I’ve had to wait a long time to get this. I’ve struggled with BPD for a long time. I’ve lost a lot of good people to it. I can’t work. I’m struggling with day-to-day life. I’m really hoping that this therapy works for me.

I realise that you only get out of it as much as you put in. So I’m going to blog about it for two reasons: 1) to process the information I get in each session, and 2) to give people who are waiting a bit of a helping taster.

I know I would’ve loved to have read a blog detailing each step of BPD-specific therapy, while I was waiting for so many years. There’s a lot you can glean online, but I’d never really read a whole account of a therapy course, from the perspective of someone who’s taking the course.

So I hope this helps some of you, who are still waiting. Please be aware, though, that my explanations may not be the best at the moment, because this therapy is very new to me, and I’m only just beginning to understand it properly.

About the introductory course

The course lasts for 10 weeks.

There is one session a week, lasting for an hour and a half.

In terms of support, we have a therapist, and an Expert of Experience^.

The groups are quite small, in terms of patients; can be around 5-7. Some are mixed, but groups tend to be all-female.

We are given information about mentalising each session, and discuss it as a group.

Personal examples are welcomed, but they’re meant to be as such that they can be wrapped up, before the end of the session.

^ An Expert of Experience is someone who’s been through the full MBT course before, to offer patients an insight into what’s going to come, what we can expect, etc. – and to give us a bit of hope, as well as a voice of someone who understands what the course is like from a patient’s perspective. I really like this approach.

The course has specific safety boundaries that all participants must follow. Some of these are:

Patients are to be non-contact with each other until the end of the course.

Patients are not to lend money to anyone else on the course.

Patients are not to talk about other patients on social media. (I take this very seriously and will not be giving any details about any of the other patients on this blog.)

details about any of the other patients on this blog.) Phones must be turned off at the start of the session.

Patients must try to be on time, each time.

Patients must aim to attend at least 75% of sessions.

Patients must give notice if they’re not able to attend a session.

What is mentalising?

My therapist said that she didn’t like the word “mentalisation”, because it sounds like a finished product, or something that is simply done; whereas, “mentalising” is something a process, a skill to be learned. We are all mentalising, all the time, without even being aware of the term. When you are aware of the term, however – or the process of mentalising, and pick that process apart, you can begin to learn how to “mentalise” better. Mentalising is a skill, like any other – and can be improved, like any other.

Curiosity

Mentalising is about being curious about the thinking and feeling process. (They say MBT is “thinking and feeling about thinking and feeling.”) When we interact with people, we make assumptions about what they’re thinking, or how they’re feeling, and that causes us to have an emotion – and that emotion can lead to an action, an often unhealthy action, which may be entirely based on a falsehood.

Often, when we assume that a person is thinking or feeling negatively about us, it is because we have deep, unresolved negative feelings towards, and beliefs about, ourselves.

It is very easy for our brains to go down a well-travelled neural pathway, towards a lie we’ve been telling ourselves, and were perhaps taught to believe about ourselves, all of our lives, since childhood: “This person is upset because I am a shit person and I don’t deserve to have friends.”

Instead, when we mentalise, and are curious about what others think and feel, we can perhaps stop ourselves from coming to these well-trodden, negative conclusions about ourselves, and about the people around us.

The thinking/feeling process

Mentalising is about picking apart the process of assumption, emotion, action, so that we can examine more closely these steps, hopefully to lead to, at least, a better action – and hopefully, eventually, with practice, a better emotional response.

I’m hoping that, by examining this process, I can begin to identify more of those negative beliefs I have about myself – which get me into horrendous states – and, from there, begin to challenge those as well.

Now, I’m only at the start of my MBT journey, and I think that the picking apart of these negative beliefs about oneself is something that’s going to come in the one-to-one aspect of the full MBT course (there is a group element, and a one-to-one element, each week, of the full course).

So, this isn’t something that’s been suggested to me, or anything, yet – but I’m going to try, when I catch myself mentalising poorly, figuring out if there’s a negative belief about myself running through the experience, and make a note of it. Even if it’s just something I can begin to work on later.

Our emotions are often based on the assumptions we make about what another person is thinking or feeling – so, if we can change that assumption, or begin to recognise that we are making an assumption, and be curious as to what else might be true, we can prevent ourselves from getting into very seriously distressing mental states – which tend to feed into (and tend to be bred from) our negative beliefs about ourselves.

Not knowing

We all have to make assumptions about other people – it’s human nature – but, we can often accept assumptions (quite negative assumptions, sometimes) as facts, and that’s when it can begin to cause problems, particularly for people with BPD. When we poorly mentalise, that’s when it becomes a fact that x doesn’t like me because I’m a bad person.

However, when we have a healthy sense of curiosity about people’s actions, thoughts, and feelings, other options can become available to us. We can slow the process down, so that it doesn’t go from 1 to 100 automatically.

Unfortunately, we don’t always know why a person is acting a certain way, or what exactly they’re thinking and feeling. This can be particularly difficult for people with BPD, because, without a definite answer, we can spiral off into overthinking, which almost always feeds into a negative belief about ourselves. This is because we suffer with black-and-white thinking, so shades of grey are uncomfortable and difficult for us, and can lead to overthinking, and spiralling back into our deeply held negative beliefs and feelings about ourselves. So mentalising is also about being okay with not knowing what a person is thinking or feeling, based on their actions.

This is something, I know, I’m personally going to struggle with. Not knowing has been incredibly difficult for me, particularly in matters of the heart. When my ex was unfaithful towards me, I wondered whether or not he’d ever really felt strongly about me at all – particularly when he mentioned that he’d never experienced heartache. Those thoughts warped around my mind for weeks, and months, and it was an incredibly distressing time for me.

It took a long time for me to be okay with not knowing what was going on in his head; but that was easier for me, in a way, because it no longer mattered what was going through his head, because I was rid of him, and that was good in and of itself. I imagine it’s very difficult to be okay with not knowing, while that person is still in your life.

In summary…

Mentalising can help you to: understand yourself – who you are, your likes/dislikes, your own values, etc.;

communicate well with close friends;

regulate/have more control over your own feelings;

avoid misunderstandings;

see the connections between emotions and action;

escape destructive patterns of thought more easily. Taken from our hand out

The problems with mentalising – hyper-mentalising

When we try to mentalise, we can go over-board, start “hyper-mentalising” and lose the process of mentalising. Mentalising is about not making assumptions about a person’s thoughts and feelings – but this is very difficult to do. So, although we are focusing on a person’s thoughts and emotions, when we overthink, or hyper-mentalise, we can begin to make assumptions about a person’s thoughts and emotions, all over again, without necessarily realising it.

“If they’re thinking x, then maybe that’s why they’re x; but then again, they did x, so they might be feeling x and x, and maybe that relates to x, which makes sense because this person doesn’t x, or hasn’t in a while…” You can see where this is going.

This is something I know I’m going to struggle with, and I’ll get back to you about methods to cope with hyper-mentalising – as I’m sure it will come up again in group – but, as far as I understand it right now, the way you’d tackle this is the same way you’d tackle poor mentalising (because hyper-mentalising is still poor mentalising), i.e., breaking down the process, and asking questions of the assumptions you might’ve made.

However, this can obviously lead to yet more hyper-mentalising, so I’d imagine another thing you’d have to do is to break the cycle. This is might be where being okay with not knowing will come in very useful. In the meantime, I’m going to try to keep in mind that a good solution to this might be distraction techniques.

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