Mentalization-Based Therapy (MBT)
Making sense of minds, especially under pressure
Individual MBT with a Chartered Counselling Psychologist and accredited MBT Practitioner, at London Bridge and online.
Book a free 30-minute consultation Read on
- FormatOne-to-one sessions
- StartingSeven introductory sessions
- Sessions50 minutes, weekly
- WhereLondon Bridge or Zoom
What is mentalizing?
Mentalizing is our ability to make sense of what is going on in our own minds and in other people’s: the thoughts, feelings, wishes and intentions that lie behind what we and others do.
It is sometimes described as seeing yourself from the outside and others from the inside. It means noticing what you might be feeling and why, wondering what someone else might have meant, and recognising that your first reading of a situation may not be the only one, or the most accurate.
Mentalizing is an everyday skill, and most of us are good at it when we are calm. But it is fragile. Under stress, when we feel criticised, rejected or threatened, or when we are close to someone who matters, it can go offline quickly. That is often when old patterns take over.
When mentalizing goes offline
You might notice:
- feeling certain you know why someone did something, and that it was about you
- black-and-white thinking, with no room for anything in between
- feelings rising so fast that you act before you can think
- losing sight of the effect people have on each other, including the effect you have
- a sense of who you are that shifts sharply when things get difficult
None of this is a failing. It is what happens to everyone’s mind under enough pressure. MBT helps you notice it sooner and find your way back to a more curious, reflective state.
What is MBT?
Mentalization-Based Therapy, also known as Mentalization-Based Treatment, is a psychodynamic therapy developed by Anthony Bateman and Peter Fonagy. Its central aim is to strengthen your capacity to mentalize, particularly when emotions run high or relationships feel threatening.
By understanding your own mental states better, you can manage your emotions more effectively, relate to others with less confusion and conflict, and feel more settled in who you are. The therapist doesn’t interpret your experience for you; the aim is to strengthen your own ability to make sense of it.
MBT in the NHS
MBT was first developed for adults with a diagnosis of borderline personality disorder, particularly people struggling with overwhelming emotions, unstable relationships and impulsive or self-harming behaviour. It has since been adapted for adolescents, families and other difficulties.
In NHS services it is usually offered as a full programme: an introductory group followed by around a year or more of weekly group and individual therapy, delivered by a team.
MBT with me
In my independent practice I offer an individual approach to MBT. I don’t offer the full group programme.
We begin with seven introductory sessions that build a shared understanding of mentalizing, emotions and attachment. We then move into weekly individual therapy, using that foundation to work on your own difficulties.
Key features of MBT
A mentalizing focus
The work keeps returning to the mind: making sense of what you and others do in terms of feelings, wishes and beliefs.
The here and now
MBT pays more attention to what is happening now, in your life and between us, than to exploring the past at length. We look at feelings and reactions as they happen.
Self and others
Understanding your own mind and other people’s go together. Holding both in view helps you manage your reactions and build more fulfilling relationships.
Making sense of emotions
We explore feelings carefully, noticing and naming them before they escalate. Over time this makes them easier to manage and less likely to drive impulsive action.
Openness and curiosity
I explain what I am doing and why, and I don’t claim to know your mind better than you do. Curiosity, on both sides, is the point.
The seven introductory sessions
The first seven sessions introduce the ideas behind MBT. They are a little like short, one-to-one seminars, and they give us a shared language and a solid foundation for the therapy that follows.
We look at mentalizing, emotions, attachment and relationships, and how they affect mental health. You’ll be encouraged to apply the ideas to your own experience as we go, and when we move into individual therapy we can take your own difficulties much further.
Mentalizing and a mentalizing stance
What mentalizing is, and what it means to take a curious, open attitude to your own mind and other people’s.
When mentalizing breaks down
What happens to our thoughts, feelings and behaviour when we stop mentalizing, and how to recognise it.
Emotions
What emotions are for, the different kinds, and how to identify and manage them.
Attachment relationships
Why attachment matters, and how it shapes our emotional lives.
Attachment and mentalizing
How patterns of attachment affect our capacity to mentalize, especially under stress.
Anxiety, depression and mentalizing
How mentalizing helps in managing anxiety and low mood, in the context of attachment.
Understanding personality difficulties
What is meant by personality disorder, and how it connects with mentalizing.
What MBT with me is like
In individual sessions we explore your mental states together. I ask questions, check what I have understood and offer tentative ideas about what might be going on, always open to being wrong.
Often we take a particular moment, an argument, a message that unsettled you, a time you felt overwhelmed, and slow it down. What were you feeling, step by step? What might the other person have been feeling or intending? Where did things start to speed up?
When feelings run high in a session, we pause and rewind rather than push on. Things that happen between us, a misunderstanding, a moment of feeling judged, are not distractions from the work; they are some of the most useful material we have.
The aim is not to remove distress quickly, but to build your capacity to reflect before you act, and to hold more than one perspective in mind, even when it is hard.
My experience in MBT
I trained in MBT at the Anna Freud Centre, completing the MBT Practitioner Training with Peter Fonagy and Anthony Bateman in 2015, and I am an accredited MBT Practitioner with the British Psychoanalytic Council. In the NHS I led the MBT service in the Lewisham Integrated Psychological Therapies Team at South London and Maudsley.
Who MBT can help
MBT can help when feelings and relationships are where things tend to go wrong, and your ability to think clearly is the first thing to go.
You might find MBT useful if:
- your feelings escalate quickly, and you act or react before you can think
- you often feel misread by others, or find that you have misread them
- close relationships feel intense, confusing or unpredictable
- your sense of who you are shifts sharply when you are under stress
- you live with long-standing difficulties sometimes described as personality difficulties
- anxiety or low mood is closely bound up with what happens in your relationships
In my independent practice I work with adults whose difficulties can be safely supported in weekly individual therapy. If you are often in crisis, or self-harm, a full MBT programme with an NHS team is likely to serve you better, and I’ll say so. More about what I do and don’t offer is on the Psychological therapy page.
If you need urgent help, contact your GP or NHS 111, or call Samaritans free on 116 123. In an emergency, call 999 or go to A&E.
Questions about MBT
Is Mentalization-Based Therapy the same as Mentalization-Based Treatment?
Yes. Both names are used for the same approach, developed by Anthony Bateman and Peter Fonagy.
Do you offer group MBT?
No. I offer MBT individually. If a full programme with group therapy would suit you better, I’ll talk that through with you and suggest where to look.
How long does MBT take?
We start with seven introductory sessions, then move into weekly individual therapy. We agree the length of therapy together and review it regularly.
Can I have MBT online?
Yes. I offer MBT in person at my room near London Bridge, and online on Zoom.
Will my health insurance cover MBT?
Many health insurers cover therapy with an HCPC-registered psychologist. Check with your insurer whether you need a GP referral and how many sessions they will authorise. There is more on the Fees and locations page.
Is MBT evidence-based?
MBT is one of the most researched therapies for borderline personality disorder and is widely offered in NHS services. Most of that research is on the full programme; its principles are also widely used in individual therapy.
Is MBT right for you?
The best way to find out is to talk it through. In a free 30-minute consultation on Zoom you can describe what has been difficult and ask any questions, and I’ll tell you honestly whether I think MBT, or something else, would help.
Book a free 30-minute consultation
Or call 07494 503557 or email carltaylor@ppslondon.net
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