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Mentalization Techniques for Families

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Mentalization techniquesIn a prior article on how mentalization can improve your family relationships, we examined how cycles of dysfunctional communication within the family unit can diminish secure attachments between caregivers and people with Borderline Personality Disorder (BPD). This article provides you some techniques and practical applications of mentalization for families struggling to overcome the constant misunderstandings and distress that poor familial interactions can cause.

Within family relationships, when a caregiver or parent begins to mirror the hyper-emotionality of the person with BPD, it diminishes secure attachments and reduces the options for problem-solving in a constructive manner. Mentalization can help break this cycle by drastically changing the family dynamic in times of conflict.

Components of Mentalization

The primary components of mentalization are as follows:

  • Making sense of the action of ourselves and others in relation to mental states (thoughts, feelings, desires, beliefs)
  • Seeing ourselves from the outside and others from the inside
  • Understanding misunderstandings
  • Keeping mind in mind
  • Introspection for subjective self-construction — know yourself as others know you but also know your subjective self based on your experience

Practicing mentalization can lead to a better connection between family members by fostering a shared understanding of the misunderstanding and a “meeting of the minds.” When we approach the person with Borderline Personality Disorder with genuine curiosity about their thoughts and feelings, we may be able to understand exactly what is causing their dysregulated behavior.

Regardless of how well family members know one another, they cannot assume that they know exactly why their relative is reacting as they are. It is not necessary to agree with each other all the time, but simply empathizing and understanding another person’s feelings goes a long way toward establishing trust and more open communication.

Successful Mentalization Techniques

In therapy that employs mentalization techniques, the following objectives are laid out:

  • Consider the contribution of family members to the problems of the symptomatic family member
  • Promote awareness of mental state in both self and others
  • Use mentalizing to strengthen self-regulation
  • Help families shift out of coercive, controlling non-mentalizing cycles to using mentalizing to foster secure attachments and trust
  • Promote parental sense of confidence in helping children mentalize
  • Practice mentalization in communication and decision making

Successful mentalization techniques involve flexibility and humor (when appropriate), describing one’s own internal feelings and taking ownership of behaviors. Family members should focus on trying to understand the feelings (both their own as well as the person with BPD’s) that lead to the conflict rather than trying to define other’s intentions or experiences. Expressing curiosity about the feelings and thoughts of others and becoming more responsive instead of more reactive will go a long way toward reducing the fall-out from misunderstandings.

Mentalization-based therapists will walk families through a series of questions that help them identify what took place during a given conflict: what was everyone thinking and feeling at the time? Can we come to a consensus about what took place and why? Once families acknowledge what they were all feeling at the time, open discussion and analysis can begin within the therapeutic process.

No single truth needs to be arrived at for understanding and empathy to take place, but it may be possible to communicate your views in a productive and non-confrontational way by phrasing things differently. For example, you can try saying to a person with BPD, “I can understand how you may have felt ignored but I think it’s possible he was simply pre-occupied with something else and wasn’t ignoring you because he hates you.”

Putting mentalization techniques into practice will take patience with yourself as well as other family members. Breaking a cycle of ingrained and automatic emotional responses takes time and effort. Improvements in familial transactions will develop with continued efforts to mentalize, and new patterns will emerge.

Through mentalization techniques, trust and secure attachments can be established over time and connections between family members can be strengthened.

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