Can Mentalization Help Your Borderline Personality Disorder?

Borderline personality disorder (BPD) is a mental health condition that causes a person to have self-image issues and difficulty understanding their role in the world. BPD also causes severe mood swings and impulsive behaviors. This condition affects about 2% of the population in the United States. Mentalization-based therapy (MBT) is a type of psychotherapy used to treat people living with BPD.

This article discusses mentalization-based therapy used to treat people with borderline personality disorder—how it works, what the benefits are, and what to expect during therapy sessions.

Counselor and client

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What Is Mentalization-Based Therapy (MBT)?

Borderline personality disorder causes a person to have a hard time managing emotions, making it difficult to have successful relationships. Individuals with BPD often misinterpret the intent behind a person's behavior, and react inappropriately.

Mentalization-based therapy (MBT) is a form of psychotherapy that helps a person understand their emotions, thoughts, and behavior, as well as other people's feelings and thoughts.

Finding an MBT Therapist

Mentalization-based therapists do not require a special certification. Mental health professionals often include MBT techniques with other treatment methods during a therapy session. Your therapist will help determine whether or not this therapy is appropriate for you.

How Mentalization-Based Therapy Works

The main focus of mentalization-based therapy is helping a person living with BPD stop and think before reacting to their emotions and feelings or before reacting to what they think another person is thinking or feeling.

Mentalization-based therapy also helps the person living with BPD recognize that the way they are interpreting someone else's actions or intentions might not be accurate.

When Is It Used?

Mentalization-based therapy is often included with other methods of psychotherapy. During treatment for BPD, the therapist may identify that a person is having difficulty understanding their own emotions and the thoughts and feelings of other people. This may prompt them to try this method.

Problems with mentalization often occur from abandonment or abuse experienced early in life. In addition to borderline personality disorder, MBT is used to treat people with addictions, eating disorders, antisocial personality, and depression.

Benefits

Mentalization-based therapy can significantly improve a person with BPD's ability to have successful relationships. MBT has also been shown to reduce symptoms of depression, self-harm behaviors, and suicide attempts, as well as improve social functioning.

What Is Mentalization?

Mentalization is the ability to recognize your emotions and thoughts, separate from the emotions and thoughts of other people. Mentalization also helps a person understand how their mental state affects their behavior.

What to Expect With Mentalization-Based Therapy

Treatment for boderline personality disorder, including mentalization-based therapy techniques, can be a lengthy process. Mentalization-based therapy is often provided for 18 months, with weekly individual therapy sessions as well as weekly group therapy.

Psychotherapy for BPD often includes other types of therapy in addition to MBT. These can include:

  • Dialectical behavior therapy (DBT): This type of therapy teaches mindfulness and other skills to help a person with BPD improve relationships, manage emotions, and tolerate stress.
  • Transference-focused psychotherapy (TFP): This treatment method identifies negative relationship dynamics during interactions between the therapist and the person and the intense emotions that arise during these interactions.
  • Schema-focused therapy (SFT): This type of therapy focuses on healing emotional experiences and trauma from childhood.

Who Should Not Have Mentalization-Based Therapy?

Mentalizing is a skill that can benefit anyone. Understanding your emotions and thoughts, as well as being able to see things from another person's perspective, can improve your relationships.

However, mentalization-based therapy is a treatment used specifically for individuals diagnosed with mental health conditions such as borderline personality disorder. Talk to a mental health professional if you are unsure if mentalization-based therapy is appropriate for your situation.

Summary

Mentalization-based therapy is one type of psychotherapy used to treat people with borderline personality disorder. This therapy focuses on helping the person understand their own emotions and feelings, as well as correctly interpreting the thoughts and feelings expressed by other people. MBT helps improve relationships and reduces negative behaviors such as suicide attempts, self-harm, and symptoms of depression.

A Word From Verywell

Living with borderline personality disorder can be very challenging, but committing to treatment, such as mentalization-based therapy, can significantly reduce symptoms and improve your quality of life. Talk to a mental health professional about the type of therapy that is appropriate for you or your loved one.

Frequently Asked Questions

  • How much does therapy cost?

    The cost of therapy depends on many factors: geographical location, type of therapy, frequency of treatment, and whether or not the services are covered by your insurance. In some cases, therapy can be more than $100 per session.

  • What are some mentalization activities?

    Mentalization activities include paying attention to your emotions and thinking about why you reacted to your emotions in a particular way. These activities can improve behaviors and help you be less reactive in difficult situations.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Mental Health. Borderline personality disorder.

  2. Harvard Health Publishing. Borderline personality disorder.

  3. Psychology Today. Mentalization-based therapy.

  4. McLean Hospital. Mentalization-based treatment: effective care for borderline personality disorder.

  5. Philips B, Wennberg P, Konradsson P, Franck J. Mentalization-based treatment for concurrent borderline personality disorder and substance use disorder: a randomized controlled feasibility studyEur Addict Res. 2018;24(1):1-8. doi:10.1159%2F000485564

  6. Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT. What works in the treatment of borderline personality disorderCurr Behav Neurosci Rep. 2017;4(1):21-30. doi:10.1007%2Fs40473-017-0103-z

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.