Table of Contents
ISRN Addiction
Volume 2013, Article ID 250751, 6 pages
Review Article

Deficits of Affect Mentalization in Patients with Drug Addiction: Theoretical and Clinical Aspects

Department of Cognitive Science and Psychology, New Bulgarian University, 21 Montevideo Boulevard, 1618 Sofia, Bulgaria

Received 24 August 2012; Accepted 15 October 2012

Academic Editors: A. M. Barr, L. Janiri, and P. Mannelli

Copyright © 2013 Svetoslav Savov and Nikola Atanassov. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Traditionally treated with wariness, drug addictions have provoked a serious interest in psychodynamically oriented clinicians in recent decades. This paper discusses the development of contemporary psychodynamic conceptualizations of addictions, focusing specifically on mentalization-based theories. The concept of mentalization refers to a complex form of self-regulation which includes attribution of psychological meaning to one’s own behavior and affective states, as well as those of the others. We hypothesize that drug-addicted patients have severe impairments in mentalizing, associated with developmental deficits, characteristic for the borderline personality disorder and psychosomatic conditions. Psychodynamic models of mentalization and their corresponding research operationalizations are reviewed, and implications for a contemporary understanding of drug addictions and psychotherapy are drawn. The authors propose that mentalization-oriented theories provide an adequate conceptualization, which is open to empirical testing and has clear and pragmatic guidelines for treatment.