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Mentalization-based treatment (MBT), and the construct of mentalizing, is currently experiencing a period of dramatic growth and expansion. Mentalization is defined as the capacity to “read,” access, and reflect on mental states (e.g., thoughts, emotions, desires, attitudes, values) in ourselves and other people. While the term has been floating around within psychoanalysis since the 1950s, this particular understanding of mentalization was first proposed in 1989 by the psychoanalyst Peter Fonagy, who suggested that people with borderline personality disorder suffer from context-dependent vulnerabilities in their ability to flexibly reflect on mental states in themselves and others (Fonagy, 1989). Fonagy partnered with fellow analyst Anthony Bateman to develop and systematize MBT: an exploratory yet structured psychotherapy that integrates principles from attachment theory, developmental psychology, neuroscience, and clinical psychoanalysis to address instability in emotions, self-esteem, and interpersonal relationships (Bateman & Fonagy, 2016).
MBT has emerged as a leading evidence-based therapy for borderline personality disorder (Storebø et al., 2020), resulting in decreased depression, anger issues, paranoia, hostility, self-injury, suicidality, medication usage, and inpatient hospitalizations, as well as notable advances in social, academic, and vocational functioning (Bateman et al., 2016, 2021; Bateman & Fonagy, 1999, 2008, 2009). But the use of MBT has extended well beyond borderline personality disorder, with research supporting MBT's effectiveness in treating antisocial personality disorder, adolescent self-injury, eating disorders, posttraumatic stress disorder, and substance use disorders (Bateman & Fonagy, 2019). More recently, the reach of MBT has expanded even further, with applications being developed for pathological narcissism (Drozek & Unruh, 2020, 2022; Drozek et al., 2023), short-term psychotherapy (Juul et al., 2019), family therapy (Asen & Fona