Mentalization Factoids

compiled by

Frederick Leonhardt

In my study guide to Dr. Pistole’s article on teen pregnancy, I mention a statement made by Daniel Stern at a large attachment conference held out in California in March of 2002 (on the UCLA campus). Stern effectively told the crowd (and I paraphrase) “Attachment doesn’t really do anything; it’s intersubjectivity that allows attachment relationships to take on a dynamic quality.” Peter Fonagy (who also spoke at the conference) mentioned research by György Gergely (2001) with autistic children. Gergely’s research suggests that although autistic children form close attachment relationships, they have an impaired ability to engage in intersubjectivity or what some researchers call a theory of minds. Terms such as intersubjectivity, theory of minds, and mentalization are often used interchangeably to convey the same basic idea (I’ll stick with the term mentalization from here on in).

In response to my Study Guide, I have had a number of people ask me what exactly is mentalization. As fate would have it, I recently discovered an edited volume (a selection of papers organized around a central theme) that spends a lot of time looking at the neurobiological underpinnings of mentalization. The edited volume is entitled “The Neuroscience of Social Interaction—Decoding, Imitating, and Influencing the Actions of Others” and is edited by Chris Frith and Daniel Wolpert (2004). (Fonagy, along with Gergely and others (2002) have also written a good book on mentalization from the perspectives of attachment and object relations.)

In this “cheat sheet” for mentalization, I have culled through the pages of Frith and Wolpert’s edited volume to come up with twenty “factoids” that describe and define mentalization. Hopefully these factoids will give you a general sense for the idea of mentalization and how mentalization allows us to navigate both the social and cognitive worlds we live in. I will give you page numbers for the quotes and ideas that I present, but I will not reference the individual articles within the edited volume. Within quotes, my comments are bracketed. If a particular quote catches your fancy, then may I suggest that you order a copy of Frith and Wolpert’s edited volume for yourself.

1) Mentalization - to perceive and communicate mental states, such as beliefs, desires, plans, and goals (p. xiii).

2) “Mental states are unobservable constructs that must be inferred by observers rather than perceived directly” (p. 219). Most of us know what an ego is (and we probably have run into one that is “inflated”) but no one has ever perceived an ego directly. Even your own ego has to be inferred. An inflated (or deflated ego) may indicate that a person has difficulty inferring inner body states. So, they are forced to learn about their inner body states by getting another person (or in some cases, animal) to objectively reflect them (i.e., through an overt fear reaction or by assuming a seductive stance).

3) Mentalization is largely “communication outside of language” (p. 49).

4) Mentalization draws heavily from context or the implications of an environment. A gun in a display case will have a different implicit sense to it than a gun being held by a police officer or soldier. We need to be able to mentalize in order to get the implicit meaning of things.

5) Mentalization is necessary to “get” the meaning behind metaphor (p. 66). Metaphor accurately depicts the nature of a situation (the objective reality) and is designed to convey a mental state. For instance, sarcasm would not “work” without mentalization. Freud’s “biting sarcasm” would not have any “bite” to it without mentalization. If Freud were here today, he would tell us that biting sarcasm is a metaphor that builds a transformation between an oral process (like gnashing mastication) and an inner desire (mental state) to “chew someone up.”

6) “What determines our behavior is not the state of the world [objectivism], but our beliefs about the state of the world [experientialism]” (p. 67). In my opinion (and linguistics researchers Lakoff and Johnson (1999) would tend to agree with me), objectivism is metaphor with implicitness stripped out. The irony here is that in order to strip out implicitness, you have to use mentalistic processes.

7) Infants are born with an imitative brain (p. 110). In other words, infants are born with an innate desire to imitate a social partner. Imitation is the seed that will eventually (if all goes well) bear mentalizing fruit (to use a metaphor).

8) Empathy is a form of mentalization (p. 115). It is difficult to be empathetic (sympathetic maybe) without the ability to mentalize. Researchers, such as Russell Barkley (1997) are looking at a possible connection between certain forms of ADHD and an impaired capacity to mentalize.

9) Imitation inherently asks the questions, “who will choose to imitate me back? to value my self? to put my self into context? (e.g., what does my self imply?).”

10 Witnessing (also a form of mentalization) is about allowing the client (in a therapeutic relationship) to have a sense of agency—both explicit and implicit agency. Witnessing allows the client to internalize the statement. “I am valued—the implicit combined with the explicit—because one chooses to imitate me and have me ‘in their brains’ so-to-speak” (p. 118).

11) “Goal detection is connected to imitation right from infancy” (p. 120).

12) The same brain regions are activated during imitation and mentalization (p. 122).

13) During imitation, we map the actions of others onto the actions of our own body (p. 122). The actions of our own body allows us to look forward and backwards to create what Daniel Stern (2004) calls a “now moment.” We (mostly unconsciously) reflect the future back to our partners through nonverbal cues. A bad poker player, upon receiving a great hand, will usually telegraph a “tell” cue to his fellow card players about his future good fortune. (Note that many world class poker players wear sunglasses to protect against spontaneous and automatic tell cues.)

14) Looking forward and backwards simultaneously to create a “now moment” is a form of abstraction (p. 116). Infants are able to engage in simple forms of abstraction at age three weeks. Musical recognition requires abstraction (which is why infants can recognize the “music” of their mother’s voice).

15) To speak explicitly and to understand explicitly, we must also speak with precise implications, for all alphabetic language (all) is metaphoric. No actual written word is what it symbolizes, not even mathematical expressions. There is no “2” outside of implied context (p. 173).

16) “The quality of our lived experience of the ‘external world’ and its contents are constrained by the presence of other subjects that are intelligible, while preserving their otherness” (p. 176).

17) “Imitation happens within social bonding” (p. 185). For instance, I imitate my dog all the time (she loves it). I may even talk to a moth as I release it to the outdoors. But rarely do I imitate or talk to an inanimate object unless I am able to project an animate presence onto that object. Children do this all the time with imaginary friends.

18) Mentalization is a “way to find social partners in the world” (p. 37).

19) “Without an observer [witness person], an emotional display will either not occur or will be muted [depressed]” (p. 242). An antidepressant drug may serve to elevate emotional display, but it will not, in and of itself, solve the problem of social bonding or being witnessed.

20) “Motor systems can be used to understand [simulate] the actions of others.” This is called “embodied simulation” (p. 160). With the discovery of mirror neurons in primates (including humans) it is clear that as we observe the motion of others, these observed motions are mapped onto the motor system maps in our brains. Through this mapping or mirroring process we are able to make predictions about the future motions we can expect to observe. This is why we cannot tickle ourselves—we already know the future of our own motions. In my opinion, the time gap that is created by our ability to observe actual real time motion and, simultaneously, motion in the future, is the same time gap that gives us our sense of anticipation. The reverse of this time gap gives us our sense of nostalgia or sentiment. A hopeful or sentimental person may be a person who can easily engage in what researchers (like Stern) call mental time travel. (Researchers, again, like Stern, have associated secure attachment with a person’s ability to engage in mental time travel.)

Allow me to end with this quote from the editors (Wolpert and Frith) along with Tania Singer:

“Humans, like other primates, are intensely social creatures. One of the major functions of our brains must be to enable us to be skillful in social interactions as we are in recognizing objects and grasping them. Furthermore, any differences between human brains and those of our nearest relatives, the great apes, are likely to be linked to our unique achievements in social interaction and communication rather than our motor or perceptual skills. In particular, humans have the ability to mentalize, that is to perceive and communicate mental states, such as beliefs and desires.” Citing work by Dennett, the authors conclude by stating: “The acid test of this ability [to mentalize] is the understanding that behavior can be motivated by false belief” (p. xiii). The Latin phrase caveat emptor (buyer beware) is a caution against false belief, both in the selling and purchasing of a product. Remember caveat emptor when you enter an automobile dealership and the salesperson begins manipulating your mental states (beliefs, goals, and desires) in an attempt to form a favorable mentalization of you driving away in your new car.

References

Barkley, R. (1997). Behavioral inhibition, sustained attention, and executive function: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65-94.

Fonagy, P., Gergely, G., Jurist, E. & Target, M. (2002). Affect regulation, mentalization, and the development of the self. New York: Other Press.

Frith, C. & Wolpert, D. (Eds.). (2004). The neuroscience of social interaction—Decoding, imitating, and influencing the actions of others. Oxford: Oxford University Press.

Gergely, G. (2001). The obscure object of desire: ‘Nearly, but clearly not, like me’ Contingency preference in normal children versus children with autism. In J. Allen, P. (Ed.) Cognitive and interactional foundations of attachment, Special Issue of the Bulletin of the Menninger Clinic, 65(3), 411-426.

Lakoff, G. & Johnson, M. (1999). Philosophy in the flesh—The embodied mind and its challenge to western thought. New York: Basic Books.

Stern, D. (2004). The present moment—In psychotherpy and everyday life. New York: Norton & Co.

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