Alliance rupture and repair in mentalization-based therapy.

Abstract

Mentalizing, or reflective functioning, refers to our capacity to see ourselves from the outside and others from the inside. Mentalizing fundamentally implies that we are able to understand ourselves and others in terms of intentional mental states, such as feelings, thoughts, wishes, and beliefs. One of the defining ideas of mentalizing theory is that mental states are opaque-that is, the process of thinking about the thoughts, feelings, ideas, or beliefs that underpin someone else's behavior is an imaginative one, something that cannot be known with any certainty. Hence, we can never know for sure what someone else is thinking or feeling. Mentalizing theory also suggests that although we might have better access to understanding our own mental states, we are still subject to being taken surprise by our own minds. Given this backdrop of uncertainty about what thoughts and feelings motivate both others and ourselves, the idea of making mistakes in our mentalizing-that is, the possibility of misunderstanding, and that these instances of misunderstanding might lead to ruptures in relationships-is a constant human reality. Mentalization-based therapy (MBT) sees moments

Observing and interpreting clinical process: Methods and findings from ‘Layered analysis’ of parent–infant psychotherapy

“…Another aspect of such pauses we observed was that that the therapist ‘comes back’ to the patient, though with a subtly different manner. The therapist at such moments seemed inclined to a more nuanced affective joining at the level of the patient and, from a mentalizing point of view, tended to a state of mind associated with and enabling genuine inquiry (Fonagy et al., 2022).…”

Dynamic relations between mentalization techniques and therapeutic alliance in psychodynamic child therapy: An evidence-based case study.

“…Bateman et al, 2021). Ruptures signify a break in the reciprocity of mental processes between the therapist and the patient (Fonagy et al, 2023). In such cases, both the child and the therapist can slip into nonmentalizing modes and responses.…”