As therapists, when we talk about Mentalization (or Mentalizing) we often realise that the people we’re discussing it with are not necessarily aware of what the concept actually means. So here’s an outline – in layperson’s terms (hopefully!) – that accompanies the video we recently put together on the same subject. (http://artofmentalizing.org/mentalization-arts-psychotherapies).
A Definition of Mentalizing
The feelings, thoughts and experiences that underlie the behaviours of ourselves and others.
To expand on this definition:
Mentalizing tells us that we should not assume that we can attach a specific meaning to a particular behaviour, without looking into it further and trying to understand the other possible motivations behind it. This includes both the way we perceive the reasons for the behaviour of others, and the way we interpret the reasons for our own behaviour.
Mentalizing in Practice
People are Mentalizing all the time. When emotions run high, however, we stop properly Mentalizing and allow assumptions to take over. This is when we need to reintroduce Mentalization (this reintroducing process also being known as the “reflective function”) – for example through the “stop and rewind” method of reviewing how events unfolded that have led us to where we are now.
So the first step in the process of Mentalization is to Stop and Think.
Essentially this means we need to step back from our assumptions about what we are experiencing, in order that we can be more curious as to the possible reasons and motivations behind these experiences.
Whether we are Mentalizing the experience of what we are feeling for ourselves, or Mentalizing the experience of what someone else is feeling, we need to stop and question our assumptions, asking ourselves “maybe I have this wrong?” and wondering whether our interpretation of things as they currently are is actually a correct one.
One of the key points here is that people are often very quick to attribute meaning to behaviour, without actually knowing whether the meaning they have assigned to the behaviour is actually true. So the process of Stopping to Think can make people step aside from their hastily-made assumptions and allow them to consider alternative motivations for behaviours.
Mentalization within Therapy
A primary goal of any therapy session will be to allow the patient to feel safe enough to be able to explore their own thoughts and feelings through the process of Mentalizing.
With the therapist remaining calm throughout the session, it can help the patient to slow things down in their own mind, giving them time to Stop and Think about their own thoughts – thus allowing them to wonder if maybe they have got things wrong in the way they are interpreting their own thoughts and feelings.
This process of stopping to think also helps the patient to wonder if perhaps they have misinterpreted the motivations of others around them.
With the therapist displaying empathy with the patient, it also allows the patient to realise that the therapist is “on their side” and is using the therapy as a means of understanding them, as well as helping the patient to understand themselves.
The Essence of Mentalization
The kind of empathy that occurs during therapy can be expressed in a manner that gets to the very basic essence of Mentalization, through the therapist expressing a thought such as:
“I get your point of view. I understand where you’re coming from”.
This allows the patient to feel validated (through having the therapist Mentalizing with them).
Arts Therapies and Mentalization
When Mentalizing is used in conjunction with arts therapies, it allows the patient to gain deeper insight into their own feelings through the use of art, rather than other therapies which will use other methods for introducing a Mentalization intervention into the therapeutic process.
Drama Therapy, for example, can enable the patient to see themselves how others might see them, and help them understand more about other people’s assumptions about their own behaviour.
Mentalizing the dramatic action can thus give the patient a better idea of why other people might behave the way they do, based on this deeper understanding of the possible motivations for their own and other people’s behaviours.
For the type of Art Therapy that involves the creation of something tangible, such as a drawing or painting, the actual physical process of creating the artwork can help the patient to feel safe. One of the reasons for this is that the patient is able to concentrate on the artwork, rather than perhaps feeling they are being scrutinised by the therapist through maintaining eye contact.
This feeling is enhanced by the fact that the artwork is “out there” rather than remaining internalised, which allows for a discussion to develop, based on the fact that the artwork has “released something” from within the patient. This artwork can act as a kind of shorthand for their feelings during the discussion, as well as providing something for them to focus on whilst they Mentalize their thoughts.
For all types of art therapy, of course, the patient must be allowed to Mentalize the idea that they don’t have to be especially good at the artform involved (ie it doesn’t matter if they don’t feel they can act, dance, draw etc particularly well). This occurs through the act of their feeling safe, which allows them to feel they have been “given permission” to simply let go and “see what happens”, thus leading to a more rewarding experience for both patient and therapist.
Hopefully the above outline has made things a little clearer regarding the basis for using Mentalization within Arts-based Psychotherapies.
For a much more detailed examination of the issues, you might be interested in the 2016 Arts in Health Care Conference – The Art of Mentalizing: Communicating the Unknown.