Transcript March 10, 2011 - Myweb @ CW Post

Mentalization/ Reflective
Function
Geoff Goodman, Ph.D.
I. Origin of Concept of Self
A. William James’ idea of two selves
1. self as subject (“I”)-- agent
2. self as object (“me”)-- mental
representation of “I”
B. Theory of mind
1. capacity to respond to others’ behaviors
2. capacity to respond to others’ beliefs,
attitudes, desires, hopes, knowledge,
imagination, pretense, deceit, intentions,
plans
3. capacity to “read” other people’s minds
4. reflective function (RF)-operationalization of the psychological
process underlying the capacity to
mentalize (Fonagy et al., 2002, p. 24)
5. important determinant of individual
difference in self-organization
II. Concept of Reflective
Function
A. What it is not
1. introspection- consciousness or self-report
(conscious self-knowledge)
2. insight- knowledge gained about oneself
B. Definition
1. unconscious, automatic, implicit,
nondeclarative procedure
2. used to regulate emotions and behaviors
3. understanding of reciprocal influences
between feelings and behaviors of self in
relation to others
Continued…
C. Conceptually similar concepts
1. depressive position (Klein)-recognition of others’ suffering
2. empathy (Kohut)-- feeling what
another person is feeling
3. alpha function (Bion)-metabolization of unthinkable
experiences
III. Development of
Mentalization
A. Theory-- theory approach
1. theory-- like network of interdependent
propositions about the mind
2. based on interpersonal experiences
B. Simulation approach
1. imaging how we would act in
interpersonal situations (introspection)
2. imagining being the other person in the
interaction
Continued…
C. Fonagy’s approach
1. understanding of mental states
embedded within social world of the
family
2. intensely emotionally charged
relationships
3. social world “gives” intentionality
to child
IV. Attachment and Reflective
Function (RF)
A. Understanding process of RF
transmission through intergenerational
attachment studies
1. parents have IWMs of their relationships with
early caregivers
2. IWMs affect the development of mental
representation of child
3. parenting behaviors in emotionally charged
situations affect child
4. development of infant IWM of attachment
to parent
Continued…
B. Internalization of self structure and RF
1. traditional psychoanalytic theory vs..
Fonagy’s theory
a. traditional theory-- child internalizes image of
caregiver to control affect (alleviate anxiety)
b. Fonagy’s theory- child internalizes image of infant in
caregiver’s mind (caregiver as container of infant’s
mental contents)
2. mother able to think about and reflect on
her own mental contents and mental
contents of infant
Continued…
3. infant able to think about and reflect on
mental contents of mother’s mind, which
contains infant’s experiences symbolized
4. when mother behaves in frightening or
rejecting or inconsistent way, infant
becomes afraid to think about or explore
what is in mother’s mind
5. thus, other’s minds become meaningless
and filled with fear because they are
unknown quantities
C. Modes of RF
1. psychic equivalence mode (C?)
a. internal and external reality are equivalent
(concrete, unsymbolized thinking and
feeling)
b. mother reflect exact replica of infant’s
affect, which does not permit symbolization
2. pretend mode (A?)
a. internal world has nothing to do with
external reality (dissociated from external
reality)
b. mother reflects noncontingent mental
contents back to infant, which serves to
develop alien self
3. reflective mode (B?)
a. internal world related to but not
identical to external reality
b. mother uses “marking” to indicate that
she understands affect is feeling
something different, thus permitting
second-order representation of
experience (symbolization)
Continued…
4. reflective mode = integration of psychic
equivalence (paranoid-schizoid position)
and pretend (pathological grandiose
self) modes of RF (mirroring neither too
close nor too distant from the infant’s
emotional experience)
5. D attachment = frightening mirroring is
also alien to infant’s experience
(controlling behavior by middle
childhood, reflecting projective
identification)
D. Four theories of mediation
between attachment security
and RF
1. pretense-- joint pretend play or
playfulness fosters understanding of
mental states (e.g., role-taking)
2. talking-- conversations about feelings
and the reasons behind people’s
actions in emotionally charged
situations
3. peer group interaction-- increase
opportunities to imagine what others
see, think, and feel, encouraging the
adoption of mentalizing concepts
Continued…
4. secure attachment = catalyst to learning
process
5. mothers mentalizing ability
a. influences security of attachment
b. influences child’s development of
mentalization
- attachment security --> social process -->
mentalization
- mother’s mentalization --> attachment
security or mentalization
IV. BPD and RF
A. Infants fearful of mentalizing or
reflecting on mother’s mind or own
mind
B. Child is sexually or physically abused by
a caregiver
C. Child is unable to resolve this abuse
because of an inability to reflect on
experience or the perpetrator’s mind
D. Child develops
borderline symptoms
1. lack of meaningful relationships
2. lack of opportunities to develop RF with
others
3. projection of child’s mental contents
(“alien self”) into other person because
of inability to reflect on thoughts of the
other
4. attachment not to soothe but to
maintain coherence of self
V. Limitations of Fonagy’s
Theory of Mentalization/ RF
A. Lack of emphasis on other levels of
personality organization
1. neurotic level
2. psychotic level
B. Theory is for cognitive, deemphasizing affective experience
and drives, especially role of
sexuality in organization of self
experience
Continued…
C. Too much emphasis on RF, which might
not be necessary or sufficient condition
for a contented mental or interpersonal
life
1. weak mentalizing capacity --> high
functioning
2. strong mentalizing capacity --> low
functioning
3. stressful situations can reduce RF
4. strong mentalizing can be hypervigilant and
ineffective
D. Too much emphasis on early
development as critical period, when
adolescent trauma can cause loss of RF