Laurel L. Williams (editor) - Adolescent Suicide and Self-Injury: Mentalizing Theory and Treatment

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Mentalizing is a deceptively simple concept. In short, to mentalize is to reflect on mental states in oneself and in others []. Mentalizing is akin to the concept called Theory of Mind , as in a persons theory about what is in someones mind. To provide a more practical example of what is meant by this, imagine a friend calls to cancel plans abruptly for the second time in a row. We might first assume that they decided that they dont like us and dont want to see us after all. We might notice that they seem stressed. We could consider that they might have had a rough week and needed a night off. Perhaps an emergency came up and they no longer have time to go out. This example leads to two important observations: First, we notice that we are uncertain about the exact intentions behind these actions. This stance of uncertainty is characteristic of mentalizing. Importantly, because we cannot know for sure anothers mental state, mentalizing is an inherently imaginative activity. Second, mentalizing involves ascribing intentional mental states based on cues. This means that when we mentalize, we recognize autonomy. We acknowledge that a persons actions can be explained by their internal state. As we will see, there is quite a bit of complexity to the way we conceptualize mentalizing today. But first it is important to understand how our current understanding came about.

The term mentalize was first recorded in writing in 1807 and made it into the Oxford English Dictionary in 1906. In the 1960s, the concept of mentalizing was brought into the psychological world by psychoanalytic theorists. Freuds concepts of binding and physical working out set the stage for the appearance of mentalization []. In 1997, Lecours and Bouchard developed a model for mentalization based on this tradition.

In the 1980s, the term Theory of Mind (ToM) gained traction in the psychological realm. When coined by primatologists Premack and Woodruff, ToM was described as an individuals ability to attribute mental states to themselves and to others []. This coining was prompted by the discovery that chimpanzees can in fact infer the mental states of humans; when presented with a human struggling with a problem and given several photographs, one of which contained a solution to the problem, the chimpanzees consistently chose the correct photograph. In essence, in order to choose the correct solution, the chimpanzees had to recognize the intentions of the other. Shortly thereafter, work on ToM began in humans.

Much work on ToM in humans has been based on the concept of false belief. In short, a scenario is presented to a subject in which a character comes to believe something that the subject knows to be false. In order to arrive at the correct conclusions about the characters beliefs, the subject must be able to decouple mental states from reality. In other words, they must recognize that what is in their mind is not the same as what as in the minds of others. A wide range of research using this sort of task has revealed that we are not born with this understanding; rather, this ability develops between ages three and four []. Thus far, we have only looked at ToM as it develops naturally; studying the impact of nurture on mentalizing brought it into the realm of attachment.