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In Mentalization-Based Treatment for Children: A Time-Limited Approach Nick Midgley and his co-authors have produced a coherent and accessible guide for child clinicians who are interested in learning about a new time-limited approach to working with a particular treatment group of children and their families. Mentalization-Based Treatment for Children (MBT-C) has grown out of MBT, which was originally designed and implemented for the treatment of personality disorder in adults (Bateman & Fonagy, 2016). Child psychotherapy readers may recognise the kinds of children described in this text as those who might be expected to experience serious personality problems later in life. These are children who have difficulties in ‘identifying and regulating affects’ and in forming a mental image of themselves from an ‘outside perspective’.
An important piece of the theory which underpins MBT-C is that which mentalization-orientated researchers call ‘epistemic trust’. The authors argue that this is an important ‘stance’, which human beings need to be able to develop in relation to the world, in order to learn about their own feelings and relationships. The authors cite Beebe and Stern (1977) and Fonagy and Target (1996), who have described a steady building up of an autobiography about oneself in relation to others. This is achieved by ‘pre-symbolic, procedural ... nonverbal memories of sensory and affective experiences’ (Midgley et al., p. 27). In order for an infant to engage in this process, they must have trust in the knowledge – about themselves and their relationships – which is imparted to them by caregivers and adults. Fonagy and Allison (2014) have suggested that infants possess a ‘natural epistemic vigilance’. This is a kind of innate critical disposition towards information which may be damaging, deceptive or inaccurate (ibid). There is something interesting here, I think, about gullibility: we might find ourselves, clinically, as concerned