Mentalization

Observing mentalizing art therapy groups for people diagnosed with borderline personality disorder_blog

Springham, N. (2019) Observing Mentalizing Art Therapy Groups for People Diagnosed with Borderline Personality Disorder. [Painting]. London: British Association of Art Therapists.


Reading

  • “How can art therapy contribute to mentalization in borderline personality disorder” by Neil Springham, Diane Findlay, Ami Woods and Jane Harris in the International Journal of Art Therapy.

Mentalizationandarttherapy

“Clay Sculpting of Mother and Child Figures Encourages Mentalization” by Michal Bat

Clay Sculptin of Mother and Child Figures


  •  Ulster University Library, E-Book: Approaches to Art Therapy: Theory and Technique edited by Judith Rubin Chapter to Read: Chapter 8, “Mentalization-Based Art Psychotherapy” by Dominik Havsteen-Franklin

“Mentalizing is the process by which we make sense of each other and ourselves, implicitly and explicitly, in terms of subjective states and mental processes. It is a profoundly social construct in the sense that we are attentive to the mental states of those we are with, physically or psychologically. Given the generality of this definition, most mental disorders will inevitably involve some difficulties with mentalization, but it is the application of the concept to the treatment of borderline personality disorder (BPD), a common psychiatric condition with important implications for public health, that has received the most attention. Patients with BPD show reduced capacities to mentalize, which leads to problems with emotional regulation and difficulties in managing impulsivity, especially in the context of interpersonal interactions. Mentalization based treatment (MBT) is a time-limited treatment which structures interventions that promote the further development of mentalizing. It has been tested in research trials and found to be an effective treatment for BPD when delivered by mental health professionals given limited additional training and with moderate levels of supervision. This supports the general utility of MBT in the treatment of BPD within generic mental health services.” Reference: Bateman, A. and Fonaghy, P. (2010) Mentalization Based Treatment for Borderline Personality Disorder. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816926/  [Accessed 3 April 2020].

Mentalization has been developed as a treatment for Borderline Personality Disorder Characteristics of Borderline Personality Disorder: Challenges with emotional regulation, impulse control, experiencing vulnerability and instability in relationships and in relation to self image. Challenges to understanding others and finding the words to communicate experiences. This condition is associated with suicide attempts and self harm, low levels of coping mechanisms, low levels of resilience, and an un-stable self identity underscored with insecure attachments. A person interprets the behaviour of others as potentially a persecution, as potentially causing further harm. This can be reflected in the therapeutic transference, whereby early experiences of not being acknowledged, understood and valued are re-lived. The behaviour, words and body language of the therapist can contribute further dismay to the client, if the therapist is  interpreted by the client to be emotionally unavailable.

Mentalizing is the way we understand ourselves and each other. It is therapeutic method that derives from Bowlby’s attachment theories, and responds to disruptions within early caring relationships, where experiences of loss, trauma, inconsistency, and rejection affected an integrated sense of self. In adult life distress and anxiety can destabilise and disorient, and the traumatic affects of early childhood development can overwhelm.

Goals of Mentalizing: Empathy, support, curiosity, open questioning, collaboration, seeking clarification, constructing a meaningful narrative and the development of a broader perspective, joint responsibility, collaborative working relationship, joint attention.

“New evidence from neuroscience and attachment theory requires us to rethink some of our basic assumptions about how we might help people. The concept of Mentalization describes a function central to everyone’s capacity to process feelings and develop health relationships. It is a faculty which allows us to be curious about and empathic towards ourselves and others. It is understood to have direct connections with the quality of nurture we receive in infancy and our attachment systems. While it may be particularly compromised in people experiencing severe mental health issues (most notably individuals diagnosed with Emotionally Unstable Personality Disorder, or Borderline Personality Disorder), the capacity to mentalize fluctuates in all of us and it is at the core of human, emotional development”. (British Association of Art Therapists, Art Therapy Mentalization Training, http://www.baat.org)

“Peter Fonagy is a Professor of Psychoanalysis and Developmental Science and Head of the Division of Psychology and Language Sciences at University College London; Chief Executive of the Anna Freud Centre, London; and holds visiting professorships at Yale and Harvard Medical Schools. His clinical interests centre on issues of early attachment relationships, social cognition, borderline personality disorder, antisocial behavior and violence. His longitudinal studies which linked the quality of parent-infant attachment to theory of mind development have important implications for strategies for early prevention not accounted for by genetic influences. The link between human attachment and social cognition led Bateman, Fonagy and colleagues to develop a model of and a highly effective treatment approach for borderline personality disorders (BPD). Mentalization Based Treatment (MBT) is now one of the two evidence-based psychological treatments used for severe PD and is widely practiced in the UK, Europe and the USA.” (Anna Freud Centre, 2020, http://www.annafreud.org)

Mentalization Based Treatment Training Videos with Professor Anthony Bateman, Anna Freud Centre Training Videos, http://www.annafreud.org

Mentalization and Art Therapy