Helping Your Client Learn Mentalization Skills

By Tamara McClintock Greenberg, PsyD

Sometimes clients seem to have trouble reflecting on their own thoughts in a neutral way. These clients may benefit from developing mentalization skills. Some researchers think mentalization may be a main underlying principal to explain mental health.

A lack of mentalization can present as:

• Clients who ask the therapist to tell them what to talk about
• Clients who may think others share the same thoughts as they do
• Clients who seem to lack empathy toward themselves and others

Mentalizing is a form of imaginative mental activity that allows us to interpret mental states, including needs, desires, feelings, and beliefs. It’s an overarching way to explain emotional reflection. Approaches to teaching mentalization skills are designed to help clients gain access to a more authentic version of themselves.

Some components of mentalization include:

• Realizing thoughts about others may not be accurate
• Focusing on the inside, not the outside
• A knowledge that we may not always know what our feelings are
• Curiosity and empathy toward others

If we identify that our clients can benefit from learning how to mentalize, we can compassionately address this.

I might say something like:

“I notice when you discuss your partner’s thoughts and feelings about you, you seem very certain. Is it possible that you don’t have all the information to confirm what you’re concluding? Maybe we could consider some other ideas?”

Or: “It seems like you spend a lot of time noticing things going on outside of you. What happens when your focus is more internal?”

By asking gentle questions, we can help clients focus more on their minds and develop an awareness that mental health involves states of ambiguity and not knowing, as well as curiosity about how their and other’s minds work.

Tamara McClintock Greenberg, PsyD, is a clinical psychologist and renowned expert in the treatment of depression, anxiety, trauma, and more. Her work has been published in HuffPost, Psych Central, Psychology Today, the San Francisco Chronicle, and she has been featured in Forbes, USA Today, Newsweek, Next Avenue (PBS), and The Washington Post. She has also been interviewed by major radio stations, including KQED’s Forum.