mentalisation – Andi Fugard

Psychotherapy techniques – beyond the brands

The therapeutic brands are misleading as there’s a lot of overlap in techniques.

I like this simple table from Mick Power (2010, p. 49) of the different techniques, expressed in a cross-brand way.

Power argues that

“… therapy heightens access to cognitive–emotional structures and processes that relate to past and present significant objects and significant others including the therapist. In the context of this heightened access, there is the common therapeutic goal that patients will relearn, cope more successfully with, view more realistically, reinterpret or reconstruct; that is, in some way view more constructively the object, person or situation that has been the source of their distress or conflict.”

Fonagy and Bateman (2006, p. 425) go somewhere similar with the interrelationship part of this:

“It is possible that psychotherapy in general is effective because it arouses the attachment system at the same time it applies interpersonal demands (psychotherapy technique), which require the patient to mentalize, to confront and experience negative affect, and to confront and review issues of morality (superego). Why might this be helpful? We speculate that thinking about feelings, thoughts, and beliefs in the context of attachment is helpful because in this “paradoxical” brain state there may be more access to modifying preset ways of conceptualizing the contents of one’s own and other’s minds, as well as issues of morality and social judgment. Activating the attachment system harnesses brain biological processes partially to remove the dominance of constraints on the present from the past (long-term memory) and creates the possibility of rethinking, reconfiguring intersubjective relationship networks.”

Both are jargon heavy, though.

References

Fonagy, P., & Bateman, A. W. (2006). Mechanisms of change in mentalization‐based treatment of BPD. Journal of Clinical Psychology, 62, 411-430.

Power, M. (2010). Emotion-focused cognitive therapy. London: Wiley

A couple of ways to pass false belief tasks earlier

1. Have some siblings (Perner, Ruffman, & Leekam, 1994)

Why? After spending a few paragraphs carefully ruling out a bunch of interpretations, they settle on:

“… as Dunn and Dale (1984) suggest, children do engage more frequently in creative social role taking with siblings than with anybody else. And since a benefit can be gained from joint pretence with a younger as well as with an older sibling, pretend play is perhaps our best candidate for a cooperative activity which furthers the eventual understanding of false belief.”

2. Having a Montessori education also seems to help (Lillard & Else-Quest, 2006). 80% of 5 year olds at Montessori schools passed the test compared to 52% at control schools. (A lottery approach was used to select who ended up at the Montessori school.) I wonder could the key advantage be mixed-age classrooms?

References

Lillard, A., & Else-Quest, N. (2006). The early years: Evaluating Montessori education. Science, 313(5795), 1893-1894.

Perner, J., Ruffman, T., & Leekam, S. R. (1994). Theory of mind is contagious: You catch it from your sibs. Child development, 65(4), 1228-1238.

What started empirical studies of false belief?

Here’s Martin Doherty (2009) with a nice introduction to the empirical study of verbal false belief tasks:

“… According to Piaget’s theory, young children are profoundly egocentric: They are only able to consider things from their own point of view until they are about 7 years or older. What is now known as theory of mind was considered to emerge as part of a general escape from the confines of egocentrism in middle childhood. This diverted attention away from the surprisingly rapid development of the ability to understand others’ beliefs around the age of 4 years. Researchers driven by a powerful theory can sometimes miss the blindingly obvious.

“The change was brought about by an influential paper by two primatologists, David Premack and Guy Woodruff (1978): “Does the Chimpanzee Have a Theory of Mind?” This question of chimpanzee theory of mind remains hotly contested, but in a commentary on the paper, the philosopher Daniel Dennett suggested a way of determining the answer. He briefly sketched what has become known as the false belief task, taking as one example a Punch and Judy show. Children squeal with glee as Mr Punch prepares to throw a box over a cliff. Although they have seen Judy escape from the box while Punch’s back was turned, it is “obvious—obvious enough for four-year-old children—that Punch believes (falsely) that Judy is in the box” (Dennett, 1978, p. 569). Dennett’s reference to 4-year-olds is a notable piece of foresight. The method was put into developmental practice by Heinz Wimmer and Josef Perner soon after. They found that 4- to 5-year-old children can indeed predict the actions of someone with a false belief.”

Reference

Doherty, M. J. (2009). Theory of Mind: How Children Understand Others’ Thoughts and Feelings. Psychology Press.