The Synergy of Mentalization, Meditation, and Hypnosis in Therapy
Written on
The journey of introducing mentalization and theory of mind principles to a broader audience has been ongoing since the establishment of the Center for Applied Theory of Mind. Although we've made strides, we recognize there’s still much to accomplish.
Occasionally, we hear from an old friend who updates us on her workplace’s meditation training sessions. In one recent message, she noted, "Hi folks, we have another competitor of yours training us on meditation skills. Would you like to discuss what they teach after I'm done?" Despite our persistent efforts to clarify the differences between mentalization and meditation, we eventually decided to simply reply, “Absolutely, that sounds intriguing!”
We often encounter individuals who mistakenly link mentalization with psychic phenomena, such as Uri Geller's spoon-bending acts. Others wonder if our mentalization skills enable us to hypnotize them on the spot to change undesirable habits.
These captivating displays by self-proclaimed “mentalists” give the impression of extraordinary psychic talents. Figures like Alexander the Man Who Knows, who thrived in the early 20th century, amassed significant wealth through psychic services like crystal-gazing, which he marketed as mind-reading (1). However, this interpretation of mind reading diverges significantly from the psychological understanding of mentalization.
Mentalization refers to our capacity to deduce what others are thinking and feeling based on observable verbal and nonverbal cues.
Despite its non-mystical nature, mentalization remains one of our most intriguing social skills (2).
The Integration of Mentalization, Meditation, and Hypnosis in Therapy
In clinical psychology, enhancing mentalization skills is becoming increasingly woven into therapeutic approaches. The same can be said for meditation and hypnosis. According to the American Psychological Association, the relationship between these practices and mental health can be summarized as follows:
Mentalization is defined as the ability to comprehend one’s own mental states and those of others, which helps in understanding intentions and emotions. This skill is considered crucial for healthy personality development, typically nurtured through secure parental attachments. It plays a significant role in addressing borderline personality disorder (BPD), where individuals often struggle with mentalization due to early attachment issues (3).
Meditation involves deep contemplation aimed at achieving focused attention or altered consciousness, providing insights into oneself and the surrounding world. Traditionally linked to spiritual practices, meditation is now also recognized for its benefits in reducing stress and aiding physical health issues like high blood pressure and insomnia (4).
Hypnosis is a therapeutic procedure that uses suggestion to prompt changes in sensation, perception, cognition, emotions, or behavior. Individuals under hypnosis exhibit varying levels of receptiveness to suggestions that alter their usual responses (5).
As the American Psychological Association examines hypnosis's therapeutic efficacy, its popularity is on the rise. All three practices are increasingly incorporated into comprehensive treatment frameworks, particularly in attachment-informed trauma therapy.
Understanding Attachment-Informed Trauma Treatment
Attachment-informed trauma treatment explores how attachment relationships can lead to traumatic experiences or affect the availability of support during adversity. Traumatic attachment experiences contribute to the development of an internal working model, which shapes an individual's understanding of self and others, ultimately influencing future attachment styles (6).
A therapist's comprehension of a client's attachment style is crucial for tailoring effective interventions. Different styles require specific therapeutic approaches. For instance, clients with insecure attachment often resort to fight, flight, or freeze responses during challenging interactions, making it difficult for them to trust therapists or seek support.
This therapeutic approach aims to empower clients to create or rebuild secure attachments that foster trust and support, essential for mitigating mental health issues like anxiety and depression.
Enhancing Therapy with Mentalization, Meditation, and Hypnosis
Research indicates that mentalization and emotional regulation play vital roles in attachment. In our book, Mastering Mentalization (2), we detail four primary attachment styles and their connection to mentalization and emotional regulation:
A "secure" attachment style is associated with individuals who have a positive self-image and view of others, along with strong mentalization and emotional regulation skills.
An "insecure-anxious" attachment style is found in individuals who see themselves negatively while perceiving others positively. Their emotional regulation is often underdeveloped, leading to biased mentalization focused more on others than themselves.
An "insecure-avoidant" attachment style is characterized by a positive self-view but a negative perception of others. These individuals may possess strong emotional regulation but often exert minimal effort in understanding others.
An "insecure-disorganized" attachment style emerges in individuals with fluctuating views of self and others, displaying a mix of anxious and avoidant behaviors, which impacts their mentalization and emotional regulation (2).
Techniques of Mentalization in Therapy
Therapeutic techniques from Mentalization-Based Therapy can be effectively adapted to enhance attachment-informed trauma treatment. According to Malberg et al. (2023), a mentalization-based approach focuses on cultivating an attitude characterized by:
- Active "wondering" and "not knowing"
- Self-monitoring of mistakes
- Genuine curiosity
- Present-moment awareness
- Identifying mentalization obstacles and reducing emotional arousal
- Attending to nonverbal communication
- Maintaining a developmental perspective as the primary lens (8)
Throughout therapy, the therapist encourages the development of this mentalization attitude. However, trauma can evoke overwhelming emotions that hinder a client's capacity for balanced mentalization. When emotional disruptions are observed, the therapist helps redirect the client’s focus back to the present, employing emotional regulation techniques to restore calm. Therapeutic meditation and hypnosis can facilitate relaxation and enhance present-moment awareness, enabling clients to engage in mentalization once they regain composure.
Meditation and Hypnosis: Commonalities and Differences
A study by Penazzi and De Pisapia (2022) (9) highlights the similarities and distinctions between meditation and hypnosis. Both involve altered states of consciousness achieved through induction, enhancing relaxation and focused attention, which yield physiological benefits.
However, hypnosis is characterized by involuntary responses, where suggestions from the therapist may reduce the client’s sense of control. In contrast, meditation involves voluntary metacognitive control, allowing the practitioner to deepen their personal experience.
Another notable difference lies in the processes involved: During hypnotherapy, clients return to a balanced, absorbed state with therapist guidance. Prior assessment of a client's susceptibility to hypnosis is essential, whereas meditation requires the client's commitment to practice. Thus, therapists must evaluate a client’s familiarity with meditation techniques to determine appropriate training for effective emotional regulation.
Determining the Right Time for Techniques
Therapeutic hypnosis may be the optimal choice for redirecting attention and regulating emotions when clients feel overwhelmed. If further meditation training is deemed necessary, hypnosis may be postponed. Establishing trust is vital for effective hypnosis, particularly with clients who exhibit insecure attachment styles.
Meditation also requires careful timing. Initially, meditation techniques necessitate client training, which may not be immediately feasible for redirecting attention and regulating emotions. Nevertheless, incorporating meditation training into therapy is beneficial as it enhances client agency and metacognitive control, allowing them to utilize relaxation techniques independently of the therapist, unlike hypnosis.
In conclusion, mentalization, meditation, and hypnosis each offer unique benefits and considerations. Unfortunately, these practices are often sensationalized, leading to widespread misconceptions about their true applications. When used in tandem, these three approaches can significantly enhance attachment-informed trauma treatment. A mentalization-focused strategy empowers clients to explore their mental states with curiosity and openness, essential for evaluating attachment relationships and developing secure attachment styles. Coping with trauma is emotionally taxing, and the accompanying intense feelings can obstruct mentalization efforts. Meditation and hypnosis techniques play a crucial role in emotional regulation and present-moment focus, supporting the client’s mentalization process.
References: 1. Charvet, David. Alexander — The Man Who Knows. 2nd revised and enlarged edition, September 2006. Via Wikipedia: Alexander (magician) 2. van der Putten, A. A. J. T. (2022). Mastering Mentalization. ToM PRESS. 3. American Psychological Association. (n.d.). Mentalization. In APA dictionary of psychology. Retrieved April 8, 2022, from https://dictionary.apa.org/mentalization 4. American Psychological Association. (n.d.). Meditation. In APA dictionary of psychology. Retrieved April 8, 2022, from https://dictionary.apa.org/meditation 5. American Psychological Association. (n.d.). Hypnosis. In APA dictionary of psychology. Retrieved April 8, 2022, from https://dictionary.apa.org/hypnosis 6. Bretherton, I. (1992). The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology, 28(5), 759–775. doi:10.1037/0012–1649.28.5.759 7. Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61*(2), 226–244. https://doi.org/10.1037/0022-3514.61.2.226 8. Malberg, N., Jurist, E., Bate, J., & Dangerfield, M. (2023). *Working with parents in therapy: A mentalization-based approach (pp. 29). American Psychological Association. https://doi.org/10.1037/0000341-000 9. Penazzi, Gabriele & De Pisapia, Nicola. (2022). Direct comparisons between hypnosis and meditation: A mini-review. Frontiers in Psychology, 13. 10.3389/fpsyg.2022.958185.