Peter Fonagy | |
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Born | |
Scientific career | |
Fields | Psychoanalysis, psychiatry |
Institutions | Professor of Contemporary Psychoanalysis and Developmental Science and Head of the Division of Psychology and Language Sciences at University College London, Consultant to the Child and Family Program at the Menninger Department of Psychiatry, Baylor College of Medicine. |
Peter Fonagy, CBE , FBA , FAcSS , FMedSci (born 14 August 1952) is a Hungarian-born British psychoanalyst and clinical psychologist. He studied clinical psychology at University College London. He is a Professor of Contemporary Psychoanalysis and Developmental Science Head of the Division of Psychology and Language Sciences at University College London and a training and supervising analyst in the British Psycho-Analytical Society in child and adult analysis. His clinical interests center on issues of borderline psychopathology, violence, and early attachment relationships. He was Chief Executive of the Anna Freud Centre in London until September 2024. His work attempts to integrate empirical research with psychoanalytic theory. He has published over 500 papers, and 270 chapters and has authored 19 and edited 17 books. [1]
Fonagy is a Fellow of the British Academy, the Faculty of Medical Sciences, the Academy of Social Sciences, and a registrant of the BPC. He was appointed twice as a Senior Investigator by the National Institute for Health and Care Research (NIHR). [2]
Fonagy was appointed Officer of the Order of the British Empire (OBE) in the 2013 Birthday Honours for services to psychoanalysis and clinical psychology and received the Wiley Prize of the British Academy for Lifetime Achievements. [3]
Fonagy received the Otto Weininger Memorial Award [4] for his contributions to the development of contemporary psychoanalysis. To this end, he has helped to improve the dialogue between analysts and cognitive therapists. Fonagy has played and still plays a major role in the evaluation of psychotherapy research. [5] The evaluation of his research is (mostly) based on the effectiveness of treatment. Evaluation of treatment has led to review, recommendations, and implications of psychotherapy. Fonagy has offered detailed evidence for the efficacy of psychological interventions for mental disorders and for special populations, including medical and psychosocial therapies for children and young people and psychological therapies for borderline personality disorder.
In their award-winning [6] book Affect Regulation, Mentalization and the Development of the Self, Fonagy and his colleagues put forth a detailed theory for the way in which the abilities to mentalise and to regulate affect can determine an individual's successful development. They define mentalisation as the ability to make and use mental representations of their own and other people's emotional states. The authors discuss the ways in which bad and insufficient parenting, leading to certain attachment styles, [7] can leave children unable to modulate and interpret their own feelings, as well as the feelings of others. [8] These inabilities to mentalize and regulate affect have implications for severe personality disorders, as well as general psychological problems of self-confidence, and sense of self. [9]
Fonagy is particularly interested in borderline personality disorder (BPD), which was for a long time assumed to be treatment-resistant. [10] He and Anthony Bateman proposed a new way to treat BPD in their book Psychotherapy for borderline personality disorder: mentalization-based treatment. [11] Mentalization-based treatment (MBT), rooted in attachment theory, is based on the idea that people with borderline personality disorder mainly lack a reliable capacity to mentalize, which is caused by an absence of contingent and marked mirroring during development. The primary goals of treatment are to improve mentalization skills, make connections between the inner experience of relationships and the actual representation, learn how to work with current emotions and how to establish real relationships. In this way, they could form a more coherent sense of self and develop new (secure) attachment styles. [12] [13]
In the 2024 Birthday Honours, Peter Fonagy was appointed a Commander of the Order of the British Empire (CBE) for services to mental health care for children and young people. [14]
Psychoanalysis is a set of theories and therapeutic techniques that deal in part with the unconscious mind, and which together form a method of treatment for mental disorders. The discipline was established in the early 1890s by Sigmund Freud, whose work stemmed partly from the clinical work of Josef Breuer and others. Freud developed and refined the theory and practice of psychoanalysis until his death in 1939. In an encyclopedic article, he identified the cornerstones of psychoanalysis as "the assumption that there are unconscious mental processes, the recognition of the theory of repression and resistance, the appreciation of the importance of sexuality and of the Oedipus complex." Freud's colleagues Alfred Adler and Carl Gustav Jung developed offshoots of psychoanalysis which they called individual psychology (Adler) and analytical psychology (Jung), although Freud himself wrote a number of criticisms of them and emphatically denied that they were forms of psychoanalysis. Psychoanalysis was later developed in different directions by neo-Freudian thinkers, such as Erich Fromm, Karen Horney, and Harry Stack Sullivan.Jacques Lacan's theory essentially represents a return to Freud. He described Freudian metapsychology as a technical elaboration of the three-instance model of the psyche and primarily examined the logical structure of the unconscious.
Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group. The term can legitimately refer to any form of psychotherapy when delivered in a group format, including art therapy, cognitive behavioral therapy or interpersonal therapy, but it is usually applied to psychodynamic group therapy where the group context and group process is explicitly utilized as a mechanism of change by developing, exploring and examining interpersonal relationships within the group.
Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, a distorted sense of self, and intense emotional responses. People diagnosed with BPD frequently exhibit self-harming behaviours and engage in risky activities, primarily due to challenges regulating emotional states to a healthy, stable baseline. Symptoms such as dissociation, a pervasive sense of emptiness, and an acute fear of abandonment are prevalent among those affected.
Narcissistic personality disorder (NPD) is a personality disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive need for admiration, and a diminished ability to empathize with other people's feelings. Narcissistic personality disorder is one of the sub-types of the broader category known as personality disorders. It is often comorbid with other mental disorders and associated with significant functional impairment and psychosocial disability.
Psychology is an academic and applied discipline involving the scientific study of human mental functions and behavior. Occasionally, in addition or opposition to employing the scientific method, it also relies on symbolic interpretation and critical analysis, although these traditions have tended to be less pronounced than in other social sciences, such as sociology. Psychologists study phenomena such as perception, cognition, emotion, personality, behavior, and interpersonal relationships. Some, especially depth psychologists, also study the unconscious mind.
Otto Friedmann Kernberg is an Austrian-born American psychoanalyst and professor of psychiatry at Weill Cornell Medicine. He is most widely known for his psychoanalytic theories on borderline personality organization and narcissistic pathology. In addition, his work has been central in integrating postwar ego psychology with Kleinian and other object relations perspectives. His integrative writings were central to the development of modern object relations, a school within modern psychoanalysis.
Psychodynamic psychotherapy and psychoanalytic psychotherapy are two categories of psychological therapies. Their main purpose is revealing the unconscious content of a client's psyche in an effort to alleviate psychic tension, which is inner conflict within the mind that was created in a situation of extreme stress or emotional hardship, often in the state of distress. The terms "psychoanalytic psychotherapy" and "psychodynamic psychotherapy" are often used interchangeably, but a distinction can be made in practice: though psychodynamic psychotherapy largely relies on psychoanalytical theory, it employs substantially shorter treatment periods than traditional psychoanalytical therapies. Psychodynamic psychotherapy is evidence-based; the effectiveness of psychoanalysis and its relationship to facts is disputed.
Allan N. Schore is an American psychologist and researcher in the field of neuropsychology.
Child psychotherapy, or mental health interventions for children refers to the psychological treatment of various mental disorders diagnosed in children and adolescents. The therapeutic techniques developed for younger age ranges specialize in prioritizing the relationship between the child and the therapist. The goal of maintaining positive therapist-client relationships is typically achieved using therapeutic conversations and can take place with the client alone, or through engagement with family members.
The Austen Riggs Center is a psychiatric treatment facility located in Stockbridge, Massachusetts. It was founded in 1913 as the Stockbridge Institute for the Study and Treatment of Psychoneuroses by Austen Fox Riggs. The institution was renamed in his honor on July 21, 1919.
In psychology, mentalization is the ability to understand the mental state – of oneself or others – that underlies overt behaviour. Mentalization can be seen as a form of imaginative mental activity that lets us perceive and interpret human behaviour in terms of intentional mental states. It is sometimes described as "understanding misunderstanding." Another term that David Wallin has used for mentalization is "Thinking about thinking". Mentalization can occur either automatically or consciously.
Mentalization-based treatment (MBT) is an integrative form of psychotherapy, bringing together aspects of psychodynamic, cognitive-behavioral, systemic and ecological approaches. MBT was developed and manualised by Peter Fonagy and Anthony Bateman, designed for individuals with borderline personality disorder (BPD). Some of these individuals suffer from disorganized attachment and failed to develop a robust mentalization capacity. Fonagy and Bateman define mentalization as the process by which we implicitly and explicitly interpret the actions of oneself and others as meaningful on the basis of intentional mental states. An alternative and simpler definition is "Seeing others from the inside and ourselves from the outside." The object of treatment is that patients with BPD increase their mentalization capacity, which should improve affect regulation, thereby reducing suicidality and self-harm, as well as strengthening interpersonal relationships.
Transference focused psychotherapy (TFP) is a highly structured, twice-weekly modified psychodynamic treatment based on Otto F. Kernberg's object relations model of borderline personality disorder (BPD). It views the individual with borderline personality organization (BPO) as holding unreconciled and contradictory internalized representations of self and significant others that are affectively charged. The defense against these contradictory internalized object relations leads to disturbed relationships with others and with self. The distorted perceptions of self, others, and associated affects are the focus of treatment as they emerge in the relationship with the therapist (transference). The treatment focuses on the integration of split-off parts of self and object representations, and the consistent interpretation of these distorted perceptions is considered the mechanism of change.
Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions vary by source and remain a matter of controversy. Official criteria for diagnosing personality disorders are listed in the sixth chapter of the International Classification of Diseases (ICD) and in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).
The mainstay of management of borderline personality disorder is various forms of psychotherapy with medications being found to be of little use.
The Goethe Award for Psychoanalytic and Psychodynamic Scholarship is given annually by the Section on Psychoanalytic and Psychodynamic Psychology of the Canadian Psychological Association. The award is given for the best psychoanalytic book published within the past two years and is juried by a peer review process and awards committee.
Sidney J. Blatt was a professor emeritus of psychiatry and psychology at Yale University's Department of psychiatry. Blatt was a psychoanalyst and clinical psychologist, empirical researcher and personality theoretician, who made enormous contributions to the understanding of personality development and psychopathology. His wide-ranging areas of scholarship and expertise included clinical assessment, psychoanalysis, cognitive schemas, mental representation, psychopathology, depression, schizophrenia, and the therapeutic process, as well as the history of art. During a long and productive academic career, Blatt published 16 books and nearly 250 articles and developed several extensively used assessment procedures. Blatt died on May 11, 2014, in Hamden, Conn. He was 85.
Andrew J. Gerber is an American psychoanalyst and the current president and medical director of Silver Hill Hospital in New Canaan, Connecticut. His principal interests and research lie in studying the neurobiological bases of social cognition, particularly in relation to autism spectrum disorders and change in response to psychotherapy. He is a member of the American Academy of Child and Adolescent Psychiatry, American Psychiatric Association, American Psychoanalytic Association and the Psychoanalytic Psychodynamic Research Society.
Nancy McWilliams, Ph.D., ABPP., is emerita visiting professor at the Graduate School of Applied and Professional Psychology at Rutgers University. She has written on personality and psychotherapy.
Psychodynamic Therapy with Infants and Parents aims to relieve emotional disturbances within the parent(s), the baby, and/or their interaction, for example, postnatal depression and anxiety, infant distress with breastfeeding and sleep, and attachment disorders. It rests on attachment theory and psychoanalysis. Sigmund Freud suggested that a modification of his method could be applied to children, and child analysis was introduced in the 1920s by [Anna Freud].., [Melanie Klein], and Hermine Hug von Hellmuth. Klein speculated on infantile experiences to understand her patients' disorders but she did not practice PTIP. Donald Winnicott, a pediatrician and analyst, focused on the mother-baby interplay in his theorizing and his brief parent-child consultations, but he did not work with PTIP.