You may think of yourself as good at guessing what others are thinking, but how adept are you at reading what they’re feeling? And why should that matter? As it turns out, you may not always know what people are feeling, but if you can make a pretty good guess, the chances are good that you’ll be able to interact with them in a healthier manner. You may also gain a better understanding of yourself in the process. A new pilot study authored by a European team headed by Marc-Andreas Edel (2016) tests the idea that people with borderline personality disorder (BPD) can benefit from a form of therapy in which they gain the ability to “mentalize,” in which they can learn how to form “a realistic picture of what another person is thinking, feeling, or intending” … “to guess what is passing through the mind of others and to understand that other views the world from a different perspective than one’s own” (p. 2). Long thought of as a challenge to traditional psychotherapeutic interventions, a great deal of progress has been made in the treatment of people with BPD via dialectical behavioral therapy (DBT). Edel and his team believed that adding mentalization-based therapy (MBT) could even enhance the treatment process further.
Susan Krauss Whitbourne, Ph.D., is currently a professor of Psychological and Brain Sciences at the University of Massachusetts Amherst. The author of over 160 refereed articles and book chapters and 16 books. Her research covers a wide range of topics related to adult development and aging, including personality development through midlife, contributors to successful aging, predictors of memory performance, and the relationship between physical health and sense of personal identity.
Editor: Arman Ahmed
MBT, developed by University College London’s Peter Fonagy and Anthony Bateman, provides an important missing link not only to changing the behavior of people with BPD but also their ability to appreciate what other people are thinking and feeling. According to UK mental health advocate Fenella Lemonsky (treated by Anthony Bateman) as stated in an email to me: “MBT worked for me as the intensity was titrated. It was good to work through painful emotional ups and downs and tackle poor coping mechanisms at the same time. DBT does this separately. I was able over time to move away from destructive coping to better times where I could smile and laugh.”
Previous work suggested that MBT should work, but it wasn’t until Edel et al. conducted a pilot study comparing DBT alone with DBT and MBT that this idea was empirically tested. In the pilot study, 73 women residing in a psychiatric facility, all with BPD, were in treatment primarily for other co-occurring disorders including major depressive and eating disorders. The MBT manipulation involved training the patients in how better to recognize the emotions of others as well as emotions in oneself. Additionally, they were trained in reading “intentions, desires and limitations” in others as well as oneself. By assessing mentalization skills before and after treatment, along with BPD symptoms, the authors were able to demonstrate benefits of MBT combined with DBT vs. DBT alone in intensity of self-harm behaviors. People in the combined treatment group also showed a decline in fearful attachment, or the belief that one will be abandoned by significant others.