Mentalization Based Therapy (MBT)

Mentalization Based Therapy is an approach, developed by Anthony Bateman and Peter Fonagy, to treat BPD patients in the U.K.

Before discussing their therapy technique, I'd like to look at what they posit as the central problem for a person living with BPD, and how they feel this condition is caused.

Much of what they have to say, if I have understood correctly, rings true for me.

BPD - Central Problem - Relationships

For Bateman and Fonagy, the central problem faced by a person with BPD, is the inability to form healthy balanced relationships. 

Relationships are either detached; or overly intense and enmeshed.  At core in this relationship impairment, is the inability to define the boundary between "self" and "other".  For the person with BPD, it is all or nothing.

The first of these two modes of how we with BPD relate to others, can perhaps be demonstrated by the following diagram:

Detached Mode

This modus operandi (way of functioning in the world) which, while lacking strong human bonds and connections, tends to be more stable. 

                                                Source: MBT Training Workshop, Bateman & Fonagy, 2009

Someone with this relationship structure has no strong human bonds or connections, so life is relatively calm.  It is also flat, empty and disconnected; contributing to a sense of emptiness--that "big hole inside" so many of us describe.

The isolation, alienation, lack of feeling understood or part of the world/reality, is intense and can lead to deep depression, self-harm and suicide.

However, compared to the other mode of BPD relationship functioning (that of being emotionally enmeshed) this mode of being in the world is relatively, a relief.

This detached form of relating is where I feel I am now.