정신화(mentalization) 개념을 통한애착 이론과 정신 분석의 재조명: 정신화의 경험적 기반과 측정의 임상적 함의 = Revisiting Attachment Theory and Psychoanalysis: Clinical Implications of Empirical Findings and Measurement of Mentalization

다국어 초록 (Multilingual Abstract)

From the perspectives of psychoanalysis, the development of the attachment theory has been paradoxical in itself. Bowlby’s theory of attachment has been initially derived from the Kleinian psychoanalytic tradition focused on ‘internal world’ and ‘mother as a representation.’ However, it has been detached from its origin and found its place within empirical tradition of social science with developmental psychology concentrating on ‘external world’ and ‘real mother,’ and further developed into more empirical tradition in the field of psychology. Interestingly enough though, Fanagy representing modern attachment theory stresses the fact that the series of empirical studies on attachment have been reversed its academic trajectory, through rounds of revisions, back to ‘internal world.’ Fonagy’s attempt to reestablish ties between the two academic trends shows its effort clearly in his concept mentalization stemming from the idea of evolution. This study looks into ‘mutual regulation’ that is a revised hypothesis of mentalization and attachment theory in relation to the psychoanalytic tradition, and reviews current neurobiological finding on attachment and mentalization. Lastly, this study covers various operational measurement schemes of mentalization and discusses clinical implications of mentalization in the contexts of evidence-based treatment and of South Korean.

국문 초록 (Abstract)

정신분석과의 관계에서 볼 때, 애착이론의 시작과 발전은 그 자체로 역설적이라 할 수 있다. Bowlby의 애착이론은 ‘정신 내적 세계’와 ‘표상으로서의 어머니’에 집중하고 있던 Kleinian 정신분석학적 전통에서 잉태되었지만, 이러한 전통에서 떨어져 나와 또 다른 경험과학, 즉 ‘외부 세계’와 ‘실제 어머니’에 주목하는 발달심리학의 주요한 하나의 거점으로 자리잡았고, 나아가 작금의 경험 과학(empiricism)적 심리학의 풍토에 성공적으로 안착하였다. 그러나 흥미롭게도, 현대 애착 이론을 대표하는 Fonagy는 ‘실제 현실’의 경로를 추적하던 애착이론의 경험적 연구들이 거듭된 수정과 재수정을 통해 ‘표상으로서의 내적 세계’에 접근하고 있음을 지적한다. 이와 같이 정신분석적 시각에서 애착 연구의 성과를 재해석하고, 결별한 두 이론적 흐름을 재결합시키는 Fonagy의 이론적 시도는 정신화 개념에서 극명하게 드러난다. 본 논문은 먼저 Fonagy의 정신화 개념 및 애착이론의 수정된 가정인 상호조절(mutual regulation) 개념을 정신분석적 전통과의 대비선상에서 조명하고, 정신화 개념을 뒷받침하는 신경생물학적 연구들을 개관한다. 마지막으로 본 논문은 정신화의 조작적 측정 도구로서의 성찰 기능 척도를 개관하고, 근거 기반 치료(evidence-based treatment)라는 최근 흐름에서의 임상적 함의와 국내 상황에서의 시사점을 탐색한다.

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