Article written by Dr Elizabeth Knock
What is mentalising?
Mentalising is the process by which we hold our own and others minds, in our mind. It is how we make sense of others thought processes as separate from our own, and our awareness of our own thoughts and emotional states. It is thinking, about thinking…
As vague as this may sound, it’s a mental process so closely connected to social interactions and interpersonal relationships. It helps us make sense of others intentions and our position within others states of minds as well as our own.
Why is it important?
Being able to Mentalise, at least the majority of the time, is an essential part of psychological health. It is vital for healthy social functioning and connection. It alsorelates to the development of affect regulation, attachment, and our sense and understanding of self. While we’re all likely to have slight lapses from time to time, significant lapses in mentalising, or an entirely reduced reflective capacity is increasingly considered a core feature of Borderline Personality disorder, and other disorders of attachment and trauma (Fonagy & Batemen, 2010).
Mentalising and Parenting
When we think about attachment, we often think about parenting, both new parent-child relationships, and intergenerational parent-child trauma as well as consequential interpersonal difficulties. Mentalising is a relevant focus when working with parents – whether they present explicitly with their own difficulties, complex histories of attachment and interpersonal issues or with a young child displaying concerning behaviours.
In the context of parenting, Mentalising refers to a parent’s capacity to understand and think about their child’s feelings and experiences, and to hold in mind their mental states. A parent’s mentalising capacity is predictive of a child’s attachment, regulation capacity, social skills; ability to play and symbolise (Fonagy et al, 2002).
Strengthening this mentalising capacity points to an opportunity to change and build a secure parent-infant relationship, and everything positive that comes with this. What’s exciting is that despite the complexity and engrained nature of parental trauma and damaged attachment, parental mentalisation actually does show improvement in response to interventions (Scheschter et al 2005). In fact, working with the parent-child dyad provides a brilliant vehicle for building this capacity, as parents are encouraged to watch, wonder and be curious about the internal world of their child. By its very nature, the flow on effect can be direct improvements in parent mental health and interpersonal functioning.
Mentalisation Based Therapy
Mentalisation Based Therapy (MBT) provides an intervention framework for creating change and building this much needed reflective capacity. It uses the safe therapeutic attachment relationship, when working with individuals, and the parent-child relationship when working with that dyad. It asks for a curious, reflective, questioning and observing stance to be taken by the therapist, with the goal of slowly reinstating periods of mentalising by assisting the parent or individual to gradually focus their mind, on the mind of another.
As well as being recognised as an effective stand-alone treatment method used by psychologists and clinicians, Mentalisation Based Therapy is also seen as a useful adjunct to other treatment styles. At The Institute for Healthy Living, clinicians work with clients in both structured and opportunistic ways to build and grow this essential skill, of thinking about thinking. To book in with Dr Knock, click here
Fonagy P., and Batemen A. W. (2010). Mentalization based treatment for Borderline Personality disorder. World Psychiatry. Feb; 9(1) 11-15.
Fonagy P., Gergely G., Jurist E and Target M. (2002). Affect Regulation, Mentalization and the Development of the Self. New York: Other Press.
Schechter D.S., Coots T., Zeanah C.H., Davies M., Coates S.W., Trabka K.A., Marshall R.D., Leibowitz M.R and Myers M.M. 2005: Maternal mental representations of the child in an inner-city clinical sample: Violence-related posttraumatic stress and reflective functioning. Attachment & Human Development 7, 313-331.