Distinguished Clinicians Series with Peter Fonagy, Ph.D. - Mentalizing with Avoidant/Narcissistic Personality Disorder

Mentalization-based treatment (MBT) has become increasingly recognized as a valuable conceptual framework to guide psychodynamically oriented psychotherapy for individuals with complicated psychiatric issues. Developed by Anthony Bateman and Peter Fonagy, MBT emphasizes the importance of the attachment process in early development and helps individuals recover from the consequences of serious disruptions in attachment. The CME will cover the MBT approach to working with avoidant and narcissistic personality disorders. It will cover the mentalizing profiles associated with each of these personality disorders (PD), which the non-mentalizing modes may predominate, and suggestions about the mentalizing stance of the therapist. Although categorized within different PD clusters in the DSM taxonomy, it will be suggested that there are similarities in elements of the mentalizing profiles of avoidant and narcissistic personality disorders, particularly between Avoidant (AvPD) and Narcissistic (NPD) with vulnerable features.  The educational activity will outline basic techniques related to establishing and maintaining a mentalizing stance in therapeutic relationships, specifically in understanding and treating individuals with avoidant /narcissistic personality disorders.

The mentalizing profile of an individual with AvPD is typically characterized by a higher than average focus on cognitive mentalizing in the affective/cognitive dimension of mentalizing, a somewhat higher focus on the self in the domain of self/other mentalizing and a somewhat higher focus on internal mentalizing in the internal/external dimension. They tend to be low in their capacity for external mentalizing and particularly low in their capacity for affective mentalizing. In the implicit/explicit dimension, they may find explicit mentalizing difficult to engage with – this is often because explicit mentalizing often involves being confronted with extremely negative self-beliefs. This difficulty with explicit mentalizing often results in AvPD patients appearing very uncertain or confused about their thoughts and feelings.

Individuals with NPD tend to have an even more pronounced emphasis on the self in the self/other domain, and a concomitant much weaker capacity for mentalizing the other, particularly when the mental state of the other is perceived to be quite different from their own. As with AvPD, individuals with NPD have a similar tendency towards cognitive over affective mentalizing. They may tend to have a somewhat more pronounced capacity for internal over external mentalizing. Individuals with NPD may appear to have a good capacity for explicit mentalizing, but when faced with the potential loss of interpersonal control/self-agency, this can collapse, and a switch to a highly automatic, implicit form of mentalizing occurs. 

At the conclusion of this live presentation, participants should be able to:

• Recognize and manage the manifestations of pretend mode of mentalizing.
• Appreciate the role of natural curiosity in mentalizing and learning about methods of enhancing this in individuals with AvPD.
• Articulate manifestations of disrupted self-structures as described in the concept of the ‘alien self’ and managing clinical relationships in the context of such experiences.
  

$25.00 Student Rate

$50.00 Professional Rate

Forms of payment accepted are Visa, MasterCard, Discover, and American Express. Registration will be finalized with receipt of payment. Payments must be made in advance. No checks or cash will be accepted at the door.

Registration is limited to 90 attendees; so sign up today.

2.0 contact/credit/clock hours have been designated by The Menninger Clinic for the following disciplines:

Physicians

Psychologists

Social Workers

Licensed Professional Counselors

Addictions Professionals

For ADA or lactation needs, please email directly to: 

Michelle A. Taylor: 

mataylor@menninger.edu