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Borderline personality disorder: the association with hypermentalization

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Borderline personality disorder is a mental disorder characterized by chaotic relationships, identity disorder, difficulty regulating emotions. Another aspect is the high suicidal risk of borderline patients (50 times higher than that of the general population).

One of the peculiarities of BPD is that compared to healthy people, those with this disorder have more broken relationships and conflicts. At the heart of the disorder are interpersonal problems affecting social cognition (which allows you to think about other people’s thoughts, intentions, and feelings). The recognition of positive or negative emotions in borderline people does not report a deficit. These people are just less accurate at recognizing emotions. In a borderline individual, socio-cognitive impairment is characterized by an excessive attribution of intentions and thoughts to others .

Hypermentalization was introduced to better understand the characteristics of borderline disorder . Mentalization is related to the ability to imagine and reflect on one’s own and others’ mental states. Something that underlies interpersonal interactions. There are several types of optimal mind setting:

  • automatic (emotional and attentionless mentalization)
  • controlled (slower mindset and requires intentionality)
  • cognitive (mentalization that is based on the use of thoughts)
  • affective (mentalization that uses emotions more)
  • among oneself (the self-mentalization, that of one’s own mind)
  • the other (referring to mentalizing the minds of others)
  • between internal (mentalisation based on internal experience)
  • external (mentalizing based on observable cues, such as facial expressions)

Overmentalizing predicts that individuals with borderline personality disorder have a lack of flexibility and balance between various mentalizing characteristics. The deficit is amplified in complex contexts and in emotional hyperactivation . Hypermentalization is characterized by “excessive twisted inferences based on social cues.” An example is when the hyper-mentalized individual sees a friend who is sad and thinks it is because of her.

A study done by McLaren et. reviewed several analyzes of the association between mentalizing and borderline personality disorder versus other disorders. The results of the study are that both the borderline personality diagnosis and other psychological pathologies are associated with hypermentalization. This, however, without a specific finding of hypermentalization in borderline personality disorder. Despite this, the findings that attest to the association between psychopathology in general and hypermentalization support the transdiagnostic use of psychotherapeutic treatments . They are based on mentalization, such as MBT (Mentalization Based Treatment).

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  • Hypermentalization and borderline personality disorder (stateofmind.it)

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