Chapter

Mentalizing and group therapy

Anthony W. Bateman and Peter Fonagy

in Mentalization-based Treatment for Borderline Personality Disorder

Published on behalf of Oxford University Press

Published in print September 2006 | ISBN: 9780198570905
Published online February 2013 | e-ISBN: 9780191754456 | DOI: http://dx.doi.org/10.1093/med/9780198570905.003.010

Series: International Perspectives in Philosophy & Psychiatry

Mentalizing and group therapy

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Group psychotherapy is a powerful context to focus on mental states of self and others. It stimulates highly complex emotional interactions which can be harnessed for all patients to explore the subjective understanding of others’ motives whilst reflecting on their own motives. Inevitably this feature of the programme is one of the most difficult aspects of treatment for borderline patients who have the task of monitoring and responding to 6–8 minds rather than being able to focus on only two as in individual therapy. Herein lies the danger of group psychotherapy. The level of complexity and the sophistication of mentalizing required for group interaction means that conditions are optimal for things to fly out of control as attachment systems become over-stimulated and rigid schematic representations of others are rapidly mobilized. As such, group psychotherapy may become highly iatrogenic stimulating mental withdrawal, a collapse in mentalizing and action rather than verbalization—the very antithesis of its aim. First and foremost the therapist has to ensure that iatrogenic effects are minimized.

There are two main types of groups in our programme—explicit mentalizing groups using explicit mentalizing exercises, and implicit mentalizing groups using implicit mentalizing process. To understand the focus and aims of these two types of groups it is important to understand the difference between explicit and implicit mentalizing even though the two are intrinsically linked and neither can exist without the other. To complicate matters further, explicit mentalizing techniques may occasionally be used in implicit mentalizing groups and explicit mentalizing groups are, in part, inevitably using implicit mentalizing. Over the trajectory of treatment explicit mentalizing activity becomes more implicit whilst implicit mentalizing process, at first somewhat reduced, becomes less hesitant, less distorted, and increasingly automatic.

Chapter.  5117 words. 

Subjects: Psychiatry

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