFP. Proponemos un cierto número de mecanismos de acción terapéutica por medio de los cuales la TFP actuaría en los pacientes límite.
Resumo
O funcionamento reflexivo (FR) é um conceito relativamente novo e refere-se à capacidade de um indivíduo de interpretar os comportamentos humanos e as reações interpessoais em termos de intenções subjacentes e estados mentais. Ele é particularmente importante no processo de regulação dos afetos e da gestão das relações interpessoais difíceis. Em comparação à terapia comportamental dialética (DBT) e as terapias de apoio, a terapia focada na transferência (TFP) tem a única vantagem de produzir mudanças ao nível do FR dos pacientes borderline. No presente artigo, adotamos uma perspectiva do desenvolvimento para explicar as mudanças ao nível do FR induzido pela TFP. Propomos um certo número de mecanismos de ação terapêutica pelos quais a TFP agiria nos pacientes borderline.
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Parties annexes
Références
- Bateman, A. W., Fonagy, P., 1999, The effectiveness of partial hospitalization in the treatment of borderline personality disorder : a randomized controlled trial, American Journal of Psychiatry, 156, 1563-1569.
- Bateman, A. W., Fonagy, P., 2004, Psychotherapy for Borderline Personality Disorder : Mentalization-Based Treatment, Oxford University Press, London.
- Clarkin, J. F., Yeomans, F. E., Kernberg, O. F., 2006, Psychotherapy for Borderline Personality : Focusing on Object Relations, American Psychiatric Publishing, Washington, DC.
- Denham, S. A., 1998, Emotional Development in Young Children, The Guildford Press, New York.
- Denham, S. A., Grout, L., 1992, Mothers’ emotional expressiveness and coping : Topography and relations with preschoolers’ emotional competence, Genetic, Social and General Psychology Monographs, 118, 75-101.
- Denham, S. A., Renwick-Debardi, S., Hewes, S., 1994, Affective Communication between Mothers and Preschoolers : Relations with Social-emotional Competence, Merill-Palmer Quarterly, 40, 488-508.
- Dunn, J., Brown, J. R., Beardsall, L., 1991, Family talk about feeling states and children’s later understanding of others’ emotions, Developmental Psychology, 27, 448-455.
- Ensink, K., Normandin, L., Lemieux, R., Berthelot, N., 2005, Child and Maternal Reflective Functioning in the Context of Sexual Abuse, Paper presented at the International Society for Psychotherapy Research, Montréal.
- Fonagy, P., Gergely, G., Jurist, E., Target, M., 2002, Affect Regulation, Mentalisation and the Development of the Self, Other Press, New York.
- Fonagy, P., Steele, H., Moran, G. S., Steele, M., Higgitt, A., 1991, The capacity for understanding mental states : The reflective self in parent and child and its significance for security of attachment, Infant Mental Health Journal, 13, 200- 217.
- 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, 217-233.
- Fonagy, P., Target, M., 1997, Attachment and reflective function : Their role in self-organization, Development and Psychopathology, 9, 679-700.
- Fonagy, P., Target, M., 2003, Psychoanalytic Theories : Perspectives from Developmental Psychopathology, Brunner-Routledge, New York.
- Gabbard, G., O., 2006, When Is Transference Work Useful in Dynamic Psychotherapy ?, American Journal of Psychiatry, 163, 1667-1669.
- Gabbard, G. O., Horwitz, L., Allen, J. G., Frieswyk, S., Newsom, G., Colson, D. B., Coyne, L., 1994, Transference interpretation in the psychotherapy of borderline patients : a high-risk, high-gain phenomenon, Harvard Review of Psychiatry, 2, 59-69.
- Garner, P. W., Jones, D. C., Gaddy, G., Rennie, K., 1997, Low income mothers’ conversations about emotions and their children’s emotional competence, Social Development, 6, 37-52.
- Harris, P. L., 2000, Understanding emotion, in Lewis, C., Haviland, J., eds., Handbook of Emotions, The Guildford Press, New York, 253-322.
- Hoffman, M. L., 1994, Discipline and internalization, Developmental Psychology, 30, 1, 26-28.
- Høglend, P., Amlo, S., Marble, A., Bøgwald, K., Sørbye, Ø., Cosgrove Sjaastad, M., Heyerdahl, O., 2006, Analysis of the patient-therapist relationship in dynamic psychotherapy : An experimental study of transference interpretations, American Journal of Psychiatry, 163, 1739-1746.
- Levy, K. N., Kelly, K. M., Meehan, K. B., Reynoso, J. S., Clarkin, J. F., Kernberg, O. F., 2006, Change in attachment patterns and reflective function in a randomized control trial of transference focused psychotherapy for borderline personality disorder, Journal of Consulting and Clinical Psychology.
- Linehan, M. M., 1993, Cognitive-Behavioral Treatment of Borderline Personality Disorder, The Guilford Press, New York.
- Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., Heard, H., 1991, Cognitive-behavioral treatment of chronically parasuicidal borderline patients, Archive of General Psychiatry, 48, 1060-1064.
- Piper, W. E., Azim, H. F., Joyce, A. S., Mccallum, M., 1991, Transference interpretations, therapeutic alliance, and outcome in short-term individual psychotherapy, Archive of General Psychiatry, 48, 10, 946-953.
- Shipman, K. L., Zeman, J., 1999, Emotional understanding : A comparison of physically maltreating and nonmaltreating mother-child dyads, Journal of Clinical Child Psychology, 28, 3, 407-417.