Pawel

Explain what mentalisation is and critically discuss how it may help us understand and treat personality disorders? Mentalization - it is the ability to understand one's own and other people's mental states; understanding the behavior of oneself and others in terms of thoughts, feelings, wishes and desires. It is an important developmental achievement that begins with a relationship that is formed with an important caregiver. In other words, our understanding of others and ourselves crucially depends on whether our own states of mind were adequately understood by caring, attentive, non-threatening caregivers during infancy. The ability to understand what is going on in my mind, as well as the other mind, also depends on the current competence in the field of maintaining mentalization, such as feeling tired, the context in which we find ourselves. In some contexts we will be able to keep thinking in others not. In most therapeutic interventions, we contribute to increasing a person's awareness of the distinctness of the mind of another person and more able to recognize the causes of their own states. On the other hand, it is mentalization that helps a person to look and think: "what am I actually accusing myself of" or "what is my specific objection to myself". It allows the mind to embrace conflicting attitudes towards others and oneself and to reconcile them calmly. A common experience of people with personality disorders is to confuse their own critical attitude towards themselves with the critical attitude of their interlocutor and not see the boundary that makes people separate. feels surrounded by enemies, reacting to it with aggression, impulsiveness and dissatisfaction. An example of such a situation is the borderline personality, which has almost no sense of peace, which gives answers to the simple questions of "who am I", "what am I doing here", "what do I mean", "who do I want to associate with" and whether "Love it or hate it." Therapy based on the concept of mentalization is focused on showing these characteristics of separateness, being able to distinguish and reconcile. Temporary or permanent loss of the ability to combine one's own and others' behavior with imaginable states of mind in stressful situations is one of the key problems they face people with personality disorders. Similarly, incoherent self-image, impulsive action with a destructive or life-difficult nature, fear of intimacy and closeness with others. These problems may be significantly reduced as a result of therapeutic activities increasing the ability to mentalize one's own states. This form of therapy is created precisely to support the development of the personality and enhance its integration. Each of the aspects of the difficulties we have talked about in functioning relates directly to the ability to mentalize, a therapy that will support this ability in its intention to overcome these difficulties. Research shows the high effectiveness of this form of therapy in relation to this group of problems, the authors of the method tried to fully and interestingly describe both their understanding of the relationship between personality disorders and mentalization, as well as therapeutic practices that were helpful in this, which is supported by very important and contributing publications .Mentalizing therapy increases self-confidence in the patient's own abilities.

Critically discuss the role of attachment in etiology and treatment Personality disorder.Personality disorders are most often described as deeply ingrained, persistent, maladaptive patterns of relationship with, thinking and perceiving the environment that cause difficulties in all aspects of a person's functioning.According to this approach, people with personality disorders are characterized by suffering - distress, disability affecting functioning, experiencing increased risk (death, pain, disability). They lack the ability to meet the requirements of maturity, do not have consistent and adaptive reality patterns, clear goals and values, and have difficulties making long-lasting and satisfying relationships with other people.The best known - borderline personality - negligence on the part of the caregivers, both by the mother and the father, is believed to be a significant etiological factor. People with this diagnosis often see the mother as distant, disengaged, or conflicting. It is usually accompanied by the physical or psychological absence of the father in the family of origin of these patients, and the very situation of this family is most often chaotic and incoherent.These individuals have often experienced separation and loss of loved ones in the past, physical abuse and sexual harassment. These experiences have a very negative impact on the bond between the child and the caregiver. Then the so-called "Distrustful pattern of attachment", and this leads to the impairment of the mentalization ability, i.e. the ability to understand the psyche of the caregiver first, and then of other people. It is the ability to reflect, understand what is happening, which allows you to work through the experienced psychological traumas and solve them. Borderline personality patients are usually incapable of reflecting on the content of their own mind and that of others; which in turn significantly impairs their ability to cope with difficult experiences.They feel deprived of the ability to influence relationships with others. They develop an overly vigilant attitude towards the environment, which is perceived as hostile and persecutory. Accumulating evidence suggests that these traumatic experiences are reflected in the structure and functioning of the brains of those who have suffered them. Therefore, the fear of such people and their relatives about the irreversibility of changes finds its justification. Therefore, it is extremely important to start specific psychotherapy in combination with comprehensive treatment. It is worth noting here that there are already reports of changes in the level of neurotransmission in the brain in the case of long-term psychological interactions (similar to pharmacological treatment).British psychiatrist and psychoanalyst John Bowlby assumed the existence of internal models of attachment, which assumed the existence of an object of attachment and a model of oneself containing thoughts and beliefs related to oneself. it attaches. Bowlby called attachment a condition in which a child feels the need to look for the closeness of the object of attachment, especially in situations of experiencing difficulties, stress and threats. According to Bowlby, internal attachment models develop between the first and third years of a child's life and are difficult to modify after that. This period is therefore called the "critical period", and the bond styles formed at this time are replicated later in life. If, in the critical period, the relations with the object are mostly positive, it is available and open to the child's needs, gives him a sense of security and responds to his needs, then internal operating models are created, in which positive beliefs about both the objects of attachment and the child itself are dominant. myself.Unfortunately, in the case of the predominance of negative experiences, in which objects do not react, when the child feels threatened, operating models are formed that include negative beliefs about the form of attachment. People with an insecure attachment style perceive the object as untrustworthy, unstable and unsafe. As a consequence of such a pattern, the client sees himself as a person who does not deserve acceptance and understanding. Most clinicians argue that neither drugs alone nor psychosocial treatments are sufficient to effectively treat schizophrenia. Critically discuss this claim against the available evidenceDespite advances in antipsychotic medication for schizophrenia that have alleviated side-effect burden, it has become clear that medications alone are not sufficient for recovery and adaptive adjustment. Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone.Compared to those receiving medications only, early stage schizophrenia patients receiving medications and psychosocial intervention had a lower rate of treatment discontinuation or change, lower risk of relapse, and improved insight , quality of life and social functioning (Arch Gen Psychiatry. 2010) We would be careless if not to address the significant contribution of pharmacological treatment to enabling people with schizophrenia to benefit more fully from participation in psychosocial treatment programs. Antipsychotic drugs are effective in alleviating or eliminating psychotic symptoms in patients with acute psychosis with schizophrenia (and other related psychotic diseases) and in preventing relapse in stable individuals. Showing the importance of continuous, continuous treatment with antipsychotics, a typical study design compares the risk of recurrence of psychosis between patients who continue to take antipsychotic drugs and those who stop taking drugs or take placebo. These studies show that those who continue to use antipsychotics have a much lower risk of relapse. These effects on stable patients are most relevant to psychosocial rehabilitation because there is a substantial evidence base indicating that psychotic symptoms can interfere with participation in psychosocial programs. Other studies indicate that interactions between antipsychotics and psychosocial therapies may be more complex. Marder et al. observed patients who were randomized to receive 2 pharmacological strategies as well as behavioral skills training and psychosocial control. More effective pharmacological treatment improved relapse rates but did not affect social adjustment. However, patients who received more effective drug treatment and behavioral skills training had the greatest improvement in social adjustment. In another study, the same group found that patients who experienced akathisia as a side effect of drugs were less likely to improve social adjustment. These results indicate that the drugs are limited to controlling psychosis and there is no evidence that that medications on their own improve function. On the other hand, drug side effects can have a negative impact on social functioning, possibly due to the side effects of the drugs. Other studies reinforce the notion that better symptom control affects participation in psychosocial treatments. Rosenheck et al144 monitored the use of different levels of psychosocial treatments and rehabilitation in patients assigned to a comparison of clozapine or haloperidol. Patients receiving clozapine were more likely to utilize higher levels of psychosocial treatment. Moreover, the use of these higher levels was associated with greater improvements in quality of life. This suggests that patients who experience more improvement in symptoms on a better pharmacotherapy have a greater potential to benefit from psychosocial interventions. It also suggests that one of the long-term goals of pharmacotherapy is to facilitate participation in psychosocial treatments. This is a goal that extends beyond just sustaining a remission Critically discuss the role of socio-cultural factors in mental healthCultural and social factors contribute to the causation of mental illness, yet that contribution varies by disorder. Mental illness is considered the product of a complex interaction among biological, psychological, social, and cultural factors. The role of any one of these major factors can be stronger or weaker depending on the disorder .One of the most developed lines of research on family factors and mental illness deals with relapse in schizophrenia. The first studies, conducted in Great Britain, found that people with schizophrenia who returned from hospitalizations to live with family members who expressed criticism, hostility, or emotional involvement (called high expressed emotion) were more likely to relapse than were those who returned to family members who expressed lower levels of negative emotionCulture is related to mental health and substance use on several different levels. First, community members from different ethnic or cultural groups may have a higher risk of mental health or substance use problems because they may experience a greater number of stressors, such as discrimination and isolation.Cultures may influence and contribute to the causation of mental illnesses, mould symptoms, render certain sub-groups more vulnerable as well as modify beliefs and explanations of illnesses. This demonstrates that cultural beliefs and values represent a crucial factor in mental illness.Sociocultural Theory? Sociocultural theory stresses the role that social interaction plays in psychological development. It suggests that human learning is largely a social process, and that our cognitive functions are formed based on our interactions with those around us who are "more skilled."A growing body of evidence, mainly from high-income countries, has shown that there is a strong socioeconomic gradient in mental health, with people of lower socioeconomic status having a higher likelihood of developing and experiencing mental health problems.Here are four ways culture can impact mental health: 1.Cultural stigma. Every culture has a different way of looking at mental health. For many, there is growing stigma around mental health, and mental health challenges are considered a weakness and something to hide. This can make it harder for those struggling to talk openly and ask for help.2.Understanding symptoms. Culture can influence how people describe and feel about their symptoms. It can affect whether someone chooses to recognize and talk about only physical symptoms, only emotional symptoms or both. 3.Community Support. Cultural factors can determine how much support someone gets from their family and community when it comes to mental health. Because of existing stigma, minorities are sometimes left to find mental health treatment and support alone.4.Resources. When looking for mental health treatment, you want to talk to someone who understands your specific experiences and concerns. It can sometimes be difficult or time-consuming to find resources and treatment options that take into account specific cultures factors and needs.These are only a few ways culture can impact the perception of and treatment for mental health. Every culture and person is different and face a unique journey to recovery.

References

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