About Mentalization Based Treatment
Mentalizing is the ability to understand our actions and the actions of other people, in terms of intentional mental states, such as desires, beliefs, thoughts, and feelings. It involves the necessary flexibility to think whilst feeling strongly and to allow these feelings to inform our ideas (rather than govern them fully)...to mentalize something is to see a thought as merely a thought: without necessarily representing an objective reality.
Mentalizing involves an attitude of curiosity about minds and hearts, a wondering about what lies beneath. Much of our day to day mentalizing however is automatic and implicit as we perceive and respond to our impressions of others’ minds as well as our own automatic, unthought about responses.
Mentalization based treatment is an integrative form of psychotherapy which aims to enhance this crucial relational capacity, to create understanding out of misunderstanding. Because failures of mentalizing underlie many of the problems that bring people to psychotherapy, particularly those with personality disorders, enhancing mentalizing can effect change in a number of areas of functioning.
The explicit aim of MBT to improve mentalizing capacity is intended to thereby improve affect regulation and strengthen relationships. Developed and manualised by Bateman & Fonagy for the treatment of borderline personality disorder (BPD) mentalizing approaches have now been adapted by other clinician’s for the treatment of a range of conditions and patient populations (Bateman & Fonagy, 2011).
Clinical trials of MBT reveal it to be more effective than structured clinical management(SCM) for BPD (Bateman & Fonagy, 2009) with similar findings replicated by an independent centre with a more severe population in the Netherlands (Bales, et al., 2015) and also in Norway (Kvarstein, et al., 2015). An eight year follow up of patients treated with MBT revealed that these gains were sustained (Bateman & Fonagy, 2008) so the model appears to provide benefit over and above SCM and to provide some lasting benefit for patients.