What is Mentalization-Based Therapy for BPD Treatment?

Mentalization-based therapy (MBT) is a form of psychotherapy that’s been found to bring long-term symptom improvement in people with borderline personality disorder (BPD). BPD is a complex form of mental illness characterized by challenges with emotional regulation and impulse control, along with difficulty in relationships and an unstable self-image.

At one time, BPD was considered untreatable, but MBT and other evidence-based therapies have been shown to reduce incidents of self-harm and suicide attempts in people with BPD, as well as to improve their ability to relate to others and the world around them.
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Understanding Mentalization

Those with BPD frequently have difficulty in their relationships, often misunderstanding the words or actions of other people. They often have problems with mentalization, which is the ability to perceive and understand their own thoughts and feelings and to make sense of them or to make sense of the thoughts, feelings, and behaviors of others.

When people interact with others, they often try to imagine what the other person is feeling and what may be triggering their actions. An individual with BPD has a lot of difficulty putting themselves in other people’s shoes or separating their own feelings and thoughts from those around them.

Mentalization in BPD

Mentalization can be very challenging for a person who has BPD. Unstable relationships and an unstable self-image are hallmarks of this form of mental illness. Since an individual with BPD often feels out of touch with their own thoughts and feelings, they aren’t able to gain insight into the feelings and actions of others.

MBT was developed by Peter Fonagy and Anthony Bateman based on their theory about how the ability to mentalize happens. The theory states that mentalization develops when a small child learns to convert an experience into a conscious thought with the help of a parent. The ability to understand others depends on whether the mental states of the small child were recognized and validated by caregivers. If a child is abused or neglected rather than being nurtured, he may avoid mentalization so that he doesn’t have to acknowledge the thoughts of the abuser.

How MBT Works

MBT is less structured than other forms of psychotherapy and is usually done on a long-term basis in the context of group or individual therapy. The focus is on the present rather than the past as they work toward recognizing how thoughts relate to behavior.

Therapy focuses on the interaction between the patient and the therapist and on enhancing the patient’s ability to mentalize.  Patients can discuss whatever is uppermost in their minds, so that the therapist and patient can work together to identify negative feelings and behavior patterns. This increased awareness can help an individual with BPD learn to change these negative patterns of behavior and the thoughts that resulted because of them.

Improvement in BPD Symptoms through MBT

MBT is a way of helping a person with BPD stabilize their sense of self. When patients are being treated with MBT, it’s important for them to feel like it’s a safe and nonthreatening environment where they can explore their feelings. The relationship between patient and therapist has to be not too intense but not too detached at the same time, keeping in mind the tendency of a person with BPD to become overly attached.

One of the goals of this type of therapy is for the patient to grow in understanding of what may be driving others. Over time, patients can develop an improved ability to mentalize, allowing them to better understand their own thoughts and feelings and to become less reactive to the actions of others. This can help patients become less likely to misinterpret the behaviors of other people, which can improve their ability to have healthier relationships.

If you or a loved one are struggling with a borderline personality disorder (BPD) or another mental health disorder, please contact us at (855) 409-0204 or submit the form below and a treatment specialist will contact you.