In my DBT residential, we had one group per week which was based on another type of therapy used to treat people with Borderline Personality Disorder, known as Mentalisation Based Therapy (MBT). Within MBT, individuals learn to better understand and differentiate between the minds of both themselves and those around them. This is especially valuable as a significant aspect of BPD is the way in which individuals struggle within interpersonal situations, and to such a great and painful extent. The aim of MBT is therefore to ultimately help these clients cope with and manage their relationships with others, as well as – and perhaps most importantly – with themselves.
Within the concept of MBT there are a few processes which arise when an individual fails to mentalise effectively, known as Mentalisation Errors. The four failures of Mentalisation I learnt about in treatment are:
- Teleological Thinking
- Pseudomentalising (Pretend Mode)
- Psychic Equivalence
In the future – when relevant to my life, or as requested by readers – I will explore each of these in more detail. However, for the moment, I am going to focus on the concept I am struggling with the most: Teleological Thinking.
Teleological Thinking is a process in which an individual looks to their external environment to gather evidence which seemingly backs up a core belief they have about themself.
More often than not this core belief will be a negative one, and oftentimes the selected “evidence” may have been skewed or manipulated to fit the self-concept this individual has and their subjective experiences of themself. It is therefore an ineffective means to use when trying to find where one stands; it is biased in its very nature by the individual’s self-perception and subsequent fears.
However it is not so easy to stray from this Mentalisation failure even with this awareness, especially whilst suffering with severe anxiety, paranoia, low self-esteem and interpersonal challenges so intensely.
I will give a personal example of some current Teleological Thinking I have been engaging in:
At the moment I am feeling very paranoid and volatile within certain relationships in my life. I am struggling to separate who I am from the reactions of those around me. As a means of reassurance seeking and self-regulation, the other evening I decided to email my therapist in an attempt to reach out and express myself after intentionally missing my session with her that morning.
I received a reply from her which I felt wasn’t ample considering the overt expression of my internal pain I had disclosed to her in Email 1. I responded with Email 2 in the hope that I would receive another, “better” reply from her with an alternative approach. Email 2 was sent over a day ago and I have still not heard anything back.
The story I tell myself in this context is that it must be true: She truly does hate me; she clearly is angry with me; she really cannot deal with me; I am the biggest burden of a client she’s ever had; I am of course not worth her time or affection; I am indeed undeserving of her support; she really doesn’t want me as a client any more; and my struggles are evidently unimportant, etc.
I know that the things listed above which I tell myself stem from the core beliefs I hold inside of me – that I am overly needy, unlovable, worthless and pathetic as a person.
I am also able to Check The Facts and rationalise to an extent: perhaps she doesn’t check her emails regularly; maybe she thinks she is being effective and therefore this is an act of kindness, not cruelty; perhaps she is just super busy; it is possible she would simply rather talk about it in person during our next session as opposed to via email, etc.
At the same time, being able to rationalise in this way doesn’t take away from the mental chaos and upheaval of emotions evoked in me by her lack of a response.
This is just one of many, many examples of an interaction between my therapist and myself whereby I use the way she interacts (or doesn’t interact) with me to back up the notion that I am indeed all these awful things I convince myself I am – a fundamentally flawed human being in my entirety – regardless of whether any of this “evidence” could be legitimately counted as proof, or not!