How Does Mentalization-Based Therapy Work?

  • 29 Nov 2022
  • General

Mentalization-based therapy (MBT) is an evidence-based psychotherapeutic approach for borderline personality disorder. It is derived from both traditional psychoanalytic concepts and new knowledge from attachment and social cognition research.

What is Mentalization Based Therapy (MBT)?

Mentalization-based therapy (MBT) is a type of long-term psychotherapy. It helps to make sense of your thoughts, beliefs, wishes and feelings and to relate them to behavior. In short, MBT aims to develop a person's mentalizing capacity.

What Can Mentalization-Based Therapy Help With?

Mentalization-based therapy can help with:

  • Eating disorders
  • Drug addiction
  • Borderline personality disorder
  • Depression
  • Trauma
  • Personality disorders

What are Mentalization-Based Therapy Techniques?

The main techniques used in mentalization-based therapy are as follows:

Support and Empathy

Support and empathy strengthen the cohesion and therapeutic relationship that is a fundamental foundation of MBT. The therapist should be able to provide support and give autonomy to the client to bring about change in the person.


To understand the behavioral sequences and associated emotions in detail, the therapist needs to clarify and elaborate them. Thus, the explanation helps the client make connections between actions and feelings.


It is a technique that helps the client share the therapist's perspective and consider alternative experiences of the same event.


Transference is often used in mentalization-based therapy to guide the client to analyze their emotions.

How Does Mentalization-Based Therapy Work?

People who come for MBT are often emotionally disorganized and insecure. Thus, the therapist aims to establish a secure foundation for promoting healthy mentalization and emotional regulation. Throughout treatment, therapists monitor the client's levels of mentalization, emotional arousal, and attachment. The aim is to encourage adequate emotional response to explore new perspectives and find meaning.

The therapist explores the person's ability to maintain and heal mentalization when faced with interpersonal emotional events. In therapy, developmental events and attachment figures are discussed to assess how well a person is able to mentalize close relationships and when the ability to do so is impaired.

When mentalization is seen to be weak, the therapist intervenes with opposing movements and encourages the client to find the missing point of view. This method helps the client learn to find a balanced perspective. At the end of therapy, the person may expand their viewpoints that are overly rigid, reactive, unrealistic, and emotionally empty. At the same time, they can learn more appropriate interpersonal behaviors.


How Long is the Treatment Period?

Mentalization-based therapy sessions last 60 minutes. Group sessions last between 75 and 90 minutes, depending on the treatment program. Treatment programs can last from 12 to 18 months. This period is completely personal.

How is the Efficiency of The Therapy?

Clinical studies have shown that mentalization-based therapy is an effective treatment for borderline personality disorder. At the same time, symptom improvement was observed years after the end of treatment.

Ongoing research shows that the therapy in question; It also shows that it is effective in many other conditions such as antisocial personality disorder, eating disorders, depression and drug addiction.

What are the Risks and Side Effects?

Mentalization-based therapy is not a quick fix. It can also be difficult to talk and think about emotional issues. You may feel anxious about speaking in a group. This is why some people may feel worse before they feel better. However, apart from this, the therapy does not have any risks or side effects.

How to Become a Mentalizing Therapist

You should work with a licensed therapist who understands borderline personality disorder and has training and experience in mentalization-based interventions. In addition to finding a therapist with the appropriate educational background and relevant experience; It is also very important to find a therapist with whom you feel comfortable with personal, family and relationship issues.

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