Putting our Heads Together: Mentalizing Systems

Abstract

This paper proposes that mentalization is usefully understood as a complex, multidimensional capacity that develops and transforms over a lifetime, and that is constantly shaped by relational contexts. The accessibility and maximization of a person's capacity to mentalize is influenced by the dynamic interplay between that person's capacity and the capacities of the other members of that person's relational world. Complexity theory highlights the conditions that facilitate or impede emergent phenomena, like mentalization, and this enhances our understanding of subtle and selective difficulties in an individual's capacity. The value of viewing mentalization through a complexity lens is illustrated clinically.

Acknowledgments

I thank Max Sucharov for his support and help in formulating and refining the ideas in this paper. His ability to grasp my ideas, often before they were clear to me, enabled me to better understand what I was trying to convey.

Notes

¹Fonagy and his colleagues delineated several prementalizing modes of processing that precede mentalization—the psychic equivalence, pretend, and teleological modes of thinking about thinking. The psychic equivalence mode is defined as “one of the prementalizing modes of thinking in which reality is equated with mental states and the sense of representingness of mental states is absent” (Allen et al., 2008, p. 349) and the foundation from which development of mentalization proceeds.

²From the perspective of complex systems theory, Sucharov (2007) described the “window relational function” in which the analyst's presence supplies a “framework of orientation that can initiate a meaning generating dialogic process.” Sucharov emphasized that the analyst functioning in this manner does not simply provide a cognitive reframing of the patient's experience. Instead, he argued that the analyst functions as a “dialogic other” who provides a “window” into alternative ways of organizing traumatic experience. The dialogic organization of meaning is not a given, however, but is contingent upon a relational context of openness and acceptance. Sucharov's focus on dialogue is similar to Fonagy's emphasis on mirroring and affect marking, but has important differences grounded in a complexity model of the mind rather than an intrapsychic representational one. A full elaboration of the distinctions between these conceptualizations, however, is beyond the scope of this paper.

³My discussion of the differences between an intrapsychic model of the mind and an intersubjective process model is informed by excellent articles by Orange (2001,2003) and Sucharov (2002).

⁴Stolorow, Brandchaft, and Atwood (1987), and Gill (1975) critiqued the idea that transference is a distortion of reality. Stolorow and Lachmann (1980) highlighted the dangers associated with this view, especially that the “truth” of said distortions is generally determined solely by the analyst.

⁵This distinction between phenomenological and theoretical levels of explanation is elaborated by Coburn (2009), who writes, “despite however much we may feel a sense of ownership and/or authorship of our own emotional lives, it is the systemic context that gives rise to and defines such life.” (pp. 189–190)

⁶Emanuel (in press) demonstrated that an autistic person's reflective capacity is optimized by a therapist working from a contemporary relational model. Her work suggests that in asymmetrical systems, where the capacities of the therapist are significantly greater than the patient's, attending to relational process and context helps to maximize an autistic person's capacity to mentalize.

⁷See Cilliers (1998), Holland (1998), Coburn (2007, 2009), and Piers (2011) for helpful descriptions of the dynamics of complex adaptive systems.

⁸People are not the only constituents, or components, of a dynamic system. The capacity to mentalize is itself one component that dynamically interacts with other capacities such as attunement, attachment, and affect regulation, all of which shape each individual's subjective experience (M. Sucharov, personal communication, July 13, 2011). Thus, the term “constituents” refers to individual persons, their unique capacities, and other factors that dynamically affect the system.

⁹Just because an interaction is “preferred” does not necessarily mean that it is desirable or healthy.

¹⁰In outlining a complexity perspective on development, Galazer-Levy (2004) commented that most analytic theories have tended to focus on problems and solutions to those problems rather than on “the process of solution” and “the ability to construct a general context for problem solution” (p. 435).

¹¹ Bromberg (2011) also noted the relationship between enactments and the development of mentalization. He emphasized that mentalization is best facilitated through a therapeutic process that involves collision and negotiation. From his perspective the negotiation of these collisions between differing subjectivities allows for “the formation of a joint mental space in which dissociation was sufficiently surrendered to permit each person to reflect on the other's mind experiencing his own, and for that experience to become amenable to negotiation” (p. 56).

¹²Kerri's rebellious behavior reflects a form of pathological accommodation described by Brandchaft (Brandchaft, 1993; Brandchaft, Doctors, & Sorter, 2010) in which a person defiantly expresses herself and seems willing to sacrifice her relational ties in order to maintain her perspective, the opposite of what we normally think of as compliant behavior. Brandchaft emphasized, however, that behind such defiance is a “well of unfulfilled yearnings” (p. 82) for a relational tie that does not require self-annihilation.

¹³“Manipulation” is not a word I normally use clinically since it implies a judgment that does not tend to facilitate deeper exploration. In the context of our discussion, however, Kerri's use of “manipulation” conveyed something important about her capacity to reflect on and use her understanding of another person's state of mind.

¹⁴ Bromberg (2011) noted, “Enactments are always dyadic, which is why the analyst's ability to experience his own dissociation and his own shame are as intrinsic to the work as the patient's dissociated experience” (p. 80).