본문 바로가기
KERD
논문

정신화(mentalization) 개념을 통한애착 이론과 정신 분석의 재조명: 정신화의 경험적 기반과 측정의 임상적 함의

Revisiting Attachment Theory and Psychoanalysis: Clinical Implications of Empirical Findings and Measurement of Mentalization

김은영|차혜명
한국심리학회 (The Korean Psychological Association)|2016.03|한국심리학회지:일반 (Korean Journal of Psychology: General)|제35권 제1호|pp. 167-190|DOI 10.22257/kjp.2016.03.35.1.167

2

조회

0

다운로드

30

인용

0

참고문헌

키워드

정신화Attachment TheoryMentalizationReflective FunctionPsychoanalysis애착이론정신 분석성찰 기능성찰 기능 척도정신화 기반 치료Mentalization-based Treatment
주제분류심리과학

초록

정신분석과의 관계에서 볼 때, 애착이론의 시작과 발전은 그 자체로 역설적이라 할 수 있다. Bowlby의 애착이론은 ‘정신 내적 세계’와 ‘표상으로서의 어머니’에 집중하고 있던 Kleinian 정신분석학적 전통에서 잉태되었지만, 이러한 전통에서 떨어져 나와 또 다른 경험과학, 즉 ‘외부 세계’와 ‘실제 어머니’에 주목하는 발달심리학의 주요한 하나의 거점으로 자리잡았고, 나아가 작금의 경험 과학(empiricism)적 심리학의 풍토에 성공적으로 안착하였다. 그러나 흥미롭게도, 현대 애착 이론을 대표하는 Fonagy는 ‘실제 현실’의 경로를 추적하던 애착이론의 경험적 연구들이 거듭된 수정과 재수정을 통해 ‘표상으로서의 내적 세계’에 접근하고 있음을 지적한다. 이와 같이 정신분석적 시각에서 애착 연구의 성과를 재해석하고, 결별한 두 이론적 흐름을 재결합시키는 Fonagy의 이론적 시도는 정신화 개념에서 극명하게 드러난다. 본 논문은 먼저 Fonagy의 정신화 개념 및 애착이론의 수정된 가정인 상호조절(mutual regulation) 개념을 정신분석적 전통과의 대비선상에서 조명하고, 정신화 개념을 뒷받침하는 신경생물학적 연구들을 개관한다. 마지막으로 본 논문은 정신화의 조작적 측정 도구로서의 성찰 기능 척도를 개관하고, 근거 기반 치료(evidence-based treatment)라는 최근 흐름에서의 임상적 함의와 국내 상황에서의 시사점을 탐색한다.

Abstract

From the perspectives of psychoanalysis, the development of the attachment theory has been paradoxical in itself. Bowlby’s theory of attachment has been initially derived from the Kleinian psychoanalytic tradition focused on ‘internal world’ and ‘mother as a representation.’ However, it has been detached from its origin and found its place within empirical tradition of social science with developmental psychology concentrating on ‘external world’ and ‘real mother,’ and further developed into more empirical tradition in the field of psychology. Interestingly enough though, Fanagy representing modern attachment theory stresses the fact that the series of empirical studies on attachment have been reversed its academic trajectory, through rounds of revisions, back to ‘internal world.’ Fonagy’s attempt to reestablish ties between the two academic trends shows its effort clearly in his concept mentalization stemming from the idea of evolution. This study looks into ‘mutual regulation’ that is a revised hypothesis of mentalization and attachment theory in relation to the psychoanalytic tradition, and reviews current neurobiological finding on attachment and mentalization. Lastly, this study covers various operational measurement schemes of mentalization and discusses clinical implications of mentalization in the contexts of evidence-based treatment and of South Korean.

참고문헌 (63)

  1. 심영숙, "성찰기능과 정신병리의 관계 : 외상과 악몽을 중심으로", 박사, 임상심리학, pp.2010
  2. 오소영, "단축형 청소년용 정신화 프로그램의 학생정신건강 증진효과 평가", 소아 청소년 정신의학, 23(3), pp.117~126 (2012), 대한소아청소년 정신의학회
  3. 오미애, "정신화 이론에 근거한 청소년기 자해행동의 분석: ‘캐주얼베이컨시’의 Sukhvinder 중심으로", 정신분석, 25(1), pp.24~32 (2014), 한국정신분석학회
  4. Allen, J. G., "Mentalizing in clinical practice" (2008), American Psychiatric Publishing
  5. Arnsten, A. F. T., "The biology of being frazzled", Science, 280, pp.1711~1712 (1998)
  6. Baron-Cohen, S., "The ‘Reading the Mind in the Eyes’ test revised version : A study with normal adults, and adults with Asperges syndrome or high-functioning Autism", Journal of Child Psychology and Psychiatry, 42, pp.241~252 (2001)
  7. Bateman, A., "Mentalizationbased treatment for Borderline personality disorder : A practical guide" (2006), Oxford University Press
  8. Beebe, B., "The origins of 12-month attachment : A microanalysis of 4-month mother-infant interaction", Attachment & Human Development, 12, pp.1~135 (2010)
  9. Beeghly, M., "Effects of prenatal exposure to cocaine in early infancy : Toxic effects on the process of mutual regulation", Infant Mental Health Journal, 15(2), pp.158~175 (1994)
  10. Blakemore, S. J., "Social cognitive neuroscience: Where are we heading?", Trends in Cognitive Sciences, 8, pp.216~222 (2004)
  11. Blatt, S. J., "The assessment of change during the intensive treatment of Borderline and Schizophrenic young adults", Psychoanalytic Psychology, 5, pp.127~158 (1988)
  12. Buck, R., "Emotion is an entity at both biological and ecological levels : The ghost in the machine is language", Emotion Review, 2(3), pp.286~287 (2010)
  13. Buhle, J. T., "Cognitive reappraisal of emotion : A metaanalysis of human neuroimaging studies", Cerebral Cortex, 24, pp.2981~2990 (2014)
  14. Cartes, C. S., "Neuroendocrine perspectives on social attachment and love", Psycho Neuroendocrinology, 23(8), pp.779~818 (1998)
  15. Caldwell, H. K., "Vasopressin : Behavioral roles of an"original"neuropeptide", Progress in Neurobiology, 84(1), pp.1~24 (2008)
  16. Choi-Kain, L., "Mentalization : Ontogeny, assessment, and application in the treatment of Borderline personality disorder", American Journal of Psychiatry, 165(9), pp.1127~1135 (2008)
  17. Crick, N. R., "Borderline personality features in childhood : A short-term longitudinal study", Developmental Psychopathology, 17, pp.1051~1070 (2005)
  18. Dziobek, I., "Introducing MASC : : A movie for the assessment of social cognition", Journal of Autism and Developmental Disorders, 36(5), pp.623~636 (2006)
  19. Child reflective functioning scale scoring manual: For application to the child attachment interview, "Ensink, K.", Anna Freud Centre, 2013
  20. Fonagy, P., "Thinking about thinking : Some clinical and theoretical considerations in the treatment of a Borderline patient", The International Journal of Psychoanalysis, 72(4), pp.639~656 (1991)
  21. Fonagy, P., "Attachment theory and psychoanalysis" (2001), Other Press
  22. Fonagy, P., "Mutual regulation, mentalization, and therapeutic action : A reflection on the contributions of Ed Tronick to developmental and psychotherapeutic thinking", Psychoanalytic Inquiry, 35(4), pp.355~369 (2015)
  23. Fonagy, P., "Psychotherapy for Borderline personality disorder : Mentalization based treatment" (2004), Oxford University Press
  24. Fonagy P., "Mechanisms of change in mentalization-based treatment of BPD", Journal of Clinical Psychology, 62(4), pp.411~430 (2006)
  25. Fonagy P., "Bad blood revisited : Attachment and psychoanalysis", British Journal of Psychotherapy, 31(2), pp.229~250 (2015)
  26. Fonagy, P., "Affect regulation, mentalization, and the development of the Self" (2002), Other Press
  27. Fonagy, P., "Borderline personality disorder, mentalization, and the neurobiology of attachment", Infant Mental Health Journal, 32(1), pp.47~69 (2011)
  28. Fonagy, "Parental development interview, addendum to reflective functioning scoring manual" (1998), City College of New York
  29. Fonagy, P., "Playing with reality : I. Theory of mind and the normal development of psychic reality", International Journal of Psycho-Analysis, 77, pp.217~234 (1996)
  30. Fonagy, P., "Attachment and reflective function : Their Role in self organization", Development and Psychopathology, 9(4), pp.679~700 (1997)
  31. Fosse, X., "Disorganized attachment and genetics in the development of Borderline personality disorder", European Psychiatry, 23, pp.94~94 (2008)
  32. Frankfurt, H., "On bullshit" (2005), Princeton University
  33. Frith, U., "Development and neurophysiology of mentalising", Biological Sciences, 365(1522), pp.1345~1350 (2003)
  34. Gallagher, H. L., "Reading the mind in cartoons and stories : An fMRI study of"Theory of Mind"in verbal and nonverbal tasks", Neuropsychologia, 38, pp.11~21 (2000)
  35. Gallagher, H. L., "Functional imaging of"Theory of Mind. "Trends in Cognitive", Science, 7, pp.77~83 (2003)
  36. George, C., "The adult attachment interview. Unpublished protocol" (1985), University of California
  37. Gergely, G., "The social biofeedback theory of parental affect-mirroring : The development of emotional self-awareness and self-control in infancy", International Journal of Pyscho-analysis, 77, pp.1181~1212 (1996)
  38. Giedd, Jay N., "The anatomy of mentalization : A view from developmental Neuroimaging", Bulletin of the Menninger Clinic, 67, pp.132~142 (2003)
  39. Gordon, I., "Oxytocin and cortisol in romantically unattached young adults : Associations with bonding and psychological distress", Psychophysiology, 45(3), pp.349~352 (2008)
  40. Grewen, K. M., "Effects of partner support on resting oxytocin, cortisol, norepinephrine, and blood pressure before and after warm partner contact", Psychosomatic Medicine, 67(4), pp.531~538 (2005)
  41. Gunderson, J. G., "The borderline patient’'s intolerance of aloneness : Insecure attachments and therapist availability", American Journal of Psychiatry, 153(6), pp.752~758 (1996)
  42. Holmes, J., "Disorganized attachment and Borderline personality disorder : A clinical perspective", Attachment & Human Development, 6(2), pp.181~190 (2004)
  43. Jolliffe, D., "Development and validation of the basic empathy scale", Journal of Adolescence, 29(4), pp.589~611 (2006)
  44. Kim, E. Y., "An activating mechanism of aggressive behaviour in disorganised attachment : A moment-to-moment case analysis of a three-year-old", Journal of Child Psychotherapy, 36(2), pp.152~167 (2010)
  45. Klein, M., "Envy, gratitude, and other works" (1946), The Free Press
  46. Kohn, N., "Neural network of cognitive emotion regulation : An ALE meta-analysis and MACM analysis", Neuroimage, 87, pp.345~355 (2014)
  47. Main, M., "Adult attachment rating and classification system" (1998), University of California
  48. Mitchell, S. A., "Freud and beyond" (1995), Basic Books
  49. Mosquera, D., "Early experience, structural dissociation, and emotional dysregulation in Borderline personality disorder : The role of insecure and disorganized attachment", Borderline Personality Disorder and Emotion Dysregulation, 1, pp.1~8 (2014)
  50. Pedersen, A., "Theory of mind in patients with Schizophrenia: Is mentalizing delayed?", Schizophrenia Research, 137, pp.224~229 (2012)
  51. Rogers, R. D., "Dissociable deficits in the decisionmaking cognition of chronic amphetamine abusers, opiate abusers, patients with focal damage to prefrontal cortex, and tryptophandepleted normal volunteers : Evidence for monoaminergic mechanisms", Neuropsychopharmacology, 20, pp.322~339 (1999)
  52. Rossouw, T. I., "Mentalization-based treatment for self-harm in adolescents : A randomized controlled trial", Journal of American Academy of Child & Adolescent Psychiatry, 51(12), pp.1304~1313 (2012)
  53. Rudden, M. G., "The brief reflective functioning interview" (2005), Weill Cornell Medical College
  54. Ryan, E. R., "Changes in object relations from psychosis to recovery", Journal of Abnormal Psychology, 93, pp.209~215 (1984)
  55. Sharp, C., "The development of a mentalization-based outcomes and research protocol for an adolescent inpatient unit", Bulletin of the Menninger Clinic, 73(4), pp.311~338 (2009)
  56. Shmueli-Goetz, Y., "The child attachment interview : A psychometric study of reliability and discriminant validity", Developmental Psychology, 44, pp.939~356 (2008)
  57. Smith, J. D., "The comparative psychology of uncertainty monitoring and metacognition", Behavior and Brain Sciences, 26, pp.317~373 (2003)
  58. Stern, D. N., "The interpersonal world of the infant : A view from psychoanalysis and developmental psychology" (1985), Basic Books
  59. Strathearn, L., "Does breastfeeding protect against substantiated child abuse and neglect? A 15-year cohort study", Pediatrics, 123(2), pp.483~493 (2009)
  60. Child reflective functioning scale scoring manual: For application to the child attachment interview, "Target, M.", Anna Freud Centre, 2001
  61. Tronick, E., "Infants of depressed mothers", Harvard Review of Psychiatry, 17(2), pp.147~156 (2009)
  62. Twemlow, S. W., "A developmental approach to mentalizing communities : II. The peaceful Schools project", Bulletin of the Menninger Clinic, 69(4), pp.282~304 (2005)
  63. Winnicott, D. W., "Playing and reality" (1971), Routledge.

관련 논문AI추천

애착이론으로부터 정신화까지: 배경과 임상적 의의반건호한국정신분석학회 · 정신분석2013 · 제24권 제2호공유된 의식, 표상의 현실 대 현실의 표상: 정신화의 이론적, 경험적, 임상적 함의와 한국적 적용을 중심으로김은영, 김흥주, 박민주, 차혜명한국심리학회 · 한국심리학회지:일반2020 · 제39권 제4호Schore의 현대애착이론과 Fonagy의 현대정신분석의 시사점황민영한국상담심리학회 · 한국심리학회지: 상담 및 심리치료2023 · 제35권 제3호애착이론의 발전과 정신분석과의 갈등: 역사를 중심으로반건호한국정신분석학회 · 정신분석2021 · 제32권 제3호정신화 기반 치료의 연구 동향과 추후 과제김은석, 이수진이화사회과학원 · 사회과학연구논총2021 · 제37권 제2호한국판 모(母) 정신화 척도의 타당화이문희, 이수림한국재활심리학회 · 재활심리연구2019 · 제26권 제1호

이 간행물의 다른 논문 (10건)

통로유도등의 안내 방향과 설치 위치에 따른공간 스트룹 효과서희영, 김초복, 오윤경, 이윤지, 최준호, 허민영pp. 1-12“부담스러운 작업, 안전을 해친다.”: 작업 부담이 직무 스트레스를 매개로 안전 행동에 미치는 영향, 그리고 변혁적 리더십과 안전 분위기의 조절 효과김병직, 정세윤, 고도원pp. 13-42자살 유가족(suicide survivors)에 관한국내 연구의 동향과 과제김영아, 변재원pp. 43-63소방대원들의 외상 후 스트레스 증상에 미치는인구통계, 직무특성 및 심리사회 요인들이종선, 구훈정pp. 65-88세월호 재난으로 친구를 잃은 청소년의 외상경험에 관한 질적 연구: 상담자의 보고(report)를 중심으로김유진, 신지영, 이동훈pp. 89-120
원문 보기