Your Essential Reference Guide To Mentalisation Based Therapy
An Insight into Mentalisation Based Therapy
We live in a world painted with hues of thoughts and feelings, a landscape within which we navigate our everyday lives. This internal world is as real to us as the external one.
But, have you ever wondered how we make sense of this emotional geography? The ability to perceive, understand, and respond to mental states is called 'mentalisation.' It's a bit like having a map of the human psyche. The more accurate and detailed your map is, the better you can comprehend the terrain of your own and others' minds.
Mentalisation Based Therapy (MBT), created by Peter Fonagy, uses this interesting phenomenon to address many mental health issues (e.g., eating disorders) and psychological challenges (e.g., relationship difficulties). Let's dig deeper into this intriguing, evidence-based approach.
What is Mentalisation Based Therapy Theory?
Mentalisation Based Therapy (MBT) is a form of talking therapy. MBT helps individuals better understand their own and others' thoughts and feelings. It focuses on enhancing an person's ability to mentalise, particularly in the context of relationships.
Now, imagine you're driving in a foreign city without a GPS or a good old-fashioned map. You're likely to miss turns, or be totally lost.
The same happens in our relationships when our ability to mentalise is impaired or underdeveloped. We misunderstand others, react impulsively, or end up hurting ourselves and others. MBT, in essence, is about giving you that GPS system, updating your mental map to navigate relationships more effectively.
The Underlying Theory of Mentalisation
Mentalisation, the linchpin of MBT, isn't just a learned skill. This ability is deeply rooted in our early childhood experiences. Primary caregiver interactions typically hone a child's ability to mentalise. You've witnessed the genesis of mentalisation if you've ever seen a mother mirroring her baby's gurgles and giggles.
This rich, emotional interaction enables the child to realise that others can understand and mirror their internal states. They are sketching out the first draft of their mental map.
However, if early interpersonal relationships are inconsistent, neglectful, or abusive, they may impair a child's mentalising ability. Imagine trying to draw a map in a moving, bumping vehicle. The lines become skewed, the directions confusing. This is where MBT comes in, offering the chance to redraw this map in a safer, steadier environment.
An Example of Mentalisation-Based Therapy
Let's take a hypothetical scenario. Sarah, a professional in her mid-thirties, struggles with sudden bouts of anger at work. This strains her relationships with her colleagues. During an MBT session, Sarah and her therapist might dissect an incident where her anger flared up.
The goal is not to suppress the anger but to understand its origin and how it impacts her actions. The therapist might guide Sarah to recognise that her anger stems from feelings of being undermined or disrespected.
Over time (typically over 18 months of therapy), she learns to react less impulsively, developing a more nuanced understanding of her emotional states.
What is the Difference Between DBT and MBT?
While MBT and Dialectical Behavior Therapy (DBT) both aim to enhance emotional understanding, they differ in their approach. DBT originally developed as a treatment for Borderline Personality Disorder (BPD). It focuses on teaching concrete skills to manage emotions and reduce self-destructive behaviours. MBT, on the other hand, primarily targets our ability to mentalise, which indirectly helps manage emotional responses.
Think of it as learning to play a musical instrument. DBT might teach you the notes and chords (the skills). MBT helps you understand and feel the music (the mental states), enhancing your overall performance.
MBT and Other Therapies
Comparing DBT and MBT gives us a glimpse into how different therapies tackle mental health issues. But we can make comparisons with several other talking therapies. Let's consider Cognitive Behavioral Therapy (CBT), another popular form of psychotherapy.
CBT operates on the premise that our thoughts, feelings, and behaviours are interconnected. If you change one component, the others shift as well. It's like adjusting the gears of a machine. CBT often focuses on identifying and restructuring maladaptive thoughts, the cogs that throw the entire machinery off balance. However, CBT also has a strong behavioural focus. Here, we look for unhelpful behaviours that maintain difficulties, searching for productive alternatives.
MBT, on the other hand, zooms out, focusing on the blueprint of the machine – your mental map. By understanding and refining this map, you automatically start identifying and managing maladaptive thoughts, feelings, and behaviours.
While CBT equips you with tools to fix individual gears, MBT helps you understand the machine's design, enhancing its overall functioning. Both have their unique strengths, and they can even complement each other, offering a more comprehensive therapeutic approach.
Remember, our emotional landscapes are complex and varied, and no single map can capture it all. It's about finding the map – or the combination of maps – that works best for you.
What is Mentalisation Based Therapy for ADHD?
ADHD, typically characterised by impulsivity and inattention, can sometimes be like trying to navigate our mental map in a fast, speeding car. Everything becomes a blur. Here, MBT helps by enhancing our ability to 'slow down,' to take a moment to understand our thoughts and feelings better.
Summary
Our understanding of the mind and its complex workings continues to evolve, and with it, our approaches to mental health. MBT, with its focus on enhancing our understanding of our own and others' mental states, offers a promising path towards healthier relationships and improved mental well-being.
Whether you're a professional striving to manage work stress or an individual dealing with personal challenges, MBT may be a good option to consider. However, make sure you always discuss your difficulties with a professional first to jointly decide which talking therapy might best suit your circumstances.
We are Coaching & Clinical Psychologists with extensive experience helping people conquer depression and other wellbeing issues. Read more about our work, watch practical skills videos or browse other articles. Get in touch anytime.
References
(1) Fonagy, P., & Bateman, A. (2006). Mechanisms of change in mentalization-based treatment of BPD. Journal of Clinical Psychology, 62(4), 411-430.
(2) Rossouw, T. I., & Fonagy, P. (2012). Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51(12), 1304-1313.e3.
(3) Jørgensen, C. R., Freund, C., Bøye, R., Jordet, H., Andersen, D., & Kjolbye, M. (2013). Outcome of mentalization-based and supportive psychotherapy in patients with borderline personality disorder: a randomized trial. Acta Psychiatrica Scandinavica, 127(4), 305-317.
