Last week Orri’s Director of Research and Development, Dr Paul Robinson, presented a seminar on Mentalization-based Therapy for Eating Disorders to healthcare professionals in our network – the first of many CPD seminars hosted at Orri. Dr. Robinson, along with his peers Finn Skarderud and Bente Sommerfeld, has pioneered this developed approach to treating eating disorders (also abbreviated as MBT-E) and we run a weekly group at Orri for our clients.
What is mentalizing?
Mentalizing is the ability to be aware of what’s going on in your mind and what’s going on in others’ minds – and being curious about this process.
When you can mentalize, you see others from the inside and yourself from the outside, meaning, you have awareness of how you are behaving and how people experience you, and you can anticipate how people are feeling on the inside. You also understand misunderstanding – appreciating that there may have been a miscommunication or misinterpretation of a situation, for instance.
Theory of Mind (TOM) precedes mentalizing and is the process of attributing mental states (intents, desires, etc) to oneself and others. Emotional TOM (E-TOM) refers to the ability of being able to anticipate what someone is feeling. Theory of Mind begins quite early in development but by the age of 3 or 4, people can usually evaluate the intentions of other people.
What is Mentalization-based Therapy for Eating Disorders (MBT-E)?
MBT-E is the “systematic focus on the enhancement of these competences”. The approach has roots in psychodynamic psychotherapy and more specifically in relational practices and attachment theory.
MBT-E provides a space for clients to feel safe enough to challenge engrained beliefs and behaviours, and forge secure attachments with the psychotherapist which is the starting point – or “secure base” – for forming relationships outside of the therapeutic dynamic.
It is person-centred rather than disorder-centred, meaning that the psychotherapist will meet the person where they are in relation to their experience of the world and journey so far. The mentalizing tradition asks “how to reach those hard to reach” which is an approach found across all of Orri’s treatment.
Why does this therapy work for eating disorders?
People with eating disorders often talk of feeling separated from their bodies and struggle to identify their emotions and the related sensations in their bodies. Moreover, they often struggle to form and maintain relationships with clear and appropriate boundaries. MBT-E helps to encourage curiosity in others’ and ones own experience. It helps flexibility of mind; in thinking, emotions and relationships. Mentalizing bridges different therapeutic traditions: psychodynamic, cognitive behavioural, narrative and systemic approaches. It is specifically focused on the therapeutic relationship (reaching those hard to reach) and forming secure attachments.
How this treatment fits into Orri’s programme
Orri is unique in that it takes a flexible, stepped approach to treatment so that every person’s programme is appropriate to their individual needs and evolves with them over time. Our goal is always to heal the whole person by addressing the underlying causes of the eating disorder, this means that there is no one-size-fits-all approach, so we combine a number of approaches to address an individual’s needs.