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공유된 의식, 표상의 현실 대 현실의 표상: 정신화의 이론적, 경험적, 임상적 함의와 한국적 적용을 중심으로

Shared consciousness, reality of representation vs. representation of reality: Theoretical, empirical, and clinical implications of mentalization and its applications in Korea

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초록

최근 정신화 이론은 유아-어머니 관계에 대한 발달연구의 성과를 토대로 마음이론의 발달을 정신분석과 애착이론 간의 교량에 위치시키고, 실제 현실의 개념을 정교화하면서 이에 따른 치료적 함의를 제안하였다. 현실이란 ‘저기 너머에’ 존재하는 독립적 현실이 아니며, 상호 응시, 공유된 의도와 감정, 의미로 구성된 공유된 의식의 과정이자 산물이다. 따라서 불투명하고 가변적인 표상으로서의 세계를 향한 탐구적 자세는 이론의 경험적 접근과 임상의 측면에서 결정적 역할을 한다. 본 연구는 현실지각에 대한 인식론적 가정인 지향성 개념을 중심으로 경계선 성격의 마음이론을 탐색하고 정신화 이론의 발달과정을 개관하고 있다. 또한 정신화의 경험적 측정과 근거기반 실천으로서의 정신화기반 치료의 기제와 근거를 둘러싼 최근의 쟁점을 논의한다. 마지막으로, 본 논문은 사회적 인식으로서의 정신화, 즉 한국적 의미에서의 마음(心)이야말로 인간의 사회적 삶과 앎의 원천이라는 사실에 주목하고, 정신화 모델의 한국적 적용에 대해 탐색한다.

Abstract

Theory of Mentalization, based on developmental observations of the mother-infant relationship, has placed the theory of mind between psychoanalysis and attachment, elaborating on the concept of reality and its therapeutic implications. The reality does not exist ‘out there’ independently; it is a process and product of shared consciousness with mutual gaze, shared intentions, shared feelings, and shared meaning. Therefore, the inquisitive stance toward the representational world, which is opaque and changeable, plays a critical role in empirical and clinical applications of mentalizing. This study, based on an epistemological concept of intentionality, explores the theory of mind of patients with borderline personality and reviews how mentalizing theory develops. It also addresses recent issues regarding the measurement of mentalization and mentalization-based treatment as an evidence-based practice. Lastly, this paper posits that mentalizing as a social cognition or the mind in Korean cultural heritage is the source of social life and knowledge, and explores its clinical applications in Korea.

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