mentalization is absent when an individual interprets their own or others’ psychological experience and/or social behaviour without reference to mental states (thoughts and/or feelings).

Sharp and colleagues also reported that 44% of the relationship between hypermentalizing and symptoms of BPD was mediated by difficulties with emotion regulation

the researchers found a very substantial (r = .41) relationship between hypermentalizing and symptoms of BPD, independent of age, gender, and other mental health symptoms

In his essay, ‘Psychoses and child care’, Winnicott described one form of imaginary play that he regarded as quite problematic. It is characterized by ‘the lack of a beginning and end to the game, by the degree of magical control, by the lack of organization of play material according to any one pattern, and by the inexhaustibility of the child’

Fonagy and Target added that reflective function entails not just a capacity to acknowledge the child’s mental states, but also the capacity for perspective-taking, a kind of play with representations. Perspective-taking allows the caregiver to put their child’s demands into context and not be overwhelmed by them: a difficult task when confronted with an infant’s seemingly endless crying.

individuals who have been trained by circumstances or have trained themselves to hold fast to mentalizing, rather than finding it a capacity to turn on or off as needed, may find such interactions hard to sustain. In considering ‘not mentalizing’, it is important to identify that even apparently mentalizing interactional frames can be conventionalized into ‘not mentalizing’: ‘How are you?’ ‘Good thanks, how are you?’.

The researchers propose that non-mentalizing modes of processing operate according to very different assumptions compared to mentalized experience, and an individual in one of these states often disbelieves in mentalized accounts of reality.

no attempt has been made to operationalize the specific modes of non-mentalizing, with the exception of hypermentalizing, leaving their reflections speculative and obstructing further scientific development of the theory

the forms of non-mentalizing are not simply the absence of mentalizing, but draw on specific aspects of the capacity to mentalize

children:

appear C5.P6to be able to use the notion of mental states but paradoxically use it only when they can clearly separate it from physical reality (for example, in play). In this state of mind, which we have called pretend mode, thoughts and feelings can be envisioned and talked about but they correspond to nothing real

worries were cut off from the specifics of her own life as they entered into a fantasy narrative. And they were also cut off from modulation or doubt

Had Rebecca been able to enter into pretend mode and then exit in a flexible way, then pretend mode would not have been at the expense of tolerating thoughts and feelings. In turn, these thoughts and feelings would then have been available for modulation, rather than expressed as fears and aggression.

for Fonagy and colleagues, the forms of non-mentalizing are so potent precisely because they ‘hijack’ the constituent parts of mentalizing. Non-mentalizing is not then simply the obverse of mentalizing, but turns the equipment of mentalizing against itself.

pretend mode can be regarded as conceiving of thoughts and feelings implicated in motivations or intentions. But it is the severed first part of mentalization. For mentalization requires also some attempt to account for and explain observable social behaviour and/or perceptual experience.

LuytenC5.P13, Fonagy, Lemma, and Target suggested five features of pretend mode that distinguish it from mentalizing

accounts organized by pretend mode tend to be ‘overly analytical, repetitive and lengthy’.

narratives tend to be out of touch with the speaker’s own affective experience as formed by the obstacles and tasks that prompt this experience

speech in pretend mode rather than mentalizing is signalled by difficulties for the speaker in switching perspectives—for instance, from a focus on the motivations of the self to those of the other, or vice versa.

Luyten, Fonagy, Lemma, and Target do seem to imply that effective mentalizing should, in general, contribute to motivations more accurately reflecting the needs of others and oneself, which in turn should contribute to beneficence.

Bateman and Fonagy define hypermentalizing as ‘a tendency to elaborate models of internal states in the absence of relevant evidence’

a shift in Hegel’s position from the Phenomenology to later work such as The Science of Logic was towards the claim that reflection is not self-grounded, and that forms of accurate and well-judged understanding and reasoning about ourselves and others need to be examined for the forces and desires that organize and animate them, and which may not be fully understood or well reasoned

Conclusions are generated for which there is no basis in experience, and these are insulated from meta-cognitive reappraisal.

the distinction between psychological theory and hypermentalizing is somewhat porous, and will depend on the extent to which the theory is grounded in the concrete specifics of observation and measurement, and the extent to which the theory is open to reconsideration of its constituent elements.

hypermentalization lacks components 2 (reconsideration) and 8 (present or past perceptual experience) from the definition of mentalization presented in the previous chapter.

reflection is not informed by perceptual experience and is not available for reconsideration, which is why it is a form of pretend mode thinking. This also explains why hypermentalization is a form of pretend mode thinking

FonagyC5.P20 has speculated that the patients who helped Freud generate psychoanalysis as a talking cure were displaying symptoms of BPD, and that much of their thinking and speech reflected hypermentalizing. They could elaborate on their mental states at length. But they were also highly and quite enduringly suggestible, since their specific difficulty was in recognizing and reflecting on present or past experience as a source of thoughts and feelings. In this state, a shared pretend mode can readily be elaborated on the basis of clinician suggestion

Fonagy and colleagues have also proposed