Mentalization-Based Work with Families

This article reviews an approach to working with families that grounds in systemic thinking the framework of mentalization-based treatment. Employing a mentalizing stance, this approach aims to interrupt coercive, nonmentalizing cycles of interaction within the family system and replace them with mentalizing conversations in which epistemic trust and the shared social-emotional learning of the we-mode can be generated. The process thus promoted is a spiral of shared attention and co-mentalizing, constantly lost and then recovered, in which therapist and family members learn to hear, recognize, understand, and trust one another and repair the inevitable disruptions in mentalizing and trust that allow family members to experience a way of shared knowing— the we-mode—that they can apply to communicate and solve problems both within the family system and in the broader social systems in which the family is embedded.