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Re: Anyone have any experience with Menninger (cli

Posted by Stavros on November 26, 2003, at 18:20:24

In reply to Re: Anyone have any experience with Menninger (cli, posted by paulk on November 25, 2003, at 12:44:57


The clinic has moved to TX now and I cannot imagine that they are still into psycho-anaylsis. They are recommended as a a top 5 psychiatric clinic by US news world report. I copied an explanation from their website and wanted to see if it sounds familiar to you.

I apprecite your suggestion but I don't live in Kansas. I am actually looking for a 2nd opinion and psychiatry is all that they do at Menneinger?

I will have to do further research on this to make sure i don't waste the $$. I hope you have a great Thanksgiving.


I. Understanding Mentalizing

Mentalizing refers to the spontaneous sense we have of ourselves and others as persons whose actions are based on mental states: desires, needs, feelings, reasons, beliefs and the like. Normally, when we interact with others, we automatically go beneath the surface, basing our responses on a sense of what underlies the other person's behavior, namely, an active mind and a wealth of mental experience. Thus we are natural mind readers, and mentalizing entails accurate and effective mind reading. By virtue of being human, this process of mentalizing comes so naturally to us that we easily overlook its significance. To understand psychiatric treatment; however, we must pay careful attention to mentalizing and the conditions under which this basic human capacity becomes impaired.

We mentalize in relationships with other persons, not in interactions with inanimate objects. A brick is a static object, inert and unresponsive, always behaving in the same way. A person's behavior is based on mental states that are always in dynamic flux, which makes understanding other persons (and ourselves) the most complex problem solving of which we are capable. Evolutionary biologists now argue that the reason we developed such fancy brains is the sheer complexity of making sense of each other for the sake of our cooperative--and competitive--living.

Mentalizing Explicitly & Implicitly
Sometimes we mentalize consciously. When we are puzzled about another person's actions, we may wonder, "Why was he so abrupt with me? Is he irritated because I didn't return his call right away?" And we mentalize consciously when we are puzzled by our own actions--"How could I have binged on that ice cream when I was so resolved to stick with my diet?"

The majority of our social conversations revolve around gossip, in the benign sense that we mostly talk about ourselves and others--what we are doing and why, and what they are doing and why. Mainly, we seemed to be interested in making sense of our social world and our place in it. We are busy practicing mentalizing.

But thinking and talking about what is going on in our own mind and the minds of others is only part of our mentalizing activity, perhaps just the tip of the iceberg. When we interact with others, we mentalize intuitively, just as we ride a bicycle by habit. Thus we don't just mentalize at an intellectual level; we mentalize at a gut level. When interactions go smoothly, we need not think explicitly about states of mind--our own or the other person's. We can respond automatically, mentalizing implicitly. For example, we often respond to others' emotions without thinking about it, nodding sympathetically with a concerned look on our face as we listen to a friend talking about her child's frightening accident. Another example: we naturally take turns in conversation, being sensitive to pauses and unthinkingly keeping our conversational partner's point of view in mind.

Mentalizing & Mental Health
Mentalizing is crucial to our well-being in several respects. First, mentalizing implicitly and explicitly is the basis of self-awareness and a sense of identity. Importantly, when we mentalize, we have a feeling of self-agency, being in control of our own behavior. Thus mentalizing provides us with a spontaneous sense of ownership and responsibility for our actions and our choices, rather than feeling that our behavior just "happens."

Mentalizing allows us to have an intuitive, as well as an explicit, sense of ourselves that has coherence and continuity. When all is well, we have a spontaneous sense that our different roles, attitudes, states of mind and modes of experiencing fit together coherently, like the pieces of a puzzle. We maintain a sense of continuity throughout different patterns of relating--as serious professionals, concerned parents and playful participants in friendly banter. We maintain a sense of continuity throughout different emotional states--feeling angry, elated, anxious, triumphant and vulnerable. These various experiences form a whole--a self--that we feel and believe is "me."

Second, mentalizing is the basis of meaningful, sustaining relationships. When we mentalize spontaneously, we cannot help but empathize, that is, putting ourselves in the other person's shoes and seeing things from their perspective. While empathizing, we retain self-awareness, a sense of where we are coming from. Such intuitive empathizing--with ourselves and with others--is the cornerstone of healthy relationships and ordinary human interactions. It makes possible the moment-to-moment adjustments we make effortlessly to the verbal and emotional signals we read in other people's behavior. For example, when we sense boredom, frustration or approval, we adjust our own behavior accordingly to convey our perspective and sustain the give-and-take that defines reciprocal human exchanges. Under ordinary conditions of mentalizing, we make these adjustments without much conscious reflection.

At their most fulfilling, relationships involve a meeting of minds. We feel affirmed and validated when we sense that the other person has our mind in their mind. We are not alone. We not only feel heard and understood, we feel felt. We connect through reciprocal mentalizing, when we are thinking explicitly about each other or, more often, when we are interacting intuitively, by feel.

Third, mentalizing is the key to self-regulation and self-direction. Mentalizing allows us to develop a sense of self that includes a sense of coherence, continuity and responsibility for our choices and behavior. At the same time, mentalizing makes possible our engagement in reciprocal, sustaining relationships. By integrating a sense of self and a sense of connections with others, mentalizing enables us to manage losses and trauma, as well as distressing feelings such as frustration, anger, sadness, anxiety, shame and guilt. Mentalizing, we manage these feelings without resorting to automatic fight-or-flight responses or efforts to cope that are ultimately self-destructive or maladaptive. Instead, coping and self-regulating responses based on mentalizing preserve flexibility and choice. They give us the tools to set goals for ourselves, to define the steps we need to take to achieve our goals and to imagine ourselves as the person we want to become. From these capacities we generate the two most basic protective experiences human beings can produce: meaning and hope.

Our focus on mentalizing in psychiatric treatment is based on a growing body of evidence that points to mentalizing as the key to resilience--the ability to adapt successfully to adversity, challenges and stress. By promoting resilience, mentalizing facilitates coping with vulnerabilities, including the genetic vulnerability to psychiatric disorders such as depression, bipolar disorder, anxiety disorders and addictive disorders. Research is demonstrating, for example, that persons who can mentalize in the face of trauma--including childhood trauma--are less vulnerable to psychiatric disorders. Research is also demonstrating that adjustment and quality of life of people with various psychiatric disorders is ultimately determined by abilities that result from mentalizing.




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