Mentalization And Its Importance In The Therapeutic Framework
Mentalization, also called reflective function, is a mental activity involved in the interpretation of human behavior and its underlying mental states (Fonagy and Target, 2006).
According to Viloria Rodriguez and Ballespí Sola (2016) “it is a skill that allows us to understand our own mental states (emotions, feelings, thoughts, desires, beliefs, etc.) as well as those of the people around us.”
From the mentalization model, it is proposed that a dysfunction in the attachment system can inhibit affective regulation skills as well as the ability to mentalize (Bateman and Fonagy, 2016).
This interpretive capacity It begins to be forged in the close relationship of an attachment figure during the first years of life. The baby expresses her emotions and the attachment figure reacts to these manifestations.
When the adult interprets what the baby may be needing, he or she is mentalizing and responding. This response, if contingent, produces some regulation in the baby. It is in this dyadic regulation where the baby learns little by little, throughout its development, to recognize and regulate its own mental and emotional states, just as it learns to observe and interpret those of other people.
Therefore, the mother’s response gives rise to the symbolic representation of that internal state. And, in this way, it shapes and gives meaning to the child’s emotional states. These representations gradually shape the baby’s sense of Self, as a differentiated being.
In this line, a secure attachment is a necessary precursor to develop the ability to regulate affects and reflect on the emotional functioning of the Self and others (Fonagy, 2001). In this way, there is evidence of the relationship between insecure attachment, emotional dysregulation and metacognitive functions (Fonagy and Target 2006).
Thus, the mentalization It is necessary for the regulation of our emotions and requires that the subject be able to maintain balance between its different dimensions and use them adapting to the context. These dimensions of mentalization refer to whether it occurs in a controlled or automatic way, about others or about oneself, about internal or external states, about cognition or affect. Mentalizing involves flexibility to become aware that mental states organize our behavior and provide them with coherence, allowing us to differentiate ourselves from other people. Furthermore, it entails assuming that it is not stable, homogeneous or unidimensional (Bateman and Fonagy, 2016).
The ability to mentalize includes a reflective component and an interpersonal component. Requires cognitive ability to focus attention and manage interpersonal relationships. The evaluation of the context is filtered by internal models of attachment. These are composed of mental representations, most of them non-conscious, that produce a subjective perception of the situation. This, in turn, provokes the behavioral response to the context, being more rigid or flexible depending on the mentalization capacity. That is, the greater the mentalization, the greater flexibility. This allows us to recognize that the internal world is different from external reality, although it is related to it.
According to Bateman and Fonagy (2016), mentalization has the following characteristics:
Its benefits in daily life and in psychotherapy
Mentalization is closely related to constructs such as metacognition, empathy and interpersonal sensitivity.
Thus, a person who is interpersonally sensitive is able to detect signals about another person’s mental and emotional states. At the same time, if you empathize, you are taking charge, in a certain way, of these states of the other, which implies balancing the ability to reason about what is happening and the ability to understand the associated affects and emotions, as well as tune in to them. .
Furthermore, there is a certain degree of metacognition to the extent that the person is able to perceive and reflect on their own mental states, their representations and thoughts.
When a person is not able to mentalize, what Fonagy calls prementalizing states (of psychic, teleological and simulation equivalence) reappear, which are activated by the Internal Operating Models.
These states constitute the evolutionary prelude to mentalization. And, in mature individuals, involve modes of activation in which the mentalizing capacity is diminished. This usually happens to people with insecure attachment within the framework of interpersonal relationships and, especially, in situations of psychological proximity and intimacy. This fact is supported from a neuropsychological perspective, since there is evidence that states of high emotional intensity inhibit the capacity for cognitive mentalization (Bateman and Fonagy, 2016).
These last aspects are especially interesting in therapy, since the therapeutic space is characterized by psychological proximity and prementalizing modes frequently occur. In this way, working from this perspective it is possible to overcome some resistance, explain some defense mechanisms and provide the patient with regulation tools, through the exploration and identification of emotions and mental schemas in various situations. Furthermore, the premental modes activated in patients are a good guide to develop the reflective function and increase therapeutic understanding (Martínez Ibáñez, 2016).
Just as mentalization is a very useful psychotherapeutic tool, the therapist’s own ability to mentalize is presupposed, who needs it to accompany and guide the patient in the intimate relationship provided by the therapeutic framework. Mentalizing the patient facilitates the process of psychological assessment from the very moment and gains strength in the creation of the bond and therapeutic alliance.
Author: Borja Luque, General Health Psychologist and Sexologist at Vitaliza Health Psychology.
