Day 2 Assessment, diagnosis and treatment of personality problems in youth Carla Sharp, Ph.D. csharp2@uh.edu Agenda 8:00-8:30: Recap of Day 1 8.30-10:00: Developmental theory 10:00-10:30: Break and refreshments 10:30-11:30: Examples from your work settings 11.30-12.30: MBT: Core components 1
Agenda 8:00-8:30: Recap of Day 1 8.30-10:00: Developmental theory 10:00-10:30: Break and refreshments 10:30-11:30: Examples from your work settings 11.30-12.30: MBT: Core components Recap of Day 1 • 3 things that you remember • 3 frustrations or confusions 2
Agenda 8:00-8:30: Recap of Day 1 8.30-10:00: Developmental theory 10:00-10:30: Break and refreshments 10:30-11:30: Examples from your work settings 11.30-12.30: MBT: Core components Developmental theory: A mentalizing lens 3
https://www.youtube.com/watch?v =8hLubgpY2_w • “The capacity to reflect on one’s own thoughts and feelings and those of others to predict and understand behavior” • People can change their minds/I can change my mind. • Things are not always as they seem/things are not always as I think they are. • Promotes uncertainty and curiosity; seeks clarification; not-knowing. 4
A working definition of mentalization Mentalizing is a form of imaginative mental activity, namely, perceiving and interpreting human behaviour in terms of intentional mental states (e.g. needs, desires, feelings, beliefs, goals, purposes, and reasons). Mentalizing 1970s 1980s/1990s 1990s/2000 1990s/onwards 1990s/onwards Mental elaboration/ Theory of mind Theory of mind/ Mentalizing Mentalizing symbolization mentalizing 5
120 100 Number of Publications 80 60 40 20 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Year 6
Mentalizing vs related constructs https://www.youtube.com/watch?v=NLT7ieO3h Tk 7
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Implicit/automatic Explicit/controlled • • Perceived/Felt/Acted Interpreted • • Emotional Resonance Explained • • Empathy (Match) Perspective • • Non conscious Conscious (or potentially conscious) • Procedural • Can be verbalized • Non verbal • Reflective (coherence) • Non Reflective • Slower, sequential, requires • Fast, requires little effort, attention, intention and effort focused attention or intention • Inhibited by arousal • Facilitated by arousal 9
Wife: My darling, did you remember to pick up the dry cleaning? Husband : Oh no. I forgot. I’m sorry. Wife (feeling annoyed and thinking that he did not really want to do it in the first place): Oh no! I need the black dress for tonight’s work function. I wish you told me that you weren’t going to pick it up and I would have made an effort to pick it up myself. Husband: I just told you I forgot. I meant to pick it up. I’m really sorry. Wife (remembering the last time her husband forgot to pick up one of the children from soccer practice): When I asked you, you looked like you didn’t really want to do it. I could have easily swung by to pick it up if you’d been honest about it. I’d much rather you don’t commit to help out if you don’t think you can follow through. At least then I know I need to get it done myself. Wife: My darling, did you remember to pick up the dry cleaning? Husband: Oh no. I forgot. I ’ m sorry. Wife (feeling annoyed thinking that he did not really want to do it in the first place): Oh no! I need the black dress for tonight ’ s work function. I ’ ll make a plan … . but listen, can I talk to you about a broader issue this relates to? Husband: Sure. What ’ s up? Wife (remembering the last time her husband forgot to pick up one of the children from soccer practice): I know I might be completely off base here, but when you forget to do something like pick up the dry cleaning after we agreed you ’ d do it, it makes me feel that I or our family is not a priority. It might just be some insecurity on my part, but our relationship is important to me and I want to get your perspective on this. 10
You wake up in the middle of the night from a noise downstairs. As you tip-toe into the living room, you see that the window has been broken and a stranger is busy rummaging through your drawers. When the stranger turns around towards you, you notice that he is carrying a knife. 11
Cognitive mentalizing • Leslie (1987): meta-representations – an agent – an informational relation that specifies the agent ’ s attitude (pretending, believing, desiring, and so forth) – an aspect of reality that grounds the agent ’ s attitude – the content of the agent ’ s attitude. • <I BELIEVE (of) you think (that) “ I ’ m being mean on purpose ” >. • “ Thinking ” language Non-representational thinking M-reprentations/metacognitive thinking “She wants to be friends with me” She would like to be friends with me” “We could be good friends” “He was going to call me last night” “We had it all figured out last time we talked” “She is upset” 12
Non-representational thinking M-reprentations/metacognitive thinking “She wants to be friends with me” “I think she wants to be friends with me” She would like to be friends with me” “We could be good friends” “He was going to call me last night” “We had it all figured out last time we talked” “She is upset” Non-representational thinking M-reprentations/metacognitive thinking “She wants to be friends with me” “I think she wants to be friends with me” She would like to be friends with me” I wonder if she would like to be friends with me” “We could be good friends” “He was going to call me last night” “We had it all figured out last time we talked” “She is upset” 13
Non-representational thinking M-reprentations/metacognitive thinking “She wants to be friends with me” “I think she wants to be friends with me” She would like to be friends with me” I wonder if she would like to be friends with me” “We could be good friends” “I believe we could be good friends” “He was going to call me last night” “We had it all figured out last time we talked” “She is upset” Non-representational thinking M-reprentations/metacognitive thinking “She wants to be friends with me” “I think she wants to be friends with me” She would like to be friends with me” I wonder if she would like to be friends with me” “We could be good friends” “I believe we could be good friends” “He was going to call me last night” “I thought he was going to call me last night” “We had it all figured out last time we talked” “She is upset” 14
Non-representational thinking M-reprentations/metacognitive thinking “She wants to be friends with me” “I think she wants to be friends with me” She would like to be friends with me” I wonder if she would like to be friends with me” “We could be good friends” “I believe we could be good friends” “He was going to call me last night” “I thought he was going to call me last night” “We had it all figured out last time we “I was under the impression that we talked” figured it all out last time we talked”. “She is upset” Non-representational thinking M-reprentations/metacognitive thinking “She wants to be friends with me” “I think she wants to be friends with me” She would like to be friends with me” I wonder if she would like to be friends with me” “We could be good friends” “I believe we could be good friends” “He was going to call me last night” “I thought he was going to call me last night” “We had it all figured out last time we “I was under the impression that we talked” figured it all out last time we talked”. “She is upset” “She seems to be feeling upset” 15
Affective mentalizing • https://www.youtube.com/watch?v=apzXGEbZht0 • Being “ present ” , “ in the room ” , “ connecting ” • Smiling, touching, synchrony, turn taking, sharing of joy, mutual attention, mutual engagement, containment, eye contact, physical closeness, touch, empathy and validation • Often unconscious/implicit but can me made conscious 16
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