Mentalizing is a key foundational concept in attachment-based therapy, and even most therapists struggle to understand what it really means in practice. Put simply, it is an attitude where we assume that the subjective experience has gone through some unconscious interpretation before it reached awareness. In slightly more technical language, it is a stance toward experience (a reflective stance) in which we treat all experience as a product of the mind, rather than a raw input of objective reality.
For example, if I’m enjoying a meal, a mentalizing stance toward that experience would be to wonder about the influences that have combined to produce the enjoyment:
the unique physiology of my taste buds compared to those of others,
the cultural experiences which have conditioned positive responses to certain flavors that may be “acquired tastes”,
my mental state at the time of the meal (everything tastes better when I’m in a good mood)
the company I’m with (I’m more likely to be open-minded toward food when in a social situation which creates subtle pressure for shared enjoyment)
the setting and manner in which the food is presented, influencing my perception of its quality
There are a few other ways I can relate to the experience. The most common and least cognitively demanding is psychic equivalence. When I’m in this mode, my subjective experience is assumed to be a complete and accurate portrayal of reality: “This is a really good meal.” This is also called an “embedded mode” of experiencing, because I’m fully embedded within my subjective interpretation, without awareness that an interpretive process has taken place. In a low-stakes situation, this is fine. It saves energy. But it also causes a lot of arguments. If the person I’m with is not enjoying the meal and also assumes their experience is “true”, they might be surprised: “What do you mean, it’s good? This isn’t good, it’s quite bad. What’s the matter with you that you would like something like this?”
Alternatively, my stance toward the experience might be teleological, which simply means that it’s focused on actions and results (telos) rather than internal states. When I disregard states of mind and focus only on problems and solutions, I may get a lot done but I’m not very fun to be around: “Would you look at this meal — why can’t you cook like this at home?” The lived experience of a great meal is lost in the mental search for what must be done.
Finally, my stance toward the experience might be pretend mode, where I “play pretend” by living in my dreams and desires about an experience rather than connecting with the experience itself. We do this as children as a way of building up to trying things in real life, but if we never try the real thing then we’re left with a hollow simulation. It’s all talk. “This meal is such a great representation of the cultural diaspora of the Los Angeles food scene.”
Bringing it into psychotherapy
A psychotherapy session has essentially one goal: to help a client understand what’s going on with their mind. Why are they having this type of experience, instead of some other kind? Why do they think like this? Why do they act like this? Why do they feel like this?
The only mental stance which facilitates this goal is the mentalizing stance. My patient comes to me with an experience, and neither of us can really know all the complex factors coming together to create that experience for them.
If I imagine that I already know the answers to all of the above questions, I’ll jump straight into a teleological mode: “It’s a good thing you’ve come to me, because I have the perfect technique for this problem.” But I’ll be operating on an idea, an objectified “patient”, not a person.
If I can’t let myself connect with the lived experience of sharing space with a person in their state, needing my help, and expecting me to understand things that I cannot possibly understand, then I’ll remain in a detached and intellectualizing pretend mode. “It seems that the reason you behave this way is on account of your unresolved oedipal complex.” I may sound smart, but I won’t have accomplished anything.
If I can’t see the patient’s experience as a product of the way their mind is working, then I may get stuck in psychic equivalence, embedded in my own interpretation: “I can see that you’re suffering, but it seems like you’re just not ready to change.” I’ll miss the fact that something is keeping them from being ready to change, and it’s my job to help them figure out what.
If, instead, I maintain a mentalizing stance toward both the client’s reported experience and my own experience of them, I’ll find many things to be curious about:
What is the relationship between their natural biological temperament and the presenting problem?
How does their mind work — could their be neurological differences in the way they process experience?
How did biological factors interact with early environments as they were growing up? How much of their way of experiencing is congruent with early lessons they may have learned about what is or isn’t important, or acceptable?
What cultural influences do these arrangements interact with? Are there past or present environmental factors which promote the problem, or restrict its range of potential solutions?
What kind of social systems is this person involved in? What kinds of overt or covert pressures might they be subject to which affect the problem? Could what appears to be a problem actually also be serving as a solution?
What is this person’s characteristic attitude toward experience? What kinds of interpretive lenses do they apply to make sense out of what’s happening to them?
What is this person’s own stance toward the activity of their own mind? How do they relate to their own interpretive process?
In truth, there are an infinite number of such questions which could be investigated, and many of them cannot ever be fully answered. To seek certainty about the nature of the problem and its potential solutions is to fall victim to the limitations of a teleological mode of functioning. At some point, I simply discard all the things I don’t know and imagine it’s time to take action.
But the healing action of psychotherapy does not come from therapeutic operations that a therapist performs on a patient, but on a healing relationship which enables the patient to increase their own mental flexibility. When the patient has gained the resiliency that comes from engaging with the real world in a manner appreciative of its infinite complexity and power, psychological problems are naturally subsumed by states of mental health, well-being, and quality relationship.
In my next essay, I’ll explore specific language patterns for therapists to employ mentalizing more effectively: