Mindreading and Mindblindness


Mentalization is the uniquely human (or so we think) ability to know one’s own mind and also the minds of others. The ability to mentalize develops in early childhood, consolidating at around 5 to 7 years old. It is the faculty of mind that allows us to understand that we have intentions, wishes, desires, feelings, hopes, knowledge, and plans, that others do as well. Moreover, once we have achieved mentalization, we also know that minds are opaque; in other words, we can guess what’s in someone else’s mind, but we can’t know it for sure unless we ask.

The theory of mentalization and how we develop it in early childhood was developed by Peter Fonagy and his colleagues at the Anna Freud National Centre for Children and Families in London. It draws on the Work of D. W. Winnicott, Wilfred Bion, and John Bowlby and on psychoanalysis, modern attachment theory, neurobiology, and ethological research. It is also in conversation with philosopher Simon Baron-Cohen, whose book Mindblindness examines the deficits in mentalization in autistic individuals.

According to Fonagy et al (2002), mentalization, also called reflective function,

 is the developmental acquisition that permits children to respond not only to another person’s behavior, but to the children’s conception of others’ beliefs, feelings, attitudes, desires, hopes, knowledge, imagination, pretense, deceit, intentions, plans.

I just returned from a 3 day workshop with Norka Malberg on Mentalization-Based Treatment for Children (MBT-C).  MBT-C is a relatively new psychotherapeutic approach that focuses on the development of mentalization in child patients through intensive work with the children and their parents. It involves honing in on moments when anxiety, fright, or anger impede our ability to slow down and think and therefore shuts down our ability to mentalize.

Research has demonstrated that the ability to mentalize relies on our ability to regulate attention and affect. However, it also facilitates affect regulation and attention. A child (or adult) who is better able to mentalize will also be better able to weather the vicissitudes of life and regain a sense of emotional regulation after she has been thrown off course. Problems in attention may also be related to an inability to mentalize.

So mentalizing is a key predictor of a child’s ability to focus, pay attention, and self-regulate.

In my work with children, I begin with the assumption that their natural tendency is to develop normally. M. Tolpin (2002) calls this assuming the “forward edge.”  This means that I focus on a children’s normal tendency to proceed in their development toward healthy adulthood and that when they go off course, it is not necessarily because of some inherent pathology, but rather because of a stressful or traumatic event or series of events. My role is to understand not what is wrong with them, but what went wrong in their environment that prevented them from growing along the forward edge.

It is quite remarkable how children can resume the forward edge when they meet with empathic understanding and a curiosity about their troubles. Taking an interest in the contents of a child’s mind and helping the child to be interested in his/her own mind slows things down, allows for processing of the stress or trauma, and ultimately facilitates a return to normal development. This is mentalization.

I base my work with parents on these same basic principles. Together, we work to try to understand what is going on in the minds of their children. This is no easy feat!  When children are dysregulated and behave in frightening or unsafe ways, the adults in their lives often become dysregulated as well. They can become frightened or angry, and they quickly lose their ability to mentalize their child.

For example, if a toddler runs away from a parent or teacher, everyone begins to feel unsafe. It is understandable that parents and teachers faced with a child who runs will work very hard to control the running. They may set consequences for the running. In some cases, schools may even expel the child! Indeed, the Rasheed Malik (2017) reported in the Center for American Progress that

Yale University researchers uncovered a surprising fact: Preschoolers were more likely to be expelled than children in any other grade. In fact, preschoolers were being expelled at rates more than three times higher than school-aged children.

But what is in the mind of a child who runs? Perhaps she wants to be pursued, to be sure that she is loved. Perhaps she is afraid of her own rage and is trying to protect those around her. Perhaps she is running from the very stressful event that has dysregulated her–has made her feel hurt, or shame, or sadness.

If we can manage our own anger and fear, as adults we can slow down and think about what is in the mind of a child who is misbehaving. If we can help the child understand that he, too, is struggling with the contents of his mind, he will calm down.

You can read more about my work at the forward edge with children in “Resuming the Forward Edge of Development: Psychoanalytically Informed School-Based Intervention”, my chapter in the book, The Social Work and K-12 Schools Casebook: Phenomenological Perspectives.


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