MENTALIZATION BASED TREATMENT

Mentalization Based Treatment (MBT) is an empirically based treatment for Borderline Personality Disorder developed by Dr. Peter Fonagy and Dr. Anthony Bateman. MBT research  produces similar outcomes to DBT. MBT however, has the longest follow-up outcome study showing eight years post treatment an continued increase in functioning associated with relationships and work/career. MBT as a psycho-analytically informed treatment focuses on mental states rather than behavior. MBT is applied to the here-and-now, with attachment theory as it’s theoretical foundation.

MBT as has been incorporated into several programs worldwide that are highly specialize in the treatment of Borderline Personality Disorder. MBT can be applied as a stand alone treatment consisting of weekly Individual and Group Therapy, or in combination with DBT or other treatment approaches. The staff at the DBT Center of NJ has been receiving multiple intensive trainings in MBT by treatment creators and ongoing supervision through McLean Hospital experts on applying MBT for the treatment of BPD.

Definition:

Mentalization refers to the capacity to understand the mental process of self and others, by paying attention to mental states, (intentions, desires, and beliefs), not behaviors.

  • Understanding misunderstanding
  • The ability to see ourselves from the outside and others from the inside
  • Know yourself as others know you and know your subjective self
  • Understanding past, present and future
  • Having mind in mind

Mentalization is a capacity needed in emotional regulation to behave skillfully in relationships. In addition to helping us to understand our own state of mind, mentalization helps us to understand the state of mind of others. Misunderstandings can be a highly aversive experience, mentalization expands the capacity to stop and pause to create an understanding.

Mentalizing Improves Relationships for Several Reasons:

  • Mentalization enables us to understand conflicts with others with out highly aversive responses to misunderstandings
  • Mentalization promotes our ability to effectively cope with conflict with out acting on false assumptions of others intentions
  • Mentalization helps us  regulate powerful and intense emotions associated with loss of relationships
  • Mentalization allows us to relate to ourselves and other people with empathy and compassion

Signs of Effective Mentalizing:

  • Reflective, curious, and interested
  • Does not over simplify the complexity of one’s mind or the minds of others
  • Stays with the emotions, can feel emotions while thinking at the same time.

Signs of Loss in Mentalizing:

  • Excessive detail, lacks emotion, or meaning
  • Using labels, judgments, and all or nothing thinking
  • Being certain, “I just know!”
  • Talk the talk, but cannot walk the walk….
  • Internal and external is the same, “I think you hate me, so you do”.
  • Shutting down, not able to look and see