How Does Mentalization-Based Therapy Help Borderline PD?

Mentalization-based therapy (MBT) is a form of long-term psychotherapy used to treat individuals with borderline personality disorder. This approach draws on several different therapeutic models but is mainly focused on "mentalizing."

Mentalizing is the ability to focus on and differentiate between your own emotions and those of others, as well as understanding how your mental state influences your behavior. These cognitive functions tend to be limited in those with borderline personality disorder (BPD). So how exactly does mentalization-based therapy work, and what are the benefits for those with BPD?

Mentalization-Based Therapy and BPD

The ability to better regulate one's emotions is at the core of mentalization-based therapy. This is one of the many reasons why people with borderline personality disorder find this approach so beneficial.

Borderline personality disorder is a complex mental health disorder characterized by a pattern of difficulties with impulse control, emotional regulation, and instability in relationships and with the self. Self-harm and suicide attempts occur in 69-80% of patients with this disorder.

There are currently no medications approved by the FDA for the treatment of borderline personality disorder, although drugs can be prescribed to treat conjunctive psychological conditions, such as depression. Finding an effective treatment for borderline personality disorder is, therefore, incredibly important. This is where mentalization-based therapy comes in.

Mentalization-Based Treatment: Techniques, Goals and Benefits

As the name suggests, mentalization is the key aim of mentalization-based treatment. To "mentalize" is an essential skill as it helps us understand how our mental state is influenced by our actions as well as those of others.

The main benefits of mentalization are:

• It helps us understand our problems, as well as how we may influence them
• It gives us insight into our conflicts with others
• It helps us calm down when we are upset
• It allows us to relate to other people with empathy and compassion
• It helps us cope with conflict and change

In therapy, healthy mentalization acts a "secure base" from which healthy thoughts and behaviors can manifest. Your therapist will teach you mentalization techniques and ways of coping when mentalization is lost.

Monitoring

If you have borderline personality disorder, your therapist will closely monitor your level of mentalization during MBT sessions. This is because mainstream therapeutic techniques can actually result in emotional arousal or insecure attachment in patients with BPD. The goal of mentalization-based treatment is to stimulate enough emotional response so that you can explore new perspectives and ideas, but not so much that the emotional arousal becomes unmanageable.

Support strategies

Your therapist will deploy various support strategies (such as empathic validation) to help you develop trust between you and your therapist. The aim is that the relational dynamics you learn in MBT sessions will translate in your relationships outside of treatment.

Is Mentalization-Based Therapy Right for You?

Mentalization is thought to lie at the root of psychological health and resilience. However, studies show that people with borderline personality disorder are limited in their capacity to mentalize, which is one of the reasons why they struggle to tolerate intense emotions. Mentalization-based therapy can be extremely beneficial for individuals with borderline personality disorder, as it helps them regulate their emotions and reduces the likelihood that they will act on impulse.

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