Mentalizing, Epistemic Trust and Couple Therapy

Replacing a purely emotional or behavioral focus in couple therapy as the main goal with an intention to facilitate the core function of couple relationships, enables a fresh view in Mentalization Based Couple Therapy, more in line with MBT theory.

You will find the previous posts on MBT Couple Therapy here and here.

Mentalizing is not the main goal in Mentalization-based Couple Therapy. Even Fonagy, Campbell and Allison (2019) shifts the weight in the their stand on MBT towards the capability to learn and explore with the actual people in the client’s life where it is being lived.
They write:

Improving mentalizing is not the main goal, but the improved mentalizing that results from the process enables the patient to start to approach and learn from his or her wider social context.

In this vein, we are proposing for MBT-CO that the main goal of promoting mentalizing in the couple is to reestablish the psychological function of a couple relationship, i.e. the couple being able to use each other as sources of information to understand experiences and events in their shared life. In relation to the above quote, the main difference between couple and individual therapy, is that the couple relationship present in the room is the wider social context for the clients, the very social context that partners should be able once again to approach and learn from.
More succinctly put, MBT-CO should adress the bio-social core function of a couple relationship, which is adaption to a changing environment to optimize chances of survival.

Epistemic trust and mentalizing

Hence, the main goal should be to support the function of being a couple, to function as a unit of two, capable of using knowledge and skills from each other as important perspectives on the social world they inhabit and must act in.
If the couple stops trusting information they get from each other as relevant and useful – as said previously when the partner by appearing incomprehensible feels unreliabel – then they will be poorer equiped to counteract the darts and arrows life throws at them.
This is the ‘System 3′ of psychotherapy, making the client able in situations of problemsolving to utilize cultural information presented by trustworthy others in the natural settings of the clients’ life, that Fonagy through several pieces of writing are proposing under the heading of fostering epistemic trust.

The goal of MBT-CO is to mobilize the relationship to be that safe haven in the sense of attachment and soothing, but to do that in order for the partners to support each other in exploration, problemsolving and cultural interpretation. In MBT-CO we help the couple move closer together, in the sense of being able to use each other as sources of support and comfort, and to be together to appraise, interpret and act in their everyday life. The use and appreciation of perspectives and knowledge from your partner, rest on epistemic trust in the relationship.
Shifting the thinking on mentalizing and MBT – as Fonagy and colleages (2018, 2019) do – towards epistemic trust in the service of learning and thriving, casts out a double effect of mentalizing in a couple:
One is the fact, that mentalizing makes each partner seem less monstrous, more humane to the other partner, through explicating intentions, dilemmas, inner struggles, emotions etc.
The other is how the ostensive cues of active mentalizing awake the experience of being seen from within, of being comprehended as I comprehend myself, and how this signals safety and promotes more epistemic trust.

Resilience and MBT Couple Therapy

Looking at the way MBT are presently being formulated on the basis of attachment theory, appraisal theory, and the developmental view on non-mentalizing modes, it is apparent how much the approach focuses on the psychological fit between individual to its environment. Fonagy, Campbell and Allison (2018, 2019) emphazise mentalizing as a component of developing resilience – the inner and outer ressources to appraise and act relevantly towards social adverse events – and in this clearly move MBT and the ability to mentalize right into its functional relation to surviving and navigating in the social world.
Understanding behavior, imagination, emotions etc. as being about adaptation to the social environment you happen to be living in, and appreciating how social communities are functional units enabling individuals to adapt to changes in the environment, puts the emotional life and the attachment behaviour of couple relationships and indeed couple therapy in an interesting and different light.
The application of couple therapy might be better off by asking how mentalizing in the couple enables them to function as a unit of two, accessing cultural knowledge together, and hence sustaining a relationship that functions in relation to adaptation to changing conditions in the environment of the couple – child rearing, finansiel investments, conflictual social relations, career choices etc.
In this context, mentalizing works to foster epistemic trust in the couple, that must work in order to make couples resilient.

In this MBT-CO line of thinking, couple therapy should help couples understand each other og continually be able to do good enough repair of breaches in trust and in emotional connection. This should facilitate for them the use of each other and the relationship as ressources when they are facing problems, and on the emotional side to feel contained by the relationship:

The aim of MBT-Couple Therapy intervention is to enable couples increasingly to be able to regulate the affect between them, as well as within themselves, so that the relationship can be experienced as a potentially containing and benign ressource rather than as a state which threatens the stability of their minds. (Nyberg og Hertzmann 2019: 134)

Mentalizing and we-ness in couple relationships

As a way of grounding MBT-CO more firmly within MBT theory, mentalizing in the couple relationship should be regarded as a ressource for affective containment and for building the epistemic trust necessary for depending on the partner as a ressource for continual social adaptation. In other words, connecting mentalizing and resilience, as do Fonagy, Campbell, and Allison, and to see that connection mediated by the individual’s use of cultural information from trustworthy others, binds together conceptually the emotional and cognitive sense of being a couple – the we-ness of couple identity, predictive of couple satisfaction (Cruwys et al 2022) – with the bio-social functionality of the couple bond.
One should not speculate for long on how much our ability for mentalizing and forming emotionally meaningful bonds to other’s has been a massive advantage in the evolution of the human species, to see the couple relationship and its emotional quality in its functional context.

The ability in a couple relationship for social communication and learning should be facilitated in MBT-CO by ‘doing’ mentalizing, discover and show interest in the other’s and your own mind behind behaviour again and again, to know the difference between interacting with your partner in mentalizing and pre-mentalizing modes, and to both step into the relationship and still keep the reflexive distance to the relationship as the ‘third’.