Handbook of Mentalization-Based Treatment

September 1, 2007
Mark Beitel, PhD

Psychiatric Times, Psychiatric Times Vol 24 No 10, Volume 24, Issue 10

Book Review

by Jon G. Allen and Peter Fonagy (eds); West Sussex, UK:
John Wiley & Sons, 2006
362 pages • $150.00 (hardcover)

The Handbook of Mentalization-Based Treatment is a well-crafted text that is intended for clinicians and researchers who are interested in the psychological aspects of mental illness and treatment. Both the editors and contributors of this book provide a fresh, integrated, and clinically relevant perspective from which to view mental activity and its associated biological underpinnings. At 362 pages, it is slender in comparison to other handbooks, which enhances both its readability and utility.

The book begins with a cogent introduction to the theoretical importance and practical implications of mentalization. Coeditor and contributor Jon G. Allen does an excellent job of placing mentalizing in the nomological network of related and divergent constructs.

Subsequent chapters in the handbook elaborate theoretical, research, and clinical approaches to mentalization. New, empirically based modes of prevention, psychoeducation, psychotherapy, and training are described clearly and in sufficient detail for readers to appreciate both their continuities with previous approaches and the novelty of the mentalization framework.

Mentalization, with its psychoanalytic roots, is presented in an interdisciplinary, pragmatic, evidence-based format that feels somehow recognizably Midwestern. There is a refreshing lack of "schoolism," since the authors offer a transtheoretical construct that can be applied to a wide variety of theoretical and clinical approaches, including cognitive- and dialectical- behavioral therapies.

The contributors anticipate and address some of the issues that the book is certain to raise, such as the controversy between conflict and deficit models of psychopathology. Mentalizing deficits are the primary focus here, insofar as the lack of mentaliz-ing is understood to be a root cause of human suffering. The issue of motivated failures in mentalizing is touched on lightly.

A related issue is that mentalizing is regarded as both a means to successful outcome in psychotherapy and as an end in its own right. Clinicians, patients, and funders-even within psychoanalysis-are certain to differ in their view of mentalization in this regard. Another issue to consider is the psychological status of mentalizing itself. Mentalization is presented in a multifaceted way-as an enduring personality disposition, as an attitude (eg, the "mentalizing attitude"), and as an ability. One future challenge will be to devise measures for each of these facets.

It is worth noting that this handbook appears very early in the development of the construct for which it serves as a reference. This is possible because the contributors review and integrate decades of related theory and research that has been conducted under various names, such as theory of mind, psychological mindedness, mindfulness, reflective function, and so on.

Given its early appearance, the handbook is far from the last word on mentalization. Instead, it provides an essential introduction to the construct and presents nascent programmatic research. In so doing, it suggests multiple points of departure for further research, and this is one reason why the book is particularly impressive and inspiring.