Lecture 4: Attachment, Mentalization And Epistemic Trust

Question 1

Interpersonal model of personality dynamics

Answer 1

This model does NOT primarily view personality as directly reflecting stable individual traits. Rather, it assumes that those who meet criteria for PDs are characterized by pervasive and persistent recurring intra-personal and inter-personal themes and dynamics

Question 2

Interpersonal field

Answer 2

A schematic depiction of the interactive field of two self-regulation individuals (e.g. client and therapist).

Question 3

Intentionality

Answer 3

Introduced into psychology by Brentano as the term for ‘aboutness’ as the mark of mental phenomena.
That is: mental phenomena are about something, i.e. intended at something.

Question 4

Intentional stance

Answer 4

A term from the philosopher Daniel Dennett. The assumption that intentionality is present in something (e.g. yourself, another human, an animal, the sun, etc.)

Question 5

Mentalization

Answer 5

The movement from a dualistic to a triadic perspective, i.e. from a cause-effect or stimulus-response understanding of the world, to the introduction of the assumption that others and oneself have a mental life with intentions that give reasons for actions. This movement is complex and hence mentalization is an umbrella term (see the article by Luyten).
The kernel of the possibility for mentalization is genetically coded, but the full skill is not present at birth.

Question 6

Attachment

Answer 6

In the lecture I refer directly to the PANIC/GRIEF neuro-affective system described by Panksepp – which is basically the same as the attachment system of Bowlby. I will explain that safe attachment, well-regulated attunement and repairs provide the basis for learning to mentalize (see article by Luyten)

Question 7

Natural pedagogy

Answer 7

Humans possess a species-specific capacity for the fast intergenerational transmission of cultural knowledge. Instead of having to work out cultural knowledge oneself, one can rely on the authority and perceived trustworthiness of the person communicating that information.
Importantly: this also goes for information about the self and the ‘me’, which we don’t invent ourselves but receive from others. Not passively, but by actively identifying with some others.

Question 8

Epistemic trust

Answer 8

It is simply ‘trust’, but then in particular the trust we need to learn from others and to give them a certain authority. We are not inclined to just trust anyone to provide us with valid information. A situation of epistemic trust enables a particular kind of species-specific learning. Thus the absence of epistemic trust makes learning (about the world, the self, etc.) really problematic.

Question 9

Epistemic hypervigilance

Answer 9

As such an important default trait in many contexts: do not trust anyone. This is the situation where we have repeatedly experienced the untrustworthiness of trusted authorities – e.g. parents. In this situation we tend to dismiss information about the world and ourselves from these sources. If this becomes a central trait it impedes development.

Question 10

what are the 5 aspects of the general model of intentionality and mentalization

Answer 10

• parental attachment
• parental mentalizing
• infant attachment
• child mentalizing
• cognitive and socioemotional development

Question 11

what are ostensive cues

Answer 11

verbal and nonverbal signs; trigger pedagogic stance, making recipients receptive to important communications

Question 12

what are 3 features of mentalizing

Answer 12

1. mentalizing is evolutionarily prewired in humans
2. mentalizing is multidimensional
3. mentalizing is an umbrella concept; many concepts fall under it

Question 13

what are 4 polarisations in mentalizing

Answer 13

1. automatic vs controlled mentalizing; play a key role in emotion/stress regulation –> increased stress/arousal leads to a switch from controlled to automatic
2. mentalizing with regard to the self or about others
3. mentalizing based on internal or external features of the self/others; inferring mental states or based on external cues (eg. facial expression, posture, tone of voice)
4. cognitive vs affective mentalizing; cognitive relies on controlled mentalizing, affective is quite automatic –> important to have balance/integration

Question 14

what are the 2 types of knowing the self and others in mentalizing with regard to the self or about others (polarisation)

Answer 14

1. shared representations system (SR) = empathetic processing relies on shared representations of other’s mental states, implicit/bodily based mirror neuron system, similarity of neural activation, allows to know how the other feels
2. mental state attribution system (MSA) = relies on symbolic and abstract processing, shaped by interpersonal relationships, regulation/correction of the SR system

Question 15

Parental reflective functioning (PRF)

Answer 15

= caregiver’s capacity to reflect on own internal mental experiences as well as those of the child

Question 16

what are 3 modes of experiencing subjectivity that reflect ineffective mentalizing

Answer 16

1. The psychic equivalence mode; In this mode of functioning, thoughts and feelings become too real. The individual can consider no perspectives other than his/her own and believes that his/her own perspective is the only one possible; reflects the domination of self over other, external over internal, and emotion over cognition.
2. The teleological mode; In this mode, only real, observable goal-directed behavior and objectively discernible events that may potentially constrain these goals are recognized; reflects extreme exterior focus and momentary loss of controlled mentalizing.
3. The pretend mode; Here, thoughts and feelings are severed from reality (so-called hypermentalizing or pseudomentalizing), and the individual becomes entangled in endless cognitive or affectively overwhelming narratives that have no connection to reality and, in the extreme, lead to feelings of derealization and dissociation; reflects domination of explicit mentalizing by implicit mentalizing, inadequate internal focus, poor belief–desire reasoning, and vulnerability to fusion with others.

Question 17

limitations of the mentalizing approach (5)

Answer 17

1. relationship between childhood attachment and developmental outcomes is less strong than expected from theory
2. meta-analyses suggest only moderate stability of attachment across development
3. historical, sociocultural and environmental factors may determine the role and function of the attachment-behavioural system (instead of innate/universal behavioural system)
4. parental sensitivity explained only a small portion of the variance in the association between parent and infant
5. there’s increasing evidence for genetic factors in determining the course of attachment

Question 18

what are the 3 communication systems through which psychological interventions are seen as social relearning

Answer 18

1. communication system 1 (lowering epistemic vigilance); use ostensive cues to activate social learning, helping the patient to recognise benign intentions and reduce epistemic vigilance through increasing epistemic trust, mutual mentalization
2. communication system 2 (enabling mechanisms of social learning); therapeutic relationship fosters mentalizing and epistemic trust, goal is to enable learning and change, learning new skills/aqcuire self-knowledge/restructure internal working models
3. communication system 3 (reengaging with the social world); capacity for learning and growth in relationships outside therapy is activated, seeking new experiences and improving relationships

Question 19

what are 3 common features of MBT interventions

Answer 19

1. focus on improving mentalizing capacities and therapeutic alliance
2. structured, manualized interventions ensuring coherence, consistency and continuity
3. emphasis on fostering resilience and salutogenesis in patients

Question 20

explain the social-evolutionary communicative model of the role of mentalizing in development

Answer 20

broader sociocultural context, wider environment, family and neighbourhood influence parental mentalizing in attachment contexts –> epistemic trust –> social learning –> child attachment/mentalizing –> epistemic trust (circle)
this all leads to resilience