What does mentalizing mean?
The mentalization approach is an innovative theory and emphasises the ability to ascribe meaning to one's own and others' behaviour by imputing intentional mental states (e.g. emotions, desires or thoughts) that underlie behaviour.
Consequently, mentalizing describes the ability to perceive and consider behaviours on the basis of motives (thoughts and feelings, desires, intentions, etc.) - one's own behaviour as well as the behaviour of others can consequently be provided with a meaningful intentionality, which strengthens self-coherence and makes behaviours more understandable and predictable (Fonagy, Gergely, Jurist, & Target, 2002; Fonagy & Allison, 2014).
For example, the violent slap of a person's hand on a car roof only appears as a plausible consequence on the basis of a mental state - namely by assuming anger as a mental state (e.g. because the car key is locked inside the car).
The ability to mentalize develops - beginning in childhood - along relational experiences across the lifespan. It is a foundation for the development of the self and emotion regulation. Persistent or severe childhood stresses (e.g. trauma) can temporarily or permanently impair the ability to mentalize. Under increased emotional arousal (stress), people are only able to take the perspective of the other person or to realise reflective problem solving to a limited extent.
Especially in the clinical field, the ability to mentalize is assumed to be a key competence and is also empirically confirmed (Katznelson, 2014; Luyten, Campbell, Allison, & Fonagy, 2020). Children and adolescents with impairments in the ability to mentalize get into emotional stress more easily and show challenging behaviour more often in social situations such as school, within the family or towards peers. Understanding this behaviour better and being able to regulate stress better is a prerequisite for social learning and influences school success, social participation and resilience.
From developmental psychology and the successful application of mentalization theory in psychiatry and psychotherapy, new fundamental knowledge has been developed on the regulation of emotions, attention and behaviour and on social learning. These are increasingly finding their way into educational fields such as Mentalization based pedagogy (Gingelmaier, Taubner, & Ramberg, 2018; Gingelmaier & Kirsch, 2020), social work and social pedagogy (Kirsch, 2014), childhood pedagogy (Behringer 2021, Turner 2021) or special needs education (Schwarzer & Gingelmaier, 2019; 2020).
What is new and important about the mentalization approach?
- A change of perspective from the consideration of action to intentions
- Dimensions of effective and non-effective mentalizing
- The importance of stress and emotion regulation
- Epistemic confidence and social learning
- The importance of reflective processes and perspective taking
- The formation of helpful relationships
Effective and non-effective mentalizing: Dimensions of mentalizing
The mentalization ability (reflexive mode) matures in early childhood through various developmental steps. The reflexive mode enables the individual to integrate different perspectives and to recognise so-called 'false beliefs'.
Within the reflexive mode, four dimensions can be distinguished, each with two poles (Fonagy & Luyten, 2009; Kirsch, Brockmann, & Taubner 2016, Debbanè & Nolte, 2019).
a) A first important distinction is made between implicit and explicit mentalizing. While implicit mentalizing refers to automatic, partly unconscious and rather reflexive ways of reacting, the latter is characterised by a controlled reflective and thus more conscious attitude (mostly communicated linguistically). The ability to reflectively consider feelings or thoughts in the relationship can be temporarily impaired during emotional stress, up to a complete breakdown. Under stress or great strain, automatic-implicit mentalizing dominates.
b) A further distinction differentiates the source of information to which mentalizing refers: A focus on external stimuli (for example, what can be deduced from the facial expression or posture of a counterpart) helps to understand mental states, but requires different mentalization work than such processes that focus on understanding internal processes (e.g. how someone is feeling at the moment, what constitutes their mental inner life).
c) The third distinction forms an axis from cognitive to affective processes. When trying to sense (affective) what feeling is currently spreading in a person, different (neural and psychological) processes are recruited than when thinking about feelings (cognitive).
d) A final aspect of the multidimensionality of mentalization lies in the distinction of focus on the self or on others. Some people can assess the feelings and motives of others very quickly, but can hardly perceive or differentiate their own feelings. For other people, it is exactly the opposite. Developmental psychological and neuroscientific findings suggest that both abilities form in parallel and with mutual reference (Fonagy & Luyten, 2009, Debbanè & Nolte, 2019).
For the description of mentalization processes, this differentiation into different dimensions is helpful for the description of specific mentalization disorders or for the target formulation of interventions. Flexible, situation-adapted mentalizing is considered central for effective mentalizing.
A mentalizing stance in practice
Based on the idea of reflectivity as a developmental goal, various building blocks can be identified that promote mentalizing processes of understanding. These building blocks can be understood as an orientation, especially in educational fields of action, as to whether and how mentalizing can be promoted. Mentalizing is much less a helpful technique than a fundamental attitude.
A mentalizing attitude is initially characterised by a benevolent, non-knowing attitude and a calm approachability and flexibility. Mentalizing becomes clear when the person is not "stuck" in his or her views and is able to engage with his or her own and other perspectives with an inner room for manoeuvre. This process can be described as playful, which can be expressed, for example, in a humorous approach.
This also includes the ability to advance problem solving while taking different perspectives into account. The prerequisite for this is an attitude characterised by curiosity - we can never know exactly what is going on in the other person. A mentalizing attitude promotes feeling responsible for one's own behaviour and thus perceiving oneself as an actor of one's own actions. The result of such processes of meeting oneself and others in a mentalizing way has essential salutogenetic and resilience-promoting aspects and promotes mental health (Nolte, Campbell, & Fonagy, 2019; Schwarzer, 2019).
Transferred to pedagogical situations, successful mentalizing means the ever-repeating attitude of "situating the child situationally, biographically and developmentally" (Gingelmaier & Ramberg, 2018, p. 90). In analogy to the mother-child relationship, this is always of particular importance "when children come from dysfunctional relationships and also enter pedagogical settings with such relationship expectations" (Nolte, 2018, p. 169).
The importance of stress and emotion regulation
From the thoughts presented so far on successful mentalizing and on shaping relationships that promote development in the pedagogical context, it can be seen that mentalizing itself also needs a suitable framework. Especially when experiencing stress, excessive demands or feelings of powerlessness and helplessness, the attachment system is activated, which subsequently limits the mentalizing function or causes it to collapse completely. Sometimes non-mentalizing cycles occur because it is difficult to maintain one's own mentalization when a counterpart does not mentalize.
Based on a neurobiological model of stress-dependent information processing in the brain (Fonagy & Luyten, 2009), a switching point from controlled to automatic mentalizing can be assumed for all people (switching from explicit to implicit mentalizing). With increasing stress levels - especially in close relationships - the ability to mentalize reflectively becomes less and less available. It becomes harder to consider the perspective of the other person and eventually older brain regions exercise behavioural control (such as "fight-and-flight" reactions).
For example, it may be comparatively easy for an educator to calm down two inconsolable children at the same time because she can draw on inner resources that enable her to see the cause of their distress in a previous argument about a toy and not feel threatened in her self-image as a professional. Another professional, however, may react quite differently, for example, by turning away from them and leaving them to their own devices with the thought that it also helped her as a toddler to come out of such a state of emotion herself. At the same time, her own memory can be so stressful that she does not want to deal with it and thus does not want to deal with the children's feelings any further.
When feelings of devaluation, powerlessness or helplessness arise in everyday professional situations, it can be helpful if the teacher is also given a space for reflection in which she is met in a mentalizing way. One could think of spontaneous collegial conversations, supervision or intervision.
Epistemic trust and social Learning
The term epistemic trust (ET) describes a basic trust in a person as a secure source of information. Based on Fonagy and Allison (2014) and the research of Csibra and Gergely (2009) and Tomasello (Tomasello 2014, 2019), it has been shown that social cognitions gained importance early in human history. People are born into a social environment full of codes of norms, objects, signs, values, attitudes, expectations, rituals, etc. that are not self-explanatory. For example, the function of a complex tool or a mobile phone can be discovered and passed on primarily through the guidance of others and not by oneself. But we can also be deceived in this process.
Early on, infants develop epistemic vigilance by distinguishing which people they want to learn from. This epistemic vigilance is reduced (epistemic trust, e.g. secure attachment) or increased (epistemic mistrust, e.g. in the case of traumatisation or hurtful and disappointing relationship experiences) by various relationship influences.
If a child experiences mentalizing, his or her understanding of how the behaviour of others is motivated improves. The feeling of being contingently perceived and mentalised by the other is the crucial signal that it is safe to learn from the other (Fonagy & Allison, 2014; Fonagy et al., 2015). The experience of being mentalised is of such particular importance because it enables the experience that a counterpart can form an idea of my personal narrative that is very close to my own construction of this narrative. In this context, one also speaks of an epistemic match.
This can also be established in pedagogical situations, namely whenever the child experiences itself as understood in its thinking, feeling and acting by the pedagogical professional and is thus put into a "we-mode" of shared attention. Here, mentalizing enables the evolutionary advantage of being able to (better) understand social interactions and promote epistemic trust by assuming mental states and taking on perspectives. (Kirsch, Brockmann, & Taubner 2016; Nolte, 2018, p. 157; Gingelmaier & Schwarzer 2019 )
If there is no understanding of the other person or if interactions within a relationship are characterised by permanent epistemic mistrust (e.g. because the other person is experienced as a non-meaning, neglectful, permanently overstimulating or even abusive person), this results in social isolation and a closedness towards other people and potentially relevant information. Change or development is then difficult.
Fonagy (2018) has clearly outlined the importance of epistemic trust for pedagogy: "A child who is prevented from participating in the educational process due to extreme epistemic mistrust may do so because he or she lacks cues to (trust) information - or rather, because the perceived cues are insufficient to ensure a hazard-free exchange of ideas. Therefore, limited mentalizing only creates a persistent barrier to learning. If the school environment does not succeed in mentalizing the child and teaching him/her to perceive him/herself, he/she will not be able to open up to the knowledge of others".
„Mentalisation is a slow and progressive process, perhaps the venture of a lifetime.“(Lecours & Bouchard 1997, S. 865)
Mentalization based education
Mentalizing in educational settings
Mentalizing in education means looking at the social-emotional development of a young person from his or her perspective in order to orient pedagogical interactions such as education, but also cognitive learning processes through professional attitudes and interventions.
The behaviour of the child or of groups is interpreted through the understanding of mental states and empirical developmental knowledge. These reflections guide the actions of educators. This means that mentalizing is ultimately to be understood as a form of appropriate reaction within pedagogical interaction. It is a promising pedagogical approach that focuses on emotions, understanding and relationship or attachment.
Mentalization theory makes a fundamental contribution to a contemporary reflexive pedagogical theory of relationships. It could provide important insights for both cognitive learning and the social-emotional development of children and young people in educational institutions.
Mentalization based pedagogy is subject to the following theoretical assumptions: It is a developmental, understanding and explanatory approach which, on the one hand, it understands, thinks and shapes pedagogical interactions and learning fields in a developmentally supportive way from the perspective of the young person and the groups to which the young person belongs - in other words, mentalizes the young person in his or her development in a needs-oriented way. On the other hand, educators also come into focus, as they use mentalizing to examine their own actions and adjust them to the needs, positively influence people, educate and form.
The approach of Mentalization based pedagogy is thus intersubjective and interactionist. Individual situational and biographical (e.g. conflictual/potentially traumatic) factors as well as empirical-developmental psychological assumptions about young people or groups play a role alongside didactic-methodological findings. The subjective significance of the educator for the interactions is also included in the reflection. The professional relationship between the educator and the young person is both an interpersonal link and the result of the cognitive efforts.
The aim is, via recognition of the child's strengths, resources and individual/group developmental needs, to offer a space in which anxiety can be managed and thus an epistemic trust can be (re)established as a basis for the ability to learn and to deal with (developmental) conflicts.
This is to be seen as a preventive and, above all, interventive contribution of pedagogy to the ability to learn, mental health and thus to psychological resilience of children and young people both in school, elementary, social, intensive and adult educational settings. The younger and the more stressed the children and adolescents are, the more this has to be included in everyday interaction as primary experiences or secondary alternative experiences and their reflection. In this sense, the interpersonal space between child and educator is seen as shaped by previous relationship contingencies and attachment experiences. At the same time, this space represents a "window of opportunity" with developmental potential if it is possible to mentalize the child as an intentional individual in the context of education and knowledge transfer (Kirsch, 2014; Gerspach, 2007; Hirblinger, 2011; Ramberg & Gingelmaier, 2016) (cf. Gingelmaier & Ramberg, 2018).
Why do we need mentalizing in social work?
The subject of social work are processes of social exclusion and their social, health and psychological effects. Health-related social work promotes health as an essential part of everyday life.
Example 1: Adults in precarious life situations
Spangenberg (1996) speaks of illusionary misjudgement in social work, because neither financial support alone nor (psychotherapeutic) treatment of life-historical stresses are sufficient to enable social participation.
Only through the provision of resources and the promotion of reflection and perspective-taking (e.g. through support in stress processing, mentalizing), empowerment, life-world orientation or help in coping with life are promoted. The result of such processes, understanding oneself and others in a mentalizing way, has essential health-promoting, salutogenetic, i.e. resilience-promoting aspects (Kirsch, 2014; Schwarzer, 2019).
Example 2: Social work takes place in institutions.
Structural contradictions (Thiersch & Böhnisch, 2014) arise between the fit of institutional support services on the one hand and personal life realities/emergencies, e.g. homeless support - drug support - community psychiatry - child and youth support, on the other.
For successful support processes, the institution needs to be willing to take on the perspective of the individual realities of the addressees' lives; at the same time, it requires the addressees to think along with the perspective of the institutions and professional staff. This requires empathy and perspective-taking, i.e. mentalizing as well as support in stress and emotion regulation on both sides.
Health-related social work
Contributes to social participation, resource promotion, network building and health promotion.
Promotes the development of skills for coping with stress and problem solving.
Mentalizing as an aid to coping with life is scientifically based, development-oriented and includes environmental conditions (Köhler-Offierski, 2014).
What does mentalizing mean for child and youth welfare services?
Mentalizing is generally considered a key concept of mental health and resilience (Taubner, 2016). For this reason, it also plays a crucial role in the everyday life of inpatient child and youth welfare in order to meet the legal goal of this measure, namely the promotion of development and the establishment of positive living conditions. It is not uncommon for the children and young people in the institutions to have had traumatic experiences that can produce challenging behaviour and impair mentalizing.
It can be assumed that interactions between professionals and children and adolescents that inhibit mentalization will manifest themselves if they cannot be actively reflected upon and processed. The consequences can be far-reaching, up to and including a termination of the measure due to unreflected or acting-out reactions. These, in turn, are patterns that are well known to the children and young people and that reinforce them in their often traumatic experience of relationships and their reactions. All these reasons speak in favour of taking a self-reflective look at mentalization processes within everyday pedagogical work, within the team and also individually. Successful mentalization processes on the part of the professionals make it possible to recognise the interpersonal reciprocity of challenging interaction processes and to offer the young people the experience that they are mentalized and that their behaviour can be understandable for others and also for themselves. In addition to recognising dynamics that inhibit mentalizing, a mentalizing attitude ultimately promises to sustain and promote relational experiences between the young people and the professionals (Behringer 2021).
Professionals in early education and care institutions play an important role in the development of the child's mental capacity. In view of the sensitisation for intersubjective professional-child processes in early childhood education, the mental capacities of professionals must be given specific attention in the future. The mentalization concept could prove to be a fruitful model for raising awareness at the child and professional level for key situations that are relevant to attachment and education. For example, it can be assumed that robust mentalization skills on the part of the professional have a direct influence on the design of everyday pedagogical interactions, in that stress-intensive events in particular (e.g. in the context of familiarisation) are reflexively accessible to professionals and subsequently enable appropriate, sensitive reactions to the child's expressions.
Last but not least, the mentalizing ability of the professionals can contribute to a more differentiated perception of their own sensitivities by promoting mentalizing understanding processes of stress-triggering situations, which contribute to keeping the professionals themselves healthy and, in the long term, to reducing staff turnover (e.g. in daycare centres with concentrated social problems).
For the work in educational teams
Mentalizing in pedagogical teams tries to understand the team as an elementary subsystem of a pedagogical institution, in which the individual child or the group of children is:
c) developmental-psychological and
e) can be located in the pedagogical institution.
f) Mentalizing can enable the child (and the interaction with his or her family system), but also
g) in the pedagogical staff,
h) to consciously derive adequate pedagogical (in the sense of upbringing, education, support, coping) attitudes and interventions (Gingelmaier, 2019).
For everyday pedagogical work, this means that it does not only take place with the child or children, but that children are also mentalized in explicitly temporally and spatially reserved team offerings (e.g. supervision, case consultation, intervision, etc.). This must be structurally planned as working time for the whole team. It is therefore not a voluntary offer, but an elementary part of the respective service obligation.
For the work in schools
School pedagogical interaction processes can be experienced as stressful situations for teachers as well as for learners, which can, for example, decrease teaching and learning motivation, cause misinterpretations as well as intra- and interpersonal conflicts. Taking into account emotional aspects of learning and teaching, it is known that the quality of the perception of educational tasks depends on the form in which teachers understand the mental states, as well as the conscious and unconscious motives, fears and inner conflicts in themselves and in their students, and can design lessons based on this. According to the concept of mentalizing (Fonagy, Gergely, Jurist and Target, 2004), mentalizing means becoming aware of mental processes in oneself and in the other person, developing and cultivating attentiveness for one's own mental states and for the mental states of other people in order to prevent misunderstandings as far as possible and to refrain from hasty attributions (cf. Allen, Fonagy, & Bateman, 2011, p. 23).
Especially in emotionally stressful situations, it is difficult for educators to focus on the current interactive events, on their own mental states and those of their counterparts. Since the ability to mentalize is not a statically acquired ability, increased intrapersonal arousal can occur, especially in situations of psychological stress and strain (cf. Brockmann & Kirsch, 2010, p. 282), so that the ability to mentalize temporarily breaks down (cf. Taubner, 2015, p. 77).
The conscious perception of emotional aspects and their meaning can be experienced as difficult to endure and repelled. It can lead to misunderstandings and misinterpretations, which subsequently limit the professional scope of action and influence the interaction with the counterpart. For example, an educator suddenly feels paralysed in the interaction with a child and can neither comfort nor calm the raging or crying child. The educator's mental space collapses at this moment, leaving him/her unable to act for a moment. If the mental space can be restored as quickly as possible in the stressful situation, a holding and pedagogically helpful relationship can be maintained.
The mentalizing of relationships is still a little considered topic in teacher training and further education. In this respect, there is an important research and development desideratum for learning, reflecting and applying psychodynamic processes in educational practice.
Mentalizing and mental health
More recently, there has been an increased focus on the potential health-preserving function of mentalizing (e.g. Borelli et al., 2019; Ballespi et al., 2019; Schwarzer, 2019). In the course of this, mentalizing ability is described as a mediating change mechanism involved in the intrapsychic processing of aversive stimuli (Stein, 2013). In particular, robust mentalizing is conceptualised as a capacity that can protect against stress-inducing events by enabling coherent self-experience despite stressful experiences and the accompanying affective arousal (Taubner, 2015; Stein, 2013). As a result, the ability to act and the conviction in one's own self-efficacy are preserved for a comparatively long time even in potentially uncontrollable states of experience.Mentalizing and mental health (german)
Tips and tricks to restore effective mentalizing (Hutsebaut, Nijssens and van Vessem 2021)
Excerpt: The power of Mentalization (Hutsebaut, Nijssens & cvan Vessem (2021) pp. 118-150.
Tips and tricks for restoring effective mentalizing.
This chapter presents ten tips to restore mentalizing and reconnect with the other, allowing someone to experience epistemic trust again. At the same time, the ten tips are not a cookbook or a set of skills that can be learned overnight. Effective mentalizing is a basic attitude, and therefore the fifth tip is perhaps the most important. If we manage to approach each other with a basic mentalizing attitude, it will undoubtedly have a positive impact on the nature and quality of our interactions.
Tip 1: Notice when you or someone else is not mentalising well.
Tip 2: Re-establish your own mentalizing
Tip 3: Mentalize out loud
Tip 4: Limit ineffective mentalizing in an empathetic way
Tip 5: Approach others with a mentalizing attitude
Tip 6: Offer emotional support to others
Tip 7: Take the lead in helping another person deal with tension
Tip 8: Validate the experience with someone who is in mental equivalence mode and make room for other perspectives
Tip 9: Look for the underlying need of a person in teleological mode
Tip 10: Connect a narrative in As If mode with emotions