mentalization

While the broader concept of theory of mind has been explored at least since Descartes, the specific term 'mentalization' emerged in psychoanalytic literature in the late 1960s, and became empirically tested in 1983 when Heinz Wimmer and Josef Perner{{cite journal |last1=Wimmer |first1=H |last2=Perner |first2=J |title=Beliefs about beliefs: Representation and constraining function of wrong beliefs in young children's understanding of deception |journal=Cognition |date=January 1983 |volume=13 |issue=1 |pages=103–128 |doi=10.1016/0010-0277(83)90004-5 |pmid=6681741 }} ran the first experiment to investigate when children can understand false belief, inspired by Daniel Dennett's interpretation of a Punch and Judy scene.

The field diversified in the early 1990s when Simon Baron-Cohen and Uta Frith, building on the Wimmer and Perner study, and others merged it with research on the psychological and biological mechanisms underlying autism and schizophrenia. Concomitantly, Peter Fonagy and colleagues applied it to developmental psychopathology in the context of attachment relationships gone awry.{{sfn|Allen|Fonagy|2006|p={{pn|date=December 2024}}}} More recently, several child mental health researchers such as Arietta Slade,{{cite journal |last1=Slade |first1=Arietta |title=Parental reflective functioning: An introduction |journal=Attachment & Human Development |date=September 2005 |volume=7 |issue=3 |pages=269–281 |doi=10.1080/14616730500245906 |pmid=16210239 }} John Grienenberger,{{cite journal |last1=Kelly |first1=Kristen |last2=Slade |first2=Arietta |last3=Grienenberger |first3=John F. |title=Maternal reflective functioning, mother–infant affective communication, and infant attachment: Exploring the link between mental states and observed caregiving behavior in the intergenerational transmission of attachment |journal=Attachment & Human Development |date=September 2005 |volume=7 |issue=3 |pages=299–311 |doi=10.1080/14616730500245963 |pmid=16210241 }} Alicia Lieberman,{{cite journal | last1 = Lieberman | first1 = A.F. | last2 = Van Horn | first2 = P. | last3 = Ippen | first3 = C.G. | year = 2005 | title = Towards evidence-based treatment: Child-parent psychotherapy with preschoolers exposed to marital violence | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 44 | issue = 12| pages = 1241–1248 | doi=10.1097/01.chi.0000181047.59702.58 | pmid=16292115}} Daniel Schechter,{{cite journal | last1 = Schechter | first1 = DS | last2 = Myers | first2 = MM | last3 = Brunelli | first3 = SA | last4 = Coates | first4 = SW | last5 = Zeanah | first5 = CH | last6 = Davies | first6 = M | last7 = Grienenberger | first7 = JF | last8 = Marshall | first8 = RD | last9 = McCaw | first9 = JE | last10 = Trabka | first10 = KA | last11 = Liebowitz | first11 = MR | year = 2006 | title = Traumatized mothers can change their minds about their toddlers: Understanding how a novel use of videofeedback supports positive change of maternal attributions | journal = Infant Mental Health Journal | volume = 27 | issue = 5| pages = 429–448 | doi=10.1002/imhj.20101 | pmid=18007960 | pmc=2078524}} and Susan Coates{{cite journal | last1 = Coates | first1 = S.W. | year = 1998 | title = Having a Mind of One's Own and Holding the Other In Mind | journal = Psychoanalytic Dialogues | volume = 8 | pages = 115–148 | doi=10.1080/10481889809539236}} have applied mentalization both to research on parenting and to clinical interventions with parents, infants, and young children.

Mentalization has implications for attachment theory and self-development. According to Peter Fonagy, individuals with disorganized attachment style (e.g., due to physical, psychological, or sexual abuse) can have greater difficulty developing the ability to mentalize. Attachment history partially determines the strength of mentalizing capacity of individuals. Securely attached individuals tend to have had a primary caregiver that has more complex and sophisticated mentalizing abilities. As a consequence, these children possess more robust capacities to represent the states of their own and other people's minds. Early childhood exposure to mentalization can protect the individual from psychosocial adversity.{{cite journal |last1=Fonagy |first1=Peter |last2=Bateman |first2=Anthony W. |title=Mechanisms of change in mentalization-based treatment of BPD |journal=Journal of Clinical Psychology |date=April 2006 |volume=62 |issue=4 |pages=411–430 |doi=10.1002/jclp.20241 |pmid=16470710 |url=https://discovery.ucl.ac.uk/id/eprint/133787/ }} This early childhood exposure to genuine parental mentalization fosters development of mentalizing capabilities in the child themselves.{{cite journal |last1=Rosso |first1=Anna Maria |last2=Viterbori |first2=Paola |last3=Scopesi |first3=Alda M. |title=Are maternal reflective functioning and attachment security associated with preadolescent mentalization? |journal=Frontiers in Psychology |date=4 August 2015 |volume=6 |page=1134 |doi=10.3389/fpsyg.2015.01134 |pmid=26300824 |pmc=4523702 |doi-access=free }}{{cite journal |last1=Scopesi |first1=Alda M. |last2=Rosso |first2=Anna Maria |last3=Viterbori |first3=Paola |last4=Panchieri |first4=Erika |title=Mentalizing Abilities in Preadolescents' and Their Mothers' Autobiographical Narratives |journal=The Journal of Early Adolescence |date=May 2015 |volume=35 |issue=4 |pages=467–483 |doi=10.1177/0272431614535091 }} There is also suggestion that genuine parental mentalization is beneficial to child learning; when a child feels they are being viewed as an intentional agent, they feel contingently responded to, which promotes epistemic trust and triggers learning in the form of natural pedagogy - this increases the quality of learning in the child.{{cite journal |last1=Fonagy |first1=Peter |last2=Allison |first2=Elizabeth |title=The role of mentalizing and epistemic trust in the therapeutic relationship. |journal=Psychotherapy |date=2014 |volume=51 |issue=3 |pages=372–380 |doi=10.1037/a0036505 |pmid=24773092 |url=https://discovery.ucl.ac.uk/id/eprint/1428567/ }} This theory needs further empirical support.

Mentalization or better mentalizing, has a number of different facets which can be measured with various methods. A prominent method of assessment of Parental Mentalization is the Parental Development Interview (PDI), a 45-question semi-structured interview, investigating parents’ representations of their children, themselves as parents, and their relationships with their children.{{cite web|title=The Parent Development Interview |url=http://caidreamh.ie/the-parent-development-interview-pdi/|access-date=2019-02-18}} An efficient self-report measure of Parental Mentalization is the Parental Reflective Functioning Questionnaire (PRFQ) created by Patrick Luyten and colleagues.{{cite web|title=The Parental Reflective Functioning Questionnaire (PRFQ)|url=https://www.ucl.ac.uk/psychoanalysis/research/parental-reflective-functioning-questionnaire-prfq|work=UCL Psychoanalysis|date=5 June 2018 |access-date=2019-02-18}} The PRFQ is a brief, multidimensional assessment of parental reflective functioning (mentalization), aimed to be easy to administer to parents in a wide range of socioeconomic populations. The PRFQ is recommended for use as a screening tool for studies with large populations and does not aim to replace more comprehensive measures, such as the PDI or observer-based measures.{{cite journal |last1=Luyten |first1=Patrick |last2=Mayes |first2=Linda C. |last3=Nijssens |first3=Liesbet |last4=Fonagy |first4=Peter |title=The parental reflective functioning questionnaire: Development and preliminary validation |journal=PLOS ONE |date=4 May 2017 |volume=12 |issue=5 |pages=e0176218 |doi=10.1371/journal.pone.0176218 |pmid=28472162 |pmc=5417431 |bibcode=2017PLoSO..1276218L |doi-access=free }}

Mentalization, it has been increasingly underscored by Peter Fonagy and colleagues,{{cite journal |last1=Luyten |first1=Patrick |last2=Campbell |first2=Chloe |last3=Allison |first3=Elizabeth |last4=Fonagy |first4=Peter |title=The Mentalizing Approach to Psychopathology: State of the Art and Future Directions |journal=Annual Review of Clinical Psychology |date=7 May 2020 |volume=16 |issue=1 |pages=297–325 |doi=10.1146/annurev-clinpsy-071919-015355 |pmid=32023093 |url=https://lirias.kuleuven.be/bitstream/123456789/667191/2/aARCP_Mentalizing_approach_to_psychopathology_FINAL_complete.docx }} may be a common factor in psychological treatment and results from a 2024 systematic review indicate the mentalization may be a mediator and moderator of mental health outcome across diagnosis and treatment approach although more studies are needed.{{cite journal |last1=Luyten |first1=Patrick |last2=Campbell |first2=Chloe |last3=Moser |first3=Max |last4=Fonagy |first4=Peter |title=The role of mentalizing in psychological interventions in adults: Systematic review and recommendations for future research |journal=Clinical Psychology Review |date=March 2024 |volume=108 |pages=102380 |doi=10.1016/j.cpr.2024.102380 |pmid=38262188 }}

A 2024 study investigated the longitudinal impact of mentalizing on well-being and emotion regulation strategies in a non-clinical sample, finding that impairments in mentalizing negatively predicted well-being and positively predicted emotional suppression over one year.{{Cite journal |last1=Schwarzer |first1=Nicola-Hans |last2=Heim |first2=Nikolas |last3=Gingelmaier |first3=Stephan |last4=Fonagy |first4=Peter |last5=Nolte |first5=Tobias |date=2024-06-14 |title=Mentalizing as a Predictor of Well-Being and Emotion Regulation: Longitudinal Evidence from a Community Sample of Young Adults |journal=Psychological Reports |language=en |doi=10.1177/00332941241261902 |pmid=38876977 |url=https://discovery.ucl.ac.uk/id/eprint/10192930/ }} Research has also found a link between dopamine levels and the ability to mentalize. In particular, reducing dopamine activity in healthy individuals using the drug haloperidol impaired their mentalizing abilities, suggesting that dopamine plays a direct role in these social cognitive processes.{{Cite web |last=Dolan |first=Eric W. |date=2024-07-22 |title=Dopamine disruption impairs mentalizing abilities |url=https://www.psypost.org/dopamine-disruption-impairs-mentalizing-abilities/ |access-date=2024-07-25 |website=PsyPost - Psychology News |language=en-US}}

According to the American Psychiatric Association's Handbook of Mentalizing in Mental Health Practice, mentalization takes place along a series of four parameters or dimensions: Automatic/Controlled, Self/Other, Inner/Outer, and Cognitive/Affective.{{sfn|Bateman|Fonagy|2019|p=8}}

Each dimension can be exercised in either a balanced or unbalanced way, while effective mentalization also requires a balanced perspective across all four dimensions.{{sfn|Bateman|Fonagy|2019|p=8}}

1. Automatic/Controlled. Automatic (or implicit) mentalizing is a fast-processing unreflective process, calling for little conscious effort or input; whereas controlled mentalization (explicit) is slow, effortful, and demanding of full awareness.{{sfn|Bateman|Fonagy|2019|p=8}} In a balanced personality, shifts from automatic to controlled smoothly occur when misunderstandings arise in a conversation or social setting, to put things right.{{sfn|Oestergaard Hagelquist|2018|pp=52–53}} Inability to shift from automatic mentalization can lead to a simplistic, one-sided view of the world, especially when emotions run high; while conversely inability to leave controlled mentalization leaves one trapped in a 'heavy', endlessly ruminative thought-mode.{{sfn|Oestergaard Hagelquist|2018|p=53}}
2. Self/Other involves the ability to mentalize about one's own state of mind, as well as about that of another.{{sfn|Bateman|Fonagy|2019|p=10}} Lack of balance means an overemphasis on either self or other.{{sfn|Oestergaard Hagelquist|2018|p=52}}
3. Inner/Outer: Here problems can arise from an over-emphasis on external conditions, and a neglect of one's own feelings and experience.{{sfn|Oestergaard Hagelquist|2018|p=52}}
4. Cognitive/Affective are in balance when both dimensions are engaged, as opposed to either an excessive certainty about one's own one-sided ideas, or an overwhelming of thought by floods of emotion.{{sfn|Bateman|Fonagy|2019|p=49}}

{{Columns-list|

• Adaptive mentalization-based integrative treatment
• Mentalization based treatment
• Metacognition
• Psychic equivalence
• Social cognition

}}

{{Reflist|2|}}

• {{cite book |doi=10.1002/9780470712986 |title=Handbook of Mentalization-Based Treatment |date=2006 |isbn=978-0-470-01560-5 |editor-last1=Allen |editor-last2=Fonagy |editor-first1=Jon G. |editor-first2=Peter }}
• {{cite book |last1=Bateman |first1=Anthony W. |last2=Fonagy |first2=Peter |title=Handbook of Mentalizing in Mental Health Practice |date=2019 |publisher=American Psychiatric Pub |isbn=978-1-61537-250-8 }}
• {{cite book |doi=10.4324/9780429471643 |title=Affect Regulation, Mentalization, and the Development of the Self |date=2018 |last1=Fonagy |first1=Peter |last2=Gergely |first2=Guörgy |last3=Jurist |first3=Elliot L. |last4=Target |first4=Mary |isbn=978-0-429-47164-3 |editor-first1=Peter |editor-first2=Gyorgy |editor-first3=Elliot L. |editor-last1=Fonagy |editor-last2=Gergely |editor-last3=Jurist }}
• {{cite book |doi=10.4324/9780429482434 |title=The Mentalization Guidebook |date=2018 |last1=Oestergaard Hagelquist |first1=Janne |isbn=978-0-429-90720-3 }}

• {{cite book |doi=10.4324/9780203833926 |title=Mindreaders |date=2010 |last1=Apperly |first1=Ian |isbn=978-1-136-84671-7 }}
• {{cite book |doi=10.4324/9780203929902 |title=Theory of Mind |date=2008 |last1=Doherty |first1=Martin |isbn=978-1-135-42079-6 }}

• [https://www.ucl.ac.uk/psychoanalysis/people/anthony-bateman Anthony Bateman's homepage].
• [https://web.archive.org/web/20130709233010/http://fhlfound.securesites.net/wordpress/mentalization-factoids/ Mentalization factoids – compiled by Frederick Leonhardt]. A summary of mentalization.
• {{cite journal | last1 = Norenzayan | first1 = Ara | last2 = Gervais | first2 = Will M. | last3 = Trzesniewski | first3 = Kali H. | year = 2012| title = Mentalizing Deficits Constrain Belief in a Personal God | journal = PLOS ONE | volume = 7 | issue = 5| page = e36880 | doi = 10.1371/journal.pone.0036880 | pmid = 22666332 | pmc = 3364254 | bibcode = 2012PLoSO...736880N | doi-access = free }}

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Category:Developmental psychology

Category:Psychological concepts