Page No.161-168
K Dharani Devi, Poornima Bhola, A Preethi Ninan, Harini Gunasekaran and
M Urvakhsh Mehta
Developmental psychopathology models of borderline personality disorder (BPD) have linked early attachment vulnerabilities with reduced capacities for mentalization and consequent disturbances in psychological and interpersonal functioning. Addressing impairments in the ability to understand the mental states (e.g. emotions, needs, thoughts, intentions) of one self and others, is an emerging focus in therapy for BPD. This case report illustrates the process of 32 sessions of individual therapy with a 26-year-old woman diagnosed with BPD. 'Concrete mentalization' and 'pseudo-mentalization' were some of the prominent styles of thinking observed in the client. Techniques to address her hypersensitivity to perceived rejection and her difficulties in understanding the intentions of others were introduced as an adjunct to Dialectical Behaviour Therapy. Innovative methods such as story-telling, comic strips and roleplays were used to enhance mentalization and were associated with increased client engagement and gains in therapy. The challenges experienced and therapist reflections on the therapy process are discussed in this paper.