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Mentalizing in Psychotherapy: A Guide for Practitioners
How can therapists help clients reflect more deeply on their own--and other people's--thoughts and emotions? How can the therapeutic relationship be leveraged effectively to create change? This concise book guides therapists of any orientation to incorporate innovative mentalization-based strategies into assessment and intervention. Complex ideas are clearly explained and illustrated with extensive session transcripts and vignettes. Ways to help clients struggling with dysregulated emotions and behavior are highlighted. Compelling topics include the role of mentalization difficulties in personality disorders, special concerns in working with adolescents, and how clinicians can improve their own mentalizing capacities.
- GenresPsychology
210 pages, Hardcover
Published August 24, 2022
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35 people want to read
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Displaying 1 - 3 of 3 reviews
January 22, 2026
Boken inleder med att introducera begreppet mentalisering i relation till psykiatriska diagnoser som kategoriska kontra dimensionella konstrukt. Historiskt, i takt med varje ny DSM upplaga, har antalet distinkta diagnoser ökat där man från och med DSM-III dessutom började förespråkade för mer observerbara och mätbara symptom, likt synen på fysiska symptom. Varje diagnos ses som en egen entitet som bör behandlas isolerat från andra diagnoser och man börjar utveckla separata manualer för varje specifik diagnos. Idag vet man att det inte är så kategoriskt som man gärna hade önskat. Diagnoser överlappar och korrelerar med varandra, forskning pekar allt mer mot en dimensionalitet i synen på psykisk ohälsa och därför kan det troligtvis vara mer effektivt att behandla underliggande transdiagnostiska sårbarhetsfaktorer. Att läsa den här boken blir som en naturlig följd efter att ha läst Zauer-Zavala & Barlows (2021) bok om neuroticism. Och här, i denna bok, presenteras mentaliseringsbaserad terapi som något som angriper ett sådant mer underliggande konstrukt: ”self and interpersonal function”, det vill säga hur vi förstår och själva och relaterar till andra. Vilket är något som särskilt brister vid personlighetspatologi men även annan psykopatologi. En så kallad ”Mentalizing Stance” blir ett medel (som kan inkorporeras i vilken terapiform som helst egentligen) för terapeuten att hjälpa patienten med just detta: det interpersonella och intrapersonalla fungerandet.
Det här är en bok som på strax över 200 sidor lyckas koka ner essensen hos mentalisering och mentaliseringsbaserad terapi. I författarnas egna ord vill de ”demystifiera” begreppet och göra det mer tillgängligt. Själv är jag bekant med mentalisering sedan innan men efter att ha läst boken har jag fått en ny förståelse för mentalisering, i synnerhet hur det uttrycker sig inom terapins ramar. Boken gör ett särskilt bra jobb med att förklara de tre olika förmentaliserande lägena (psykisk ekvivalens, teleologiskt tänkande, låtsasläge), samt vikten av att kunna identifiera dessa hos patienter och, inte minst, hos sig själv.
Tycker det blir tydligt i den här boken hur bristande mentalisering och förmentaliserande lägen går att betrakta som, eller åtminstone påminner mycket om, försvar (AFT, ISTDP) eller undvikande emotionell coping (KBT). Även mentaliseringspyramiden, som presenteras mot slutet av boken, tycks bygga på en liknande logik som det graderade formatet i ISTDP. När terminologi och skolbildning skalas bort från olika terapimetoder återkommer ofta samma grundläggande idéer, om än paketerade i olika format. Det tycks som om fältet ibland byter begrepp oftare än innehåll.
Det här är en bok som på strax över 200 sidor lyckas koka ner essensen hos mentalisering och mentaliseringsbaserad terapi. I författarnas egna ord vill de ”demystifiera” begreppet och göra det mer tillgängligt. Själv är jag bekant med mentalisering sedan innan men efter att ha läst boken har jag fått en ny förståelse för mentalisering, i synnerhet hur det uttrycker sig inom terapins ramar. Boken gör ett särskilt bra jobb med att förklara de tre olika förmentaliserande lägena (psykisk ekvivalens, teleologiskt tänkande, låtsasläge), samt vikten av att kunna identifiera dessa hos patienter och, inte minst, hos sig själv.
Tycker det blir tydligt i den här boken hur bristande mentalisering och förmentaliserande lägen går att betrakta som, eller åtminstone påminner mycket om, försvar (AFT, ISTDP) eller undvikande emotionell coping (KBT). Även mentaliseringspyramiden, som presenteras mot slutet av boken, tycks bygga på en liknande logik som det graderade formatet i ISTDP. När terminologi och skolbildning skalas bort från olika terapimetoder återkommer ofta samma grundläggande idéer, om än paketerade i olika format. Det tycks som om fältet ibland byter begrepp oftare än innehåll.
April 2, 2024
Insights Even for Lay People - Looking for a book on this subject, I happened on this title. Upon reading the sample, this text seemed quite straightforward and practical. While geared for therapists, the text offers many insights for those trying to better deal with significant people in their lives that have personality and sensory issues (e.g. see my reviews of Siegel’s “Mindsight” and Kranowitz’s “The Out of Sync Child”). Authors Sharp and Bevington use plain language to make explicit ways we can better engage in the “serve and volley” seeking to better understand and interact with one another in a constructive and health advancing manner.
More specifically, the book’s contents include a Foreword, Preface, and 9 chapters. Namely, there is (1) Setting the Stage for Mentalizing, (2) What Is Mentalizing? (3) How Does Mentalizing Develop? (4) Difficulties in Mentalizing . . . and Difficulties in Learning, (5) Mentalizing Assessment and Formulation, (6) MBT Structure, (7) The Mentalizing Stance, (8) Mentalizing Interventions, and (9) Going Further with the Mentalizing Stance. There are also Key Terms and Concepts, References, and an Index.
Aspects that stood out for me were the clarity of the narrative and the explanations where the authors describe mentalizing difficulties and where enhancement of this capability can improve circumstances and situations. For instance, early on (in Kindle Location 129-36), they indicate that “. . . [one with] insecure attachment . . . [includes] more conflict or misunderstanding . . . [with an absence of what is] called thematic coherence . . . “ Their explication (in Location 217) is that “. . . meaning-making is subjective, so two individuals may experience the same event but construct completely different representations of it [in their minds].” As a result [Location 234], there can be “. . . epistemic hypervigilance [that] is a mode of mistrust . . .” Consequently, “ . . . the loss of mentalizing in conditions of high emotion . . . [can lead to] overthinking or overreacting . . . [where one] cannot maintain constructive social interaction, mutuality in relationships, or a robust and integrated sense of self . . . [to] acquire basic structures that prepare . . . for future learning [Location 238-66].”
Sharp and Bevington state (in Location 242-46) that “. . . mentalization-based therapies . . . [contribute to] the lowering of epistemic hypervigilance . . . interpreted and subjective . . . [along with a reduction of] thinking errors . . .” They emphasize (in Location 464) that “When we mentalize, we imagine what might be going on in the mind of another, while simultaneously imagining (or reflecting upon) our own thoughts and feelings . . . introduce uncertainty, tentativeness, and curiosity . . .” Accordingly, the authors (in Location 581) say that “The Mentalizing Stance asks for humility, intellectual curiosity, and the willingness to learn” and (in Location 718) . . . promote[s] dialogue . . . even in times of crisis . . . adopting a not-knowing [attitude] . . .” and (in Location 1136) “. . . let go of an authoritative [posture] . . .”
Limitations come into play in that the book is obviously pitched for those preparing to or already are professionally conducting therapy. For instance, assessing the dimensions of difficulty or disorder someone may be experiencing still seems quite nuanced where coaching and advanced training are critical in making appropriate and useful determinations. In this regard the book deserves commendation as it can aid in devising methods that can contribute to developing more skilled therapists who can help with these issues. In a backhanded way, this narrative seems to acknowledge that finding and engaging such assistance can be a major challenge as described in books like Morton’s “Are U Ok: A Guide to Caring for Your Mental Health” and Kennedy’s “A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction” (see my reviews).
Fortunately, the book does stress that, for the professional as well as for us lay people who are trying to better cope, adopting a “Mentalizing Stance” can be most beneficial. For this reason, “Mentalizing in Psychotherapy” is worth the attention of those seeking such resources.
More specifically, the book’s contents include a Foreword, Preface, and 9 chapters. Namely, there is (1) Setting the Stage for Mentalizing, (2) What Is Mentalizing? (3) How Does Mentalizing Develop? (4) Difficulties in Mentalizing . . . and Difficulties in Learning, (5) Mentalizing Assessment and Formulation, (6) MBT Structure, (7) The Mentalizing Stance, (8) Mentalizing Interventions, and (9) Going Further with the Mentalizing Stance. There are also Key Terms and Concepts, References, and an Index.
Aspects that stood out for me were the clarity of the narrative and the explanations where the authors describe mentalizing difficulties and where enhancement of this capability can improve circumstances and situations. For instance, early on (in Kindle Location 129-36), they indicate that “. . . [one with] insecure attachment . . . [includes] more conflict or misunderstanding . . . [with an absence of what is] called thematic coherence . . . “ Their explication (in Location 217) is that “. . . meaning-making is subjective, so two individuals may experience the same event but construct completely different representations of it [in their minds].” As a result [Location 234], there can be “. . . epistemic hypervigilance [that] is a mode of mistrust . . .” Consequently, “ . . . the loss of mentalizing in conditions of high emotion . . . [can lead to] overthinking or overreacting . . . [where one] cannot maintain constructive social interaction, mutuality in relationships, or a robust and integrated sense of self . . . [to] acquire basic structures that prepare . . . for future learning [Location 238-66].”
Sharp and Bevington state (in Location 242-46) that “. . . mentalization-based therapies . . . [contribute to] the lowering of epistemic hypervigilance . . . interpreted and subjective . . . [along with a reduction of] thinking errors . . .” They emphasize (in Location 464) that “When we mentalize, we imagine what might be going on in the mind of another, while simultaneously imagining (or reflecting upon) our own thoughts and feelings . . . introduce uncertainty, tentativeness, and curiosity . . .” Accordingly, the authors (in Location 581) say that “The Mentalizing Stance asks for humility, intellectual curiosity, and the willingness to learn” and (in Location 718) . . . promote[s] dialogue . . . even in times of crisis . . . adopting a not-knowing [attitude] . . .” and (in Location 1136) “. . . let go of an authoritative [posture] . . .”
Limitations come into play in that the book is obviously pitched for those preparing to or already are professionally conducting therapy. For instance, assessing the dimensions of difficulty or disorder someone may be experiencing still seems quite nuanced where coaching and advanced training are critical in making appropriate and useful determinations. In this regard the book deserves commendation as it can aid in devising methods that can contribute to developing more skilled therapists who can help with these issues. In a backhanded way, this narrative seems to acknowledge that finding and engaging such assistance can be a major challenge as described in books like Morton’s “Are U Ok: A Guide to Caring for Your Mental Health” and Kennedy’s “A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction” (see my reviews).
Fortunately, the book does stress that, for the professional as well as for us lay people who are trying to better cope, adopting a “Mentalizing Stance” can be most beneficial. For this reason, “Mentalizing in Psychotherapy” is worth the attention of those seeking such resources.
December 4, 2023
This book is part of the Guilford section about psychoanalysis and research, and is the perfect book for those who want to get closer to the construct of mentalization and its applications in clinical practice. It is composed by 9 chapters and at the end has a useful "key terms and concepts" section. I found particularly intriguing the section about therapist/patient misunderstandings.
Displaying 1 - 3 of 3 reviews