The Concept of Mentalisation

United Kingdom

Many of our speakers discuss the importance of mentalisation. For example, Jenny Perkel mentions that mentalisation is something that therapists should model for parents when working with their children; Yvette Esprey talks about how difficulty with mentalisation is part of the clinical presentation in Borderline Personality Disorder; Vanessa Hemp discusses it when talking about psychotherapy with adolescents and Ella Brent uses the concept often in talking about Dialectical Behaviour Therapy. So what exactly is it?

Mentalization refers to the ability to reflect upon and to understand one's own state of mind and the state of mind of the other. This includes the capacity to have insight into what one is feeling, and why, and to make inferences, based on these, as to the motivations of one’s own and other’s behaviour. This is one of the main building blocks for intersubjectivity, attachment and relationships.

The theory posits that mentalisation develops throughcontingent(accurate) andmarked(exaggerated or different) mirroring by caregivers, and it is through this process that children learn that they are beings with minds of their own and are then able to relate to others as being with minds. If the mirroring is notcontingent, the child will identify incorrectly with emotions that he or she sees on the parent’s face, and develop a false or ‘alien’ self. If the affect is notmarked, the child will not understand that the affect being reflected belongs to him, but will rather believe it to be the parent’s expression of their own feeling.

Peter Fonagy, a British psychoanalyst, has written extensively on the topic[i], theorising that a poor ability to mentalise is a large part of the difficulty facing people with Borderline Personality Disorder. In line with his thinking, he developed a treatment model, Mentalization Based Treatment (MBT), aimed at teaching patient with Borderline Personality Disorder traits to mentalize, thus developing a more coherent sense of self and better relationships with other people.

Watch the following interview with Fonagay where he explains mentalization. He expands on some of the processes involved in its development and how problems related to poor mentalization can occur.

[i] See Affect Regulation, Mentalisation and the Development of the Self Fonagay, P. & Jurist E.L; The Handbook of Mentalization-Based Treatment Allan, J.G & Fonagay, P. for examples

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