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The role of epistemic trust in mentalization-based treatment of borderline psychopathology
Nolte,T. Hutsebaut,J. Sharp,C. Campbell,C. Fonagy,P. Bateman,A.
Nolte,T.
Hutsebaut,J.
Sharp,C.
Campbell,C.
Fonagy,P.
Bateman,A.
Abstract
Building on the notion of epistemic trust as facilitating social learning, in this article we clarify how interventions from mentalization-based treatment (MBT) for borderline personality disorder generate this process. We suggest first that being mentalized is a critical cue in interactions to establish epistemic trust and second that epistemic mistrust may represent a final common pathway through which aversive relational experiences in the past may exert their influence on treatments-both as a disposition of the patient and as a characteristic of the therapist-patient encounter. By charting MBT interventions from the initial assessment and formulation, through individual and group therapy sessions, to re-engaging with the wider social environment, we examine how each of these can establish a "we-mode," an interpersonal experience associated with being mentalized that unlocks the barrier posed by epistemic vigilance. In addition, implications for relational mentalizing and rupture and repair within the therapeutic relationship are discussed.
Description
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Research Projects
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Journal Issue
Keywords
MBT, attachment, borderline personality disorder, childhood adversity, epistemic stance, epistemic trust, mentalization-based therapy, mentalizing, we-mode
Citation
Nolte, T, Hutsebaut, J, Sharp, C, Campbell, C, Fonagy, P & Bateman, A 2023, 'The role of epistemic trust in mentalization-based treatment of borderline psychopathology', Journal of Personality Disorders, vol. 37, no. 5, pp. 633-659. https://doi.org/10.1521/pedi.2023.37.5.633