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      ¿En qué mejora la Teoría del Apego nuestra práctica clínica? Es hora de recapitular Translated title: How does Attachment Theory improve our clinical practice? A time for summing-up

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          Abstract

          Resumen La Teoría del Apego ha hecho contribuciones muy útiles para la intervención psicológica, y exponemos las más relevantes. Partiendo de que la psicoterapia conlleva inevitablemente la activación del sistema de apego, abordamos sus distintas presentaciones en función del estilo de apego, y planteamos algunas recomendaciones para su manejo (responder a necesidades subyacentes, desplegar actitud terapéutica en dos fases, considerar trabajo metacomunicacional, y ser cautos al activar el apego). Exponemos la influencia del apego en la capacidad para relacionarse con las experiencias internas (como fuente de amenaza o como vivencias no accesibles). Consideramos los tres tipos de seguridad buscada tras la activación del apego (física, emocional y cognitiva) y las distintas demandas que imponen en la relación terapéutica. Abordamos las implicaciones de la Teoría del Apego en los procesos de auto-regulación. Finalmente, revisamos brevemente algunas contribuciones adicionales a nivel conceptual, de evaluación y de tratamiento.

          Translated abstract

          Abstract Attachment theory has provided us with very useful resources for psychological intervention. The most relevant of these resources are presented here. Considering that psychotherapy inevitably involves the activation of the attachment system, some advice is provided in managing this (addressing underlying needs, deploying a two-stage therapeutic stance, including meta-communication dialogues, and being cautious when activating attachment). The influence of attachment on the ability to relate to inner experience (either as a threat or an experience that is difficult to reach) is presented. Three kinds of security related to attachment (physical, emotional, and cognitive) are taken into account, as well as their different demands on therapeutic relationships. Implications of attachment theory on self-regulation processes are presented. Finally, some additional contributions about conceptualization, assessment, and treatment are revised.

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          Most cited references49

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          The role of mentalizing and epistemic trust in the therapeutic relationship.

          Mentalizing--the capacity to understand others' and one's own behavior in terms of mental states-is a defining human social and psychological achievement. It involves a complex and demanding spectrum of capacities that are susceptible to different strengths, weakness, and failings; personality disorders are often associated with severe and consistent mentalizing difficulties (Fonagy & Bateman, 2008). In this article, we will argue for the role of mentalizing in the therapeutic relationship, suggesting that although mentalization-based treatment may be a specific and particular form of practice, the "mentalizing therapist" is a universal constituent of effective psychotherapeutic interventions.
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            Attachment and development: a prospective, longitudinal study from birth to adulthood.

            There is much to digest in a 30 year longitudinal study of the developing person (Sroufe, Egeland, Carlson, & Collins, 2005a). The following paper summarizes some key points regarding the place of infant attachment in the developmental course. It is argued that understanding the role of attachment entails grasping the organizational nature of the attachment construct and embracing a non-linear transactional model. Using such concepts, attachment history was shown in the Minnesota study to be clearly related to the growth of self-reliance, the capacity for emotional regulation, and the emergence and course of social competence, among other things. Moreover, specific patterns of attachment had implications for both normal development and pathology. Even more important than such linkages, however, study of the place of early attachment in later adaptation reveals much about developmental processes underlying both continuity and change. Findings are over-viewed concerning the complex links between attachment and ultimate outcomes and the preservation of early patterns even during times of change. In all, these findings have implications both for future research and for clinical application.
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              Epistemic Petrification and the Restoration of Epistemic Trust: A New Conceptualization of Borderline Personality Disorder and Its Psychosocial Treatment.

              A new developmental model of borderline personality disorder (BPD) and its treatment is advanced based on evolutionary considerations concerning the role of attachment, mentalizing, and epistemic trust in the development of psychopathology. We propose that vulnerability to psychopathology in general is related to impairments in epistemic trust, leading to disruptions in the process of salutogenesis, the positive effects associated with the capacity to benefit from the social environment. BPD is perhaps the disorder par excellence that illustrates this view. We argue that this conceptualization makes sense of the presence of both marked rigidity and instability in BPD, and has far-reaching implications for intervention.
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                Author and article information

                Journal
                pappsicol
                Papeles del Psicólogo
                Pap. Psicol.
                Consejo General de Colegios Oficiales de Psicólogos (Madrid, Madrid, Spain )
                0214-7823
                1886-1415
                April 2020
                : 41
                : 1
                : 66-73
                Affiliations
                [1] orgnameServicio Extremeño de Salud
                Article
                S0214-78232020000100066 S0214-7823(20)04100100066
                10.23923/pap.psicol2020.2917
                d85800fe-dae4-4e00-961a-bb74bcd0869b

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 03 September 2019
                : 04 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 49, Pages: 8
                Product

                SciELO Spain

                Categories
                Artículos

                Psicología Clínica,Psicoterapia,Apego,Clinical Psychology,Psychotherapy,Attachment

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