Dialectic Mentalization Based Therapy for severe Somatoform disorders (D-MBT-S)

Eikenboom, Center for Psychosomatic Medicine in Zeist, The Netherlands, is a tertiary referral clinic for severe and chronic somatoform disorders. Patients have been treated extensively but usually unsuccessful before being referred to our Center. Cognitive Behaviour Therapy, which is often used for patients with Somatically Unexplained Physical Symptoms (SUPS) is not always sufficiently effective for very complex patients. It can be important to broaden the therapeutic perspectives for these patients.

This poster presents a transdiagnostic explanation model in which impaired mentalization of primary representations of the body (body-mentalization) plays a central role next to the following factors: 1) problematic attention and perception; 2) low acceptation of symptoms and the restrictions they imply; and 3) negative systemic influences. A body-mentalization based treatment for severe variants of SUPS is described. In Dutch we call this model MAMS (Mentalization, Acceptation, Modulation, Systemic Work). In this multimodal therapy the dialectics between change and acceptation, individual and group, fixed structures and organic development is a starting point. This is why the therapy is called: Dialectic Mentalization Based Therapy for severe Somatoform disorders (D-MBT-S).

This integrative multi-modal approach improves quality of live significantly. It has shown to decrease psychopathology and medical costs.

Literatur: Bühring, MEF,Vom Körperleben zum sprachlichen Ausdruck-Psychosomatische Rehabilitation in den Niederlanden, Praxis Klinische Verhaltensmedizin und Rehabilitation 2000; 52: 52-61. Spaans J, Veselka L, Luyten P. & Bühring M (im Druck). Lichaamsmentalisatie: over mentaliseren bij ernstige somatoforme stoornissen. Tijdschrift voor Psychiatrie Bühring, MEF, Boom KJ, Spaans J ( red.) Regionaal Zorgprogramma Somatoforme stoornissen - Een regionaal samenwerkingsproject van Altrecht, Universitair Medisch Centrum Utrecht, Vindicta, SBWU, Hofpoortziekenhuis, Mesos Medisch Centrum, locatie Overvecht, Centrum Maliebaan, Regionale Commissie Vrijgevestigde Psychotherapeuten, Regionaal Orgaan Eerstelijns Psychologen, Zuidwest Utrecht, 2006

Mentalization Based Therapy - multimodal therapy - severe somatoform disorders