MBT – Mentalization Based Treatment

MBTMentalization Based Treatment

Clinical Information Only

CLINICAL INFORMATION (word for word from my 12 Booklets I’ve got from my Therapy Treatment clinic)

What is Mentalization & a Mentalizing Stance

  • Mentalizing is about attending to states of mind in oneself & in others
  • The ability to mentalize is our capacity to know & manage our own mind & to be able to understand & manage our experience of the minds of others. it is the process by which we interpret feelings, actions & behaviours as being meaningful. This involves attending to mental states such as thoughts, beliefs, desires & feeling.

 

  • To understand what is taking place between people
  • To understand yourself, who you are, your preferences, your own values, etc
  • To communicate well with close friends
  • To regulate your own feelings
  • To avoid misunderstandings
  • To se the connection between emotions & actions more easily, so that you can escape destructive patterns of thoughts & feelings more easily.

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Misunderstandings

Mentalizing has a lot to do with misunderstandings. Misunderstandings can be commonly related to the following issues:

  • The mind’s non-transparency. This is a key point: How can we know what is going on in another person’s mind.
  • Our tendency to attribute thoughts to others. Think that others are thinking  the same way as we do. This is also known as projection which refers to the possibility that we may project our own unacknowledged feelings or thoughts onto other people.
  • Experience that others understand without you having to say it yourself. The group leader also mentions here about the importance of not succumbing to this wish or assumption in individual & group therapy. Therapists aren’t able to read other people’s minds either.
  • Layers of the mind. This refers to the fact that it is also impossible to fully understand what is going on in our own minds. It is easy to misunderstand oneself; you may have access to some thoughts & feelings, but underneath these lie unclear thoughts & emotions that can be difficult to understand.
  • Differences in interpretations & actions. Individuals vary with respect to how they interpret things, how they arrive at judgements & their ability to deal with situations; in short, individuals have different perspectives on the world. To acknowledge this difference involves acknowledging that wishes & interpretations depend on perspectives, and that, by wishing & believing differently, an individual can behave differently even in similar situations. An individual’s wish & interpretation of a situation in light of his or her views about the future & understanding of the past. Wishes & interpretations about specific situations also influence memories, preferences, hopes & other mental experiences. The significant effect that cultural differences can have on our perspectives, wishes & beliefs also needs to be emphasized, not least because group members may have different ethnic backgrounds.
  • Defensiveness. When another person adopts a defensive attitude or position & holds back feelings &/or thoughts because he or she is afraid of something (e.g. of being embarrassed or judged) then this will inevitably affect one’s ability to understand what is going on in their mind.
  • Having difficulty finding words to express inner-thoughts & feelings
  • Deliberate concealment or playing mind games. If the other person is hiding his or her intentions, playing a game or being dishonest it adds to the difficulty of interpreting their mental states. It is minds non-transparency which makes it possible for people to hide things in this way.

A Mentalizing Stance

A mentalizing stance is characterised by a curiosity about the other person’s experiences, thoughts & feelings; it is a not-knowing, exploratory stance.

 

What does it mean to have problems with mentalizing?

  • Feeling certain about other people’s motives
  • Thinking in black-white terms (i.e. without nuances)
  • Poor acknowledgement of accompanying feelings (reduced empathy)
  • Overlooking the fact that people influence each other
  • Interpretation of others without careful consideration may be irrelevant, be off the point, or even be very concrete (i.e. that first this happened then that happened, etc)
  • Little curiosity about mental states
  • Lots of words are spoken with poor content
  • Speech is filled with clichés & fancy words that do not seem to have been digested & that tend to alienate the discussion partner
  • External factors are emphasised at the expense of mental states, for example that it rained, or that one had a headache, or the situation is described as being “, without any more explanation.

Possible consequences of poor mentalizing

  • It is easy to misunderstand each other & that this can have negative consequences (e.g. others feel overlooked, not heard or wrongly interpreted & become upset about this,etc.)
  • One’s actually behaviour may differ from other person’s expectations, which can confuse the other person
  • One may react in a very emotional way, based on misunderstandings & become afraid, angry, disappointed, etc
  • Poor mentalizing of one’s own thoughts & emotions means that way one does & may second guess oneself
  • Feeling insecure or needing constant confirmation from others
  • Becoming overwhelmed by emotions or acting without reflection (i.e. letting the surroundings or one’s own impulses govern ones actions, etc)

Early warning signs of compromised mentalizing

  • Being alert to the use of the words such as ‘always’& ‘no one’ is key
  • Being alert to such words might help to prevent a collapse into non-mentalizing by making the individual ‘think twice’ about what he/she is saying & experiencing. could there be other possibilities? is it likely that someone will ALWAYS be right?

Poor mentalizing leads to…(VERY KEY)

  • Recurrent problems in relationships with other people
  • Insecurity, an unstable sense of self, poor emotional control, impulsivity, & more

Mentalizing & Emotions … (VERY  IMPORTANT)

  • Feelings are activated faster & more strongly in some people than others
  • The FIGHT/FLIGHT response can kick in at different times for different people, depending on the individual’s personal threshold
  • The time it takes to return to a normal state after intense emotional activation varies among people

Why do we have Emotions & what are the basic types?

Emotions

  • There is a difference between basic emotions & newer (social) emotions. Basic emotions are emotions that exist in all mammals, while newer emotions exist in more developed primates & humans
  • Basic emotions are localized in the same area in the brain, evoke the same physical reactions & each of them are linked to a set reaction pattern

Seven basic emotions

1.Interest & Curiosity, Exploratory behaviour

2. Fear

3. Anger

4. Sexual Lust

5. Separation anxiety/sadness

6. Love/Caring

7. Play/Joy

Seven basic emotions

  • These feelings have been shown to be important with respect to survival & reproduction
  • We do not need to learn these emotions or reaction patterns because they are determined by nature
  • They supply us with automatic responses that have been important for human survival over the course of 100 millions of years

Interest & Curiosity, Exploratory Behaviour

This motivates us to find out useful information about our surroundings (e.g. what resources are available, where food & water can be obtained, whether there is a safe place to hide, whether there are any sexual partners around etc.)

Fear

This stimulates us to ask ourselves questions such as: is what I am facing dangerous; can it injure me; could it kill me; is he/she a rival who is stronger than I am; is he/she an enemy? When the fear becomes intense enough & the source seems stronger than oneself, it prompts our decision to flee or submit. Fear can also prompt us to freeze/play dead if the threat is overwhelming & we are in mortal danger.

Anger

If we identify someone or something that is standing our way, we may show anger & see if he/she submits. If the person resists, the intensity of anger will increase & possibly lead us to attack

Sexual Lust

This encourages reproduction & the continuation of one’s genes

Love/Caring

This motivates us to care for our offspring, family, partner & friends

Separation anxiety/Sadness

These emotions function as an appeal for others to take care of oneself. They signal to potential caregivers that one is in danger/in need of protection or that one has become isolated from the group/family, or that one has lost someone close who one depends on

Play/Joy

This stimulates interaction with others so that one remains a ‘pack animal’ rather than a hermit, increases our skills of interacting with others, introduces the limits to one’s own excitement, & enables the development of strategies for dealing with anger through rough & tumble play

  • Humans, unlike other animals have the ability to suppress the feelings of emotional reactions. That is why the relationship between emotions & feelings sometimes seems obscure
  • Because of their upbringing & socialization, people can be distanced from their natural, emotional reactions. This means that people can react emotionally, but that they do not necessarily feel their emotions. Emotions can be suppressed. You can therefore be emotionally activated, but at the same time be unaware of the specific nature of the emotions involved

How do we register & regulate emotions? Metalizing emotions

How do we register emotions in others?

  1. By interpreting others ‘Facial expressions’ (The soul’s Mirror); this is consistent across all cultures &, to some extent, across animal species. We also interpret others body language, what they do & say. This is external mentalizing that was discussed in the beginning of the blog.
  2. Via identification. There are nerve cells called MIRROR NEURONS in the brain that enable us to experience what someone else is experiencing when they do or feel something. For example, when we see another person feeling sad, we can become sad ourselves. This is part of the basis of Empathy

Emotional Regulation

Role play: Consoling another person

  • One person is to act being emotionally upset, perhaps a mixture of disappointment & anger
  • The other person is 1) to find out what feelings the person has; 2) to find out why she/he feels this way; 3) to try to console the person.

(My opinion – Try this with a friend to help find your emotional state, in any circumstances, try this role play. It works to help you locate your actual emotional state rather than just the anger or sadness)

Impaired Emotional Regulation

Impairment means that one is stuck in a painful, uncomfortable & often unclear emotional state & resorts to dramatic means (such as getting drunk or self harm) to escape it

This significance of attachment relationships

Attachment

  • Attachment refers to a positive emotional bond with another person
  • This first attachment relationships are with your parents/caregivers & other family members. These attachment relationships will later influence your relationships & interaction patterns with others, for good & for bad
  • Humans can have different attachment patterns. In children, this is tested by observing how the child reacts when it is separated from the attachment person, which is most often the mother. In the test situation, the mother leaves the room after a while & leaves the child alone; then an unfamiliar person (observer) enters the room. The situation of being both abandoned & in the same room with a complete stranger triggers separation anxiety & fear in most children. An observation is made about how the child deals with this situation & how he/she reacts when the mother enters the room again after some time

Secure Attachment

  • Children with so-called SECURE ATTACHMENT, react with unease & protest when the mother is about to leave, but relax after a while & start to play with some of the toys in the room. When the mother returns, the child goes to the mother & will often whine a bit, but will quickly calm down, possibly by sitting on her lap. After a short period of time the child will usually resume playing.
  • There are two types of insecure attachment patterns:
  • An AMBIVALENT or OVERINVOLVED type
  • A DISTANCED type

Insecure Attachment (The Ambivalent/Overinvolved pattern)

  • In the AMBIVALENT/OVERINVOLVED pattern, the child is insecure about his or her attachment person – In all likelihood with good reason, because the person has behaved unpredictably (i.e. has been erratic in response & presence). In order to attract the attachment person’s attention, the child has therefore learned to exaggerate his or her emotional expressions (e.g. they express an excessive amount of unease & crying). When such a child is abandoned in the test situation, he or she cries loudly & clings to the mother when she is about to leave the room. The child then has difficulty quietening down & playing while the mother is away. And when the mother returns, the child is Ambivalent in relation to her, cries & protests when she wants to pick the child up, but quietens down gradually. It takes a longer time for the insecurely attached child to start playing again after this experience. It is if the child needs to hold onto mother for fear that she will leave again

Insecure Attachment ( The distanced pattern)

  • The other insecure pattern is called DISTANCED. It is in many ways the opposite of the ambivalent type. While the ambivalently attached children have exaggerated emotional reactions, the distanced children exhibit little response. They are detached. They do not react at all on being abandoned in the test situation. It is as if they do not care whether the mother leaves or returns. When these children’s physical responses are measured, they have been shown to be stressed in the situation, but they EXPRESS this stress to A VERY LITTLE DEGREE. They have learned to overregulate their feelings. They may have experienced that their feelings are commonly overlooked, consistently misunderstood & thought to be something else, or they may been ridiculed or tormented for what they were feeling, or experienced other negative consequences

Attachment & Mentalization

A Mentalizing Culture

  • Growing up in a mentalizing culture promotes a secure attachment which facilitates a person’s mentalizing abilities
  • A Mentalizing culture implies a culture with frequent discussions about people & why they behave the way they do, including why people do what they do within the family, for example. A mentalizing culture is necessary to manage any significant events that affect anyone in the family. Discussion about experiences needs to be done with a reasonable degree of open-mindedness, minimal certainty & without triggering any oppressive family taboos
  • There can be consequences for a person’s mentalizing abilities when the relationship to an attachment person is problematic or simply bad
  • There may be many reasons for such a situation. The attachment person may not have been available physically or mentally, the person may not have had ability to listen, to understand or be empathic. There may have been, & indeed still be, someone else in the way (sibling, other parent); the person may not have had good caregiving skills or there was an environment of mental or physical abuse or substance abuse
  • The end result is often ATTACHMENT CONFLICT

Attachment Conflict

  • Attachment conflict means that one inhibits or exaggerates signals about one’s emotional state because one fears or is insecure about what will happen if one calls for the attachment person
  • Attachment conflict means that an impulse to get closer is inhibited by something else (e.g. fear of punishment, or own wish to punish)
  • Attachment relationships are important, in order for the child to become aware of their own emotional states, find out the reasons for them, & use emotions to orient themselves in a mental landscape
  • Attachment conflicts inhibit a child’s mentalizing abilities right from the start, & leave behind emotional scars & confusion. They undermine the child’s ability to deal with attachment conflicts later in adult life
  • Impaired mentalizing ability makes it difficult to deal with conflicts in close relationships (e.g. thinking often becomes black-white, & emotions will tend to overwhelm to the ability to think, etc)

What is a Personality Disorder? & What is Borderline Personality Disorder?

(Id like to just say this part is in my opinion the most important part in the entire Blog, This section holds true meaning to myself & this section is the key to understanding BPD)

  • A person has a personality disorder when the person’s personality features a certain number of maladaptive personality traits, which are typical ways of thinking, feeling, regulating impulses & relating to other persons. The traits need to have been characteristic of the person since at least late adolescence or early adulthood & have been relatively consistent since that time
  • Personality traits typically affect self-image & self-esteem, but also influence ways of thinking about others, & will usually cause problems in schooling, work &/or family life (e.g. being shy, not self-assertive, extremely suspicious, dependent on others, uncontrolled temper, always avoiding conflicts, etc.)
  • A personality disorder does not affect the entire personality. One can have many good & positive personality traits & many talents in addition to those that are problematic. For example, Edvard Munch clearly suffered from a personality disorder. He was an extremely skilful & innovative painter, but a difficult person in the sense that he had problems interacting with other people
  • Personality disorders are not necessarily permanent. Many traits can change with age, which usually results in a person becoming more relaxed, less intense & learning to deal with situations in a better way. Problems can pop up again during times of stress, however (for example, in connection with work problems or problems in close relationships, e.g. separation & divorce). Personality disorders improve quicker through treatment, for example, through mentalization-based treatment
  • Personality disorders arise as a result of a combination of Genetic Influences (Temperament & Vulnerabilities) & negative environmental influences during childhood. Depending on the balance of these factors, certain characteristics come to dominate our ways of relating to others & these, in turn, define the different personality disorders

What is a Personality Disorder

  • SCHIZOTYPAL PD: Very shy & suspicious, few friends, bizarre views

  • SCHIZOID PD: Flat affect, little need to be together with others, prefers doing most things alone

  • PARANOID PD: Suspicious, uncompromising, & temperamental

  • ANTISOCIAL PD: Repeated criminal acts, ruthless, aggressive, little capacity for caregiving

  • BORDERLINE PD: Unstable relationships, unstable emotions, fluctuating self-image

  • NARCISSISTIC PD: Grandiose sense of self, arrogant, lacking in empathy

  • HISTRIONIC PD: Theatrically, exaggerated expression of emotions, plays on sexuality, constantly draws attention to self

  • AVOIDANT PD: Anxious, inhibited in new interpersonal situations, reluctant to take personal risks, excessively fearful of criticism or ridicule

  • DEPENDENT PD: Lack of self-confidence, goes to excessive lengths to obtain nurturance from others, constantly needs advice & reassurance from others

  • OBSESSIVE-COMPULSIVE PD: Rigid & stubborn, preoccupied with order & schedules, difficulty delegating tasks to others, perfectionist

  • PERSONALITY DISORDER NOT OTHERWISE SPECIFIED: Insufficient traits to meet the threshold for any one of the above personality disorders, but has several traits from many personality disorders

Criteria for Borderline Personality Disorder

  • Intense & Unstable relationships, alternating between extremes of idealization & devaluation. Quickly enters into new romantic relationships, idealizes the person, & allows himself or herself to be seduced or infatuated, which reduces his or her social judgements; does the opposite when the negative where before they could only see the positive
  • Has difficulties with being alone & strong feelings associated with being abandoned. Therefore he/she carries out desperate efforts to avoid being abandoned, e.g. allowing himself/herself to be treated poorly, acting submissively, carrying out dramatic acts such as injuring himself/herself or threatening to commit suicide
  • Identity problems: Fluctuating self-esteem, unstable self-image, constant changes in life-goals, difficulties in holding on to one’s inner core self
  • Impulsivity that can be self-destructive (i.e. impulsive risk-taking): e.g. purchasing things one can’t afford, driving & recklessly &/or above the speed limit, acting on poorly considered decisions, promiscuity, abuse/misuse of alcohol & narcotics, etc
  • Self-destructive acts such as self-mutilation & suicide attempts (to regulate painful emotional states)
  • Recurrent feelings of inner emptiness & meaninglessness
  • Constant mood swings: e.g. fluctuating between intense dysphoria & euphoria in a single day, or between positive moodiness & sadness, bitterness or anger
  • Intense anger that is difficult to control (e.g. that may result in throwing things, swearing or physical fighting)
  • Reacting with suspiciousness or a feeling of being outside of oneself when stressed

On Mentalization-Based Treatment Part 1

  • Is to improve a person’s mentalizing ability in close relationships
  • Improved mentalizing ability means that the person experiences having a more stable inner core self, that the person is less likely to let emotions get the better of himself/herself, & when this happens, that he/she is more quickly able to regain his/her composure, i.e. the person is more robust emotionally, less vulnerable to interpersonal conflicts & better able to deal with arising conflicts

How does Psychotherapy enable people to achieve this?

  • Psychotherapy means that one talks about one’s innermost problems with another person &/or several other people. In this way, one becomes more aware about oneself & one’s feelings & how one relates to others. This is a benefit in & of itself, because in general the person has been left on his or her own to figure this out & may have gone astray in these thoughts & feelings
  • It also deals with getting closer to other people, about letting others into one’s life, i.e. daring to trust others & make bonds to others, letting others become significant in one’s life

***MentalizationBased Treatment ***

  • MBT involves practicing mentalizing skills in close relationships
  • MBT therapists provide little direct advice. They try to engage the patients in a mentalizing stance &, in doing so, help the patient gradually develop their own solutions having reflected on their problems in increasing detail
  • Mentalization-Based Treatment is based on practicing mentalizing skills together with the therapist & other group members
  • The mentalizing group therapy can be described as a training arena for mentalization & requires the following from each individual participant:
  1. That they regularly bring in (tell about) events from their own lives, preferably recent events, resulting in poor mentalizing (strong or confusing feelings, impulsive actions poor conflict resolution, etc.) or in which the person has been subjected to stress. (Particularly in relation to others) that put high demands on mentalizing ability
  2. That they try to understand more about these events using a mentalizing stance (exploratory curious, open for alternative understanding, etc.)
  3. That other group members participate in this process by exploring their own problems & those of others through a mentalizing stance
  4. That everyone together tries to find out about events in the group in the same way
  5. That they try to bond to the group, its members & the therapists

On Mentalization-Based Treatment Part 2

Attachment in MBT

  • Bonding is a significant aspect of MBT
  • This is done through establishing attachment to the therapists & the other group members
  • Making attachment to others activates difficult emotions & represents a challenge to one’s mentalizing endeavours
  • It is important to consider how one’s reactions to feeling upset by others might “go underground” instead of being spoken about

Anxiety, Attachment & Mentalizing

Anxiety & Fear

  •  Anxiety is intimately connected to fear
  • Fear is indispensable for survival in a dangerous world; it signals danger & turns on an animals ‘Alarm button’, schematically activating a preparedness for fight or flight
  • The threshold at which fear stimulates a fight & flight reaction & the intensity of the response varies between individuals. To a large extent this is a matter of temperament. Some individuals are more intrinsically fearful than others

Considering simple phobias

  • The word phobia is derived from the Greek word “Phobos” & means simply fear
  • Simple phobias are fear of specific things, animals or situations. It might be spiders, snakes, knifes, lifts, tunnels, etc
  • Most people will experience fear in an encounter with a snake. Reacting emotionally when encountering a snake is not evidence of an illness; it is a natural & purposeful reaction that is grounded in evolution
  • If the mere sight, or thought of a snake elicits panic, however, or if one harbours a constant fear of encountering a snake in European countries, it approximates a phobia. The fear reaction is stronger than normal & will lead to troublesome consequences for the individual

Unspecified Anxiety

  • One may experience unspecified anxiety where the source of the emotion is unknown. In such cases we assume that the source is forgotten & that it is buried in unconscious layers of the mind
  • The intensity of fear can be strong that the physical & mental processes may not handle it properly. The autonomic nervous system can become overloaded causing the individual to experience a panic attack: increased heart rate, difficulties breathing, dizziness, fear of fainting, dying, or going mad, or simply losing control, etc

Agoraphobia

  • Individuals may attempt to avoid triggers for panic attacks. Often these will be situations packed with people & perceived difficulties with the escape route, such as buses, trains, shops, restaurants, etc
  • If one avoids such situations to the extent that this avoidance has significant negative consequences, we would describe the individual as suffering from AGORAPHOBIA (agora being the greek word market place)

Social Phobias

  • Fear of exposure & embarrassment in the presence of others
  • Social phobias are closely connected to excessive performance anxiety, which may prompt the individual to avoid social gatherings such as parties, restaurants, group seminars or situations where the individual feels a burdensome obligation to perform in some way

Other Phobias

  • Generalized anxiety, in which the individual is tense & worried about problems with daily living
  • Obsessive-Compulsive anxiety with its obsessions & rituals
  • Post traumatic anxiety, in which the individual is exposed to painful re-experiences of traumatic memories

Treatment of Anxiety

  • Treatment of anxiety disorders involves controlled exposure
  • Exposure to the anxiety triggering situation in itself is usually not enough. It is necessary for it to be done in a manner that implies an experience of mastery & control, not defeat

Fear & Attachment

  • By default, children’s natural reaction when experiencing fear is to turn to their attachment figure or another secure person who they trust
  • The natural reaction of this person is generally to take care of the child & calm him/her down
  • Multiple experiences of this kind informs the child that fear is an emotion that can be handled
  • However, this interaction will not always be ideal, for different reasons, & this can leave the child continuing to feel frightened or feelings that it is useless or worse than useless to approach others, leading to the conclusion that fear has to be handled by oneself alone, or even that one has to hide one’s experience of fear

Anxiety, Attachment & MBT

  • The best remedy for anxiety is a calming other person
  • The very act of approaching another person when experiencing anxiety is significant because it is the attitude that patients are encouraged to develop towards the therapists & the group members in the MBT programme
  • As has been said before in MBT it is important to try to bond with the therapists & the group members
  • This requires that one “brings in”, talks about in the sessions, things that one fears, including things that happen within the sessions that activate fear. THIS IS EASILY SAID, BUT MAY BE DIFFICULT TO DO
  • When trying to be open with respect to one’s anxieties, one will often experience a kind of resistance within oneself. It may be related to the fact that fear is often connected with shame, or that one gets an uneasy feeling of being childish & helpless, or that one does not trust that the other has the capacity to be helpful, etc

Depression, Attachment & Mentalizing

Depression & Separation Anxiety

  • Depression is associated with a basic emotion -separation anxiety & sadness
  • This is also a natural reaction related to a break in what we call the attachment system
  • All children who have established an attachment relationship will respond with separation anxiety when they are abandoned & with sadness when the person they miss does not return when expected
  • Separation anxiety is a natural part of a type of protest phase & that it is connected to crying & screaming which are used to attract the parent’s attention
  • Sadness belongs to a later phase in which the protest has not had the desired result. When this is because of the death of the caregiver or a close person, then we refer to it as a grief reaction

Greif Reaction & Depression

  • An intense grief reaction is quite similar to depression, although qualitatively different
  • Individuals vary with regard to what they react to in terms of sorrow, how strong their grief reaction is & how long it lasts. In most people, the emotion passes after a time & the individual is able to adapt to his/her new life circumstances relatively quickly; but when the emotion remains intense for a longer time, we refer to it as a depression
  • In depression the person is sad & low in mood, tired & with low self-esteem & has ruminative thoughts, feels profoundly negative about life & often guilty. The person has difficulties concentrating, life seems meaningless & there seems to be little hope for the future. The thought of giving up on life may not be far away
  • The relationship between depression & grief reaction is therefore quite close. This hypothesis is supported by research on large population studies. The loss of someone dear is the most common trigger for depression. It does not need to be a death. It could be that someone travels away for a long period of time, that you yourself are sent away, that the attachment person is ill & unavailable, that one’s parents divorce or that one moves away & loses close friends. It may also involve the loss of social standing & social position, or being disgraced in public in some way
  • If a person has first experienced a serious loss at a young age that has led to a poorly processed grief reaction, one will be more disposed to reacting with depression after a loss in adult age. And the more depressive episodes one has had, the easier it is to experience it again. It is as if one establishes an automatic response pattern to stress & discomfort. The response pattern, a depressive reaction, may also be triggered by things other than loss, but we think that it is in relation to the loss of an attachment person that the reaction pattern is established as part of evolution. Other things that can trigger depression are general stress & physical illness, as well as factors of which we are still unaware

Treating Depression

  • Most depressive episodes resolve themselves, while some are never completely resolved
  • The person can continue in a chronic state, which is not as serious in terms of risk as when the depression was at its worst, but is characterized by constant low spirits in which the person has difficulty feeling happy about anything. The individual has low self-esteem & is pessimistic in all aspects of life, including about the future
  • Depressive episodes pass quicker with treatment & many chronic depressions can be normalized with treatment. Serious depressions should be treated with medication, with so-called antidepressants
  • Antidepressants can also be effective for panic attacks & they can also reduce strong mood swings that are due to general emotional instability
  • Many people with BPD have taken antidepressants in the past & may still be on medication
  • When someone takes part in a comprehensive treatment programme such as the MBT, they should take advantage of the situation by reducing or ending the antidepressants treatment if possible.This should be done after the treatment is well underway, & the person feels more in control of his/her life. The reason for this is not only that one should learn to deal with life’s difficulties without medication, but also because antidepressants have a tendency to blunt emotions. This is particularly true for sexual desire. Accessibility to one’s emotions is important in order to get the most out of this treatment programme

Depressive Thinking

  • The term “depressive thinking” refers to a seat of automated thought patterns that tend to accompany a depressed mood & which can establish themselves as part of “normal thinking” after repeated depressive phases or when a depressive state lasts for a long period of time
  • It refers to thoughts that quickly pop up with content such as “everything is hopeless”, “nothing helps”, “it’s impossible for me”, “I am hopeless” etc. Depressive thoughts such as these, which are often the result of adverse life experience, may in themselves sustain a depression or a depressive tendency

A Mentalizing Approach to Depression

  • The mentalizing approach to understanding the difficulties of individuals with depression is to view these cognitive distortions as acquiring overwhelming potency because of mentalizing failure
  • The low mood acts directly on mentalizing capacities, thereby shutting down the mental processes that are needed to recover from depression
  • Being able to question fixed negative thoughts is an important part of mentalizing & to recover from depression patients need to begin to mentalize

(Id like to say thank you for anyone who read this entire blog on MBT. This therapy has changed my life for the better. I’m currently has I post this I’m 7 months into my 13 month programme, But with this therapy you don’t have to wait till the end to be able to speak on it, MBT is the best treatment for BPD in my opinion, it is the hardest thing in the world for BPD but its also the greatest thing to achieve). Please feel free to leave any feedbacks or comments

 

 

 

 

 

 

 

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