Mentalization-based therapy (MBT)

Mentalization-based therapy (MBT) is a type of long-term psychotherapy. Mentalization is the ability to think about thinking.

It helps to make sense of our thoughts, beliefs, wishes and feelings and to connect these to our actions and behaviours. This means examining your own thoughts and beliefs, and assessing whether they’re useful, realistic and based on reality.

For example, many people with borderline personality disorder will have a sudden urge to self-harm and then fulfil that urge without questioning it. They lack the ability to “step back” from that urge and say to themselves: “That’s not a healthy way of thinking and I’m only thinking this way because I’m upset.”

What is mentalization?

Mentalization is a normal capacity that we all use in everyday life. It underpins all human relationships. However, some people find it more difficult to mentalise in certain situations than others.

MBT aims to improve a person’s capacity to mentalise. We focus on what is going on in their mind and in the minds of other people and link this to understand and alleviate problematic behaviours.

Another important part of mentalisation is to recognise that other people have their own thoughts, emotions, beliefs, wishes and needs, and your interpretation of other people’s mental states may not necessarily be correct. In addition, you need to be aware of the potential impact your actions will have on other people’s mental states.

The goal of mentalization-based therapy is to improve your ability to recognise your own and others’ mental states, learn to “step back” from your thoughts about yourself and others and examine them to see if they’re valid.

How is MBT delivered?

Initially, MBT may be delivered in a hospital, where you would stay as an inpatient. The treatment usually consists of daily individual sessions with a therapist and group sessions with other people with BPD.

A course of mentalization-based therapy usually lasts around 18 months. Some hospitals and specialist centres encourage you to remain as an inpatient during this time. Other hospitals and centres may recommend that you leave the hospital after a certain period of time but remain being treated as an outpatient, where you visit the hospital regularly.