Mentalization and Mortality

AbstractThis chapter elucidates the concepts of mentalization and double awareness. Mentalization refers to the ability to reflect on and describe one’s own mental state and that of others and to connect feelings, thoughts, and beliefs to behaviours. This capacity varies amongst individuals and may fluctuate, based on the affective state, the relational context, and the nature of the conversation. Though it is often considered to be an individual capacity, we have argued that mentalization is a relational construct that is co-produced within therapeutic conversations. A mentalization-based therapy, such as CALM, can help patients to “think about their thinking,” and to consider multiple and alternate ways of viewing their situation. Mentalization may be supported by gentle invitations to patients to consider multiple perspectives and to expand the possibilities for living while facing the end of life, a capacity that we have termed “double awareness.” Using detailed conversation analysis, this chapter illustrates the process by which therapists encourage mentalization in CALM therapy.