Journal
AMERICAN JOURNAL OF PSYCHOTHERAPY
Volume 75, Issue 1, Pages 32-37Publisher
AMER PSYCHIATRIC PUBLISHING, INC
DOI: 10.1176/appi.psychotherapy.20210023
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Mentalization-based treatment for ASPD (MBT-ASPD) offers a promising intervention for addressing the dysfunction of the attachment system and reduced mentalizing abilities that lead to impulsive behavior and relational reactivity in individuals with antisocial personality disorder.
Antisocial personality disorder (ASPD) is a common condition associated with interpersonal and social violence, and current treatments are unsatisfactory. Mentalizing, which has developmental roots in attachment processes, offers a framework to reconsider treatment for ASPD, in which dysfunction of the attachment system temporarily inhibits affect regulation and reduces mentalizing abilities, resulting in impulsivity and relational reactivity. Mentalization-based treatment for ASPD (MBT-ASPD), which focuses on the mental and relational processes central to personality disorder rather than on anger management and violent behavior, is a promising intervention. Implemented as a group psychotherapy, MBT-ASPD targets the mentalizing vulnerabilities and attachment patterns of patients by using a semistructured group process focused on personal formulation and by establishing group values to promote learning from other members and generating we-ness. The treatment then emphasizes mentalizing in relationships. This article discusses the mentalizing model of ASPD and outlines strategies for MBT-ASPD from a therapy group conducted in Great Britain.
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