Mentalizing : Competence and process

Abstract: Mentalizing means making sense of oneself and others in terms of mental states, such as thoughts and feelings. The Reflective Functioning (RF) scale is the golden standard in measuring mentalizing. This thesis aimed to explore the concept of mentalizing and its operationalization RF in different contexts and what RF means in human interaction. The first part of the thesis focused on capturing the applicability of RF in difficult situations of adulthood. The concept of mentalizing was studied as a trait capacity (in young criminal offenders and in mothers who reflected upon their relations to their children and upon limit setting in relation to their children). Findings in the first study indicated that mentalizing might be considered to function as a buffer against committing criminal acts. The second study showed that limit setting RF was more predictive of the mothers’ behavior, measured as emotional availability in interaction with their children, than their general RF concerning the child. In the second part of the thesis, mentalizing was investigated in therapy sessions and analyzed as a state and interactional phenomenon. In study III, therapist interventions were studied and found to be related to the degree of mentalizing that occurred in patient statements, implying that interventions that demanded mentalizing predicted higher levels of RF in patient statements. In study IV, a new instrument to investigate dyadic mentalizing (i. e. both patient and therapist together) was tested. In one of the cases studied, higher dyadic RF predicted patient rated symptom relief in the next session, indicating that dyadic RF might be a mechanism of change. In conclusion, the studies of this thesis suggest that mentalizing can be meaningfully viewed both as an individual competence and as an interactional phenomenon and that RF seems to be highly context- and relationship-specific.