The repercussions of an inability to effectively mentalize are on display throughout Mind to Mind. In the opening chapter by mentalization pioneers Peter Fonagy and Mary Target of the Anna Freud Center at the University College London, we see that criminals who had abusive parents are unable to coherently express self-awareness. What is normally seen as antisocial or even sociopathic behavior is, from this perspective, the result from a confused and retarded development of mentalization as a result of trauma or neglect. In one chapter by Karen Gilmore, we hear the devastating story of Mr. N, an adopted, talented man prone to failure who did not undergo any form of psychotherapy until the age of 28. Despite stories of an excessively tough adopted father, the early death of his adopted mother, and his insecurities regarding his seemingly flawless wife, Mr. N simply could not mentalize at a healthy level, and behaved irrationally and disinterestedly towards his therapist. At the same time, while the five years on therapy ended on sour and incomplete note, Mr. N still gained significant tools to address his psychological problems with introduction to mentalization training. Even a little ability to mentalize can mean significant progress.
In terms of therapeutic practice, two strands of mentalization theory seem to be dominant: Mentalization-Based Treatment (MBT), which seeks to intensively train a patient to become more self-aware of his own mind, and Transference Focused Psychotherapy (TFP), which focuses on making connections of current associations to past experiences in order to awaken a patient’s mentalization ability more subliminally. Both treatments may be crucial for people suffering from Borderline Personally Disorder, and in comparing MBT to TFP, the latter is older, more battle-tested, and more historically successful. In each case, however, the focus is on, according to Otto F. Kernberg, et al., utilizing “implicit and explicit mentalization.” Treatment of borderline personality has its dangers, and traditional practices such as free association and looser talk therapy can be especially pernicious. Yet, breakthroughs in mentalization research have opened up the floodgates to treating a disorder once thought untreatable.
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