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Psihijatrija danas
2011, vol. 43, iss. 1, pp. 83-94
article language: Serbian
document type: Paper

The relationship between somatization disorder, level of personality organization, attachment pattern and mentalization
Univerzitet u Beogradu, Medicinski fakultet, KBC 'Dr Dragiša Mišović'

e-mail: borovnicavladimir@yahoo.com

Abstract

In this article we will propose a model of somatization representing an attempt to integrate the concept of mentalization (as defined by Peter Fonagy), the attachment theory and the interpersonal model of summarization. According to the interpersonal model, somatization can be understood as a form of interpersonal behavior, triggered by anxiety and maladaptive pattern of attachment, which eventually leads to the rejection of the environment and consequently increasing the feeling of rejection and somatic complaint. Studies indicate that personality pathology in patients with somatization disorder is pronounced, but not specific and unambiguous. Alexithymia (which, at least partly, can be understood as the opposite of mentalization) is often pointed out as the common denominator. In addition to this, studies confirm that the group of patients with somatization disorder includes a significantly higher number of those who display insecure attachment pattern than the control group. On the other hand, there is an unbreakable connection between mentalization as a function and attachment. The child develops the capacity to mentalize in the context of safe attachment, while the activation of the system of attachment ('threat') inhibits the capacity for mentalization. Finally, the capacity for mentalization (and symbolic representation system) is the key contribution to the regulation of affect. In this article we will propose a model that connects the above concepts, and explains the development as well as the circular pattern through which the somatization reaction is maintained - both in the family and in the clinical context.

Keywords

somatization disorder; mentalization; attachment; interpersonal patterns

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