MINDING THE BABY

Abstract

The primary aim of this article is to give a theoretical and empirical background for clinical interventions in family-oriented treatment for substance use disorders. The article refers to an ongoing research project, which is based on the concepts of mentalization and parental reflective functioning. Theory of mentalization and attachment theory is explored as explanatory tools of both addictive problem and risk/resilience factors in offspring. Mentalization is defined as the competence to envision mental states in self and others and to understand behaviour in terms of mental states. Substance use is discussed as clinical expressions of impaired mentalizing skills and disorders of state- and affect regulation. Parental reflective function particularly refers to parents’ competences to interpret the mind of their own infant or child. Parental reflective functioning, as ‘minding the baby’, promotes sensitive care, which again serves to protect the infant and the immature brain from potentially dangerous stress and physiological arousal. Substance use often makes the parent ‘absent-minded’ and thus imposes a risk of impaired interactions between caregivers and the extra vulnerable substance exposed child.Without a lifeline to the caregivers’ mind, the development of self regulation and social competences is endangered. High-risk families need substantial support to break the burden of intergenerational transmission of internal representations of caregiving experiences, and to promote good enough care for the infant. The mentalization-based treatment programs (MBT) briefly outlined here, propose a long-term multidisciplinary treatment and follow-up.

Keywords:

• Addiction
• alcohol
• competence
• drug
• mentalization
• prevention
• psychotherapy
• theory
• parenting
• infant mental health