Mentalization and psychosis: trying to understand the un-understandable

Psychotic disorders tend to severely invalidate patients, which accounts for a substantial part of the worldwide burden of disease. Hallmarks of psychotic disorders are the ‘positive’ symptoms like hallucinations and delusions and ‘negative’ symptoms like a lack of motivation. Next to these clinical symptoms, psychotic disorders tend to involve significant problems in social functioning, such as the inability to maintain relationships and employment. Although the past century has seen the development of effective medication to treat positive symptoms, there has been remarkably little improvement in overall social functioning. The causes of both the clinical symptoms and poor social functioning observed in psychotic disorders are incompletely understood, but childhood abuse and impaired mentalizing ability – the ability to understand human behaviour in terms of mental states such as thoughts, beliefs and feelings – are potentially harmful factors. This dissertation explored the interrelatedness of childhood abuse, mentalization and psychosis and investigated whether mentalization based treatment for psychotic disorder (MBTp) is an effective adjunct treatment.