Mentalizing Bodies: Explicit Mentalizing Without Words in Psychotherapy

Abstract

Introduction: Mentalization concerns the human ability to understand the actions of others (and oneself) in terms of intentional mental states. Theoretically, the notion has been described via the poles of automatic, non-verbal implicit mentalization as opposed to conscious and verbal explicit mentalization. In this article, we challenge this standard distinction by examining examples from psychotherapy. We argue that explicit mentalization can also be carried out via embodied non-verbal actions.Method: Four cases of real-life interaction from psychotherapy sessions are analyzed from the qualitative perspective of embodied cognition and multimodal interaction analysis. The analyses are based on video data transformed into transcriptions and anonymized drawings from a larger cognitive ethnography study conducted at a psychiatric hospital in Denmark.Results: The analyses demonstrate the gradual development from predominantly implicit mentalizing to predominantly explicit mentalizing. In the latter part of the examples, the mentalizing activity is initiated by the therapist on an embodied level but in an enlarged and complex manner indicating a higher level of awareness, imagination, and reflection. Thus, the standard assumption of explicit mentalization as contingent on verbal language is challenged, since it is demonstrated how processes of explicit mentalization can take place on an embodied level without the use of words.Conclusion: Based on real-life data, the study demonstrates that online processes of implicit and explicit mentalization are gradual and interwoven with embodied dynamics in real-life interaction. Thus, the analyses establish a window into how mentalization is carried out by psychotherapists through interaction, which testifies to the importance of embodied non-verbal behavior in psychotherapy. Further, informed by the notion of affordance-space, the study points to alternative ways of conceptualizing the intertwined nature of bodies and environment in relation to conveying more complex understandings of other people.

The role of interpersonal coordination dynamics in alliance rupture and repair processes in psychotherapy—A systematic review

“…Such a system could support the use of timely and contingent interventions and support management, emotion regulation, and meaning-making during challenging events beyond conversational content during sessions ( Safran, 2003 ), and might help prevent deterioration and premature drop out ( Eubanks et al, 2018 ; Wiltshire et al, 2020 ; Deres-Cohen et al, 2021 ). The knowledge could be integrated into our theoretical models to outline more explicit intervention strategies for the more implicit processes during therapeutic interaction, which could be integrated into the training and supervision of psychotherapists ( Kleinbub et al, 2020 ; Jensen et al, 2021 ). Nevertheless, it remains unclear to what degree clinicians are able to consciously adapt interpersonal coordination strategies into their clinical models and what the gains of this would be which is still a question to be answered in the future ( Kleinbub, 2017 ).…”

Evaluation of the Danish version of the prenatal parental reflective functioning questionnaire in early pregnancy as a screening tool

“…It is likely that structured observation of interactions could yield a more accurate assessment of reflective function. Observational measures are of particular interest because they have the potential to assess on‐going mentalization as a live process (Fogtmann Fosgerau et al., 2018; Jensen et al., 2021). Further research is needed to achieve more insight regarding this problem.…”

Irony detection, implicit and explicit response biases in patients with borderline personality disorder

“…Both findings emphasize the relevance of a shared and open discussion of the possible inferences BPD patients may draw from social interactions. But they also stress the vital role of non-verbal, embodied treatments beyond talking therapies (Fonagy et al, 2017b;Jensen et al, 2021), such as dance movement therapies (Kleinlooh et al, 2021). Explicit mentalization is not a fully abstract process, but inherently interwoven with implicit, bodily intersubjectivity (Fuchs, 2013;Gallese, 2014).…”