Metaphors, a central conduit of change in psychotherapy, have not been taken adequately into account in Mentalization-Based Treatment (MBT). Despite successfully utilized by other evidence-based treatments for borderline personality disorder (BPD), MBT considers metaphors confusing for patients with low mentalizing abilities. For metaphors and teaching stories to stimulate growth within the window of tolerance, interventions should be responsively tailored (e.g., explained). Metaphors might be a route to making spoken matter more apprehensible, and bridge emotions with cognitive content. They hold the potential for challenging without being too confronting, and to translate knowledge between different range of understanding. This theoretical article presents why the use of metaphors in MBT—in the hands of a responsive therapists—may prove a powerful tool to open social trust, despite being considered a “high risk” intervention. The timeless lens of the metaphor may help us connect with archetypical versions of our own narratives, hence understanding our subjectivity in a larger perspective. By reaching towards concepts beyond our normal reasoning, typically denoted perennial philosophy or wisdom, they may substitute and/or supplement mentors in a memorable way.

隐喻是心理治疗变革的核心渠道，但在基于心理化的治疗 (MBT) 中并未得到充分考虑。尽管其他边缘型人格障碍 (BPD) 的循证疗法已成功使用，但 MBT 认为隐喻会使心智化能力低的患者混淆。对于在宽容的窗口内刺激成长的隐喻和教学故事，干预措施应该响应性地量身定制（例如，解释）。隐喻可能是使口语更容易理解的途径，并将情感与认知内容联系起来。他们具有挑战的潜力，但又不会太直面，并在不同的理解范围之间转换知识。这篇理论文章阐述了为什么在 MBT 中使用隐喻——在反应灵敏的治疗师手中——可能被证明是建立社会信任的有力工具，尽管被认为是“高风险”干预。隐喻的永恒镜头可以帮助我们与我们自己叙事的原型版本联系起来，从而从更大的角度理解我们的主观性。通过超越我们正常推理的概念，通常表示永恒的哲学或智慧，他们可能会以一种令人难忘的方式替代和/或补充导师。