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How Robust Mentalization and Secure Attachment are Related- Sydni P.

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How Robust Mentalization and Secure Attachment are Related- Sydni P.

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People who are securely attached are easily able to adjust to emotionally stressful situations, even when those situations involve temporary negative emotions towards those that they love. These individuals readily employ coping strategies and reconcile peacefully with others. Similarly, individuals who have robust mentalization are able to quickly rationalize their thoughts and emotions, as well as those of others, after they have become upset, or are faced with emotionally difficult situations.

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Hyperactivation vs. Deactivation- Sydni P. 

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Hyperactivation vs. Deactivation- Sydni P. 

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Hyperactivation attachment strategies involve becoming quickly invested in new relationships, and intensely attaching to others very early on. Contrastingly, deactivation strategies involve emotionally distancing oneself from the relationship, whether that may be by spending less time with the person, or calling less frequently.

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Hi Sydni, great job on this discussion post! I appreciate how succinctly you explained the difference between attachment hyperactivation and deactivation strategies and it helped my own understanding of this topic. Thank you!

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I 100% agree with everything you said. I also choose this question to answer for this discussion as well and our answers were very similar. We both touch upon the same points and I'm glad I understood the topic in a similar way as you! Great job!

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In MBT, the main role of the therapist is to assist the patient in their ability to mentalize and to validate the feelings of the patient. There are 5 key components of the therapist stance according to Bateman and Fonagy (2013). They include: “humility deriving from a sense of not knowing, patience in taking time to identify differences in perspectives, legitimizing and accepting differences in perspective, actively asking (what more than why)” and carefully deciphering when something is not clear (p. 600). This includes paying attention to how individuals experience concrete inability to mentalize as well as acting as a model in the mentalization process as a way to help them to relearn. Modeling as a role of the therapist also relates to the final role of making sure to acknowledge shortcomings in the therapeutic space. The concept of the sense of not knowing made me think about another concept that I learned when working which was “the patient is the expert of their own life,” which exemplifies the concept that the therapist is not always correct in their interpretation.

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Hyperactivation and deactivation strategies are both responses that an individual utilizes to compensate for the internal experiences they have. Bateman and Fonagy (2013)  write that individuals who utilize hyperactivation strategies may have anxious attachment styles and often quickly attach to individuals. This can manifest in the treatment space by idealizing the therapist and overstepping boundaries. The neural systems utilized in trusting are compromised. There is then a flip in which the patient becomes upset and confrontational or adversarial and they take a longer time to regain their ability to mentalize. Deactivation strategies are used to distance from mounting stressors, and they are often deployed by those with avoidant attachment strategies. These individuals may utilize these strategies to maintain independence and are often able to retain their ability to mentalize for longer than others. This often leads to a sudden “reactivation” and increased internal distress and often greater negative self-talk/self-image. Although they may be experiencing larger internal stress, they are outwardly calm and collected (Bateman & Fonagy, 2013).

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Hi Sydni! You made a great point about securely attached individuals and those with robust mentalization skills. Securely attached people handle emotional stress well, reconciling peacefully after conflicts due to their trust and resilience in relationships. Individuals with strong mentalization are able to quickly understand and rationalize emotions, which helps them navigate difficult situations effectively. These qualities are important for managing emotions and maintaining healthy relationships. Great work!

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This is an extremely thoughtful post and I appreciate the way you interpreted and answered this question. The way you were able to explain mentalization and the way the therapist should be paying attention to mentalization when in the theraputic setting. great job!

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Response to Question & Commentary to another student's (Casey's) post-G. Castro

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Response to Question & Commentary to another student's (Casey's) post-G. Castro

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The emphasis on the therapist’s stance, as detailed by Bateman and Fonagy (2013), underscores the importance of creating a therapeutic environment grounded in humility, patience, and acceptance of differing perspectives. This aligns well with the broader therapeutic principle that Casey brought up, which is that the patient is the expert of their own life.

As noted in the reading, the concept of humility, particularly the “sense of not knowing,” is crucial in fostering a non-judgmental and open space where patients feel validated and understood. It also helps mitigate any power imbalances in the therapeutic relationship, reinforcing the idea that the therapist is a guide rather than an authoritative figure. This humility allows therapists to better attune to the patient’s experiences and perspectives, which is essential in promoting effective mentalization.

Casey, I really appreciated how you drew a connection to your own clinical work by sharing this idea that “the patient is the expert of their own life”, as it particularly resonates with me. I believe that this perspective encourages therapists to listen actively and to prioritize the patient’s subjective experience. It also underscores the importance of the therapist’s role in facilitating, rather than directing, the therapeutic process as noted by Bateman and Fonagy (2013). By acknowledging the patient’s expertise in their own life, therapists can better support the development of the patient’s mentalizing abilities.

Moreover, the components you mentioned—especially the focus on asking “what” rather than “why”—highlight a crucial technique in MBT. This approach encourages exploration and curiosity, helping patients to articulate their thoughts and feelings without feeling judged or misunderstood. It also helps to build a collaborative dialogue, where both therapist and patient work together to understand the patient’s inner world.

Modeling mentalization is another significant aspect of the therapist’s role. By demonstrating mentalizing behaviors, therapists provide patients with a tangible example to emulate. This not only aids in the patient’s relearning process but also helps to normalize the challenges they face in mentalizing. Acknowledging shortcomings in the therapeutic space is also vital, as it models authenticity and transparency, fostering a safe environment where patients can explore their vulnerabilities.

Overall, your commentary brings to light the delicate balance therapists must maintain in MBT. By embodying these principles, therapists can effectively support their patients in developing stronger mentalizing capacities, ultimately aiding their journey towards better emotional regulation and interpersonal relationships.

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How robust mentalization and secure attachment are related -G. Castro

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How robust mentalization and secure attachment are related -G. Castro

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Robust mentalization and secure attachment are deeply interconnected, influencing each other in significant ways. Mentalization, which Bateman & Foanagy define as the ability to understand and interpret one’s own and others’ mental states, is dynamic and multifaceted, and is particularly crucial in the context of attachment relationships. To respond to this question, I have organized my thoughts into different components highlighted by Bateman & Fonagy (2013) of the interconnectedness of mentalization and secure attachment.

1. Foundation of Secure Attachment: Secure attachment forms the groundwork for developing robust mentalization. Early attachment experiences with caregivers who are responsive and attuned to a child's needs foster a secure attachment, providing a stable base from which the child can explore the world. This secure attachment allows the child to develop a strong sense of self and others, facilitating the growth of mentalizing abilities.

2. Stress Resilience: Individuals with secure attachment tend to have more robust mentalization, allowing them to continue mentalizing even under stress and to recover quickly from lapses in mentalization. This resilience is a hallmark of robust mentalization and is crucial for maintaining healthy relationships and emotional regulation. Securely attached individuals are better equipped to manage stress and adversity, partly because their early experiences taught them that they can rely on others for support and that their emotional needs will be met.

3. Broadening and Building: The "broaden and build" cycles of attachment security, as described by Fredrickson (2001), illustrate how secure attachment reinforces mentalization. Secure attachment promotes feelings of safety and personal agency, which in turn foster affect regulation and the development of more adaptive environments. These positive cycles enhance the ability to mentalize, creating a feedback loop where secure attachment and robust mentalization mutually reinforce each other.

4. Resilience and Perspective: Individuals with high levels of mentalization, often developed through secure attachment, show considerable resilience in the face of stress. They can gain beneficial perspectives on their lives from adversity, displaying a capacity for growth and adaptation. This resilience and ability to maintain mentalization under stress are closely tied to the secure base provided by early attachment experiences.

5. Exploration and Creativity: Secure attachment and robust mentalization encourage exploration of both the external world and internal experiences. This is often manifested in creativity, the ability to symbolize, and an interest in dreams, fantasies, art, and music. Securely attached individuals are more likely to explore and verbalize even difficult memories and experiences, reflecting their inner security and mentalizing capacity.

6. Relationship Recruiting and Coregulation: Securely attached individuals exhibit strong capacities for relationship-recruiting, meaning they can form attachments to caring and helpful others, and for effective coregulation of stress and adversity. These abilities further enhance their mentalization, as supportive relationships provide additional opportunities for reflective functioning and emotional regulation.

In summary, robust mentalization and secure attachment are intricately linked. Secure attachment lays the foundation for robust mentalization, which in turn reinforces secure attachment through resilience, adaptability, and a capacity for meaningful exploration and relationship-building. This dynamic interplay supports healthy psychological development and well-being throughout life.

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How robust mentalization is related to secure attachment- Ian L.

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How robust mentalization is related to secure attachment- Ian L.

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Robust mentalization is strongly linked to secure attachment as secure attachment forms the basis for robust mentalization. This relationship is reciprocal in that secure attachment is necessary for mature mentalization, and the ability to mentalize under significant stress promotes "broaden and build" cycles of attachment security. These cycles enhance feelings of secure attachment, personal agency, and emotional regulation (build), leading to the development of more adaptive environments (broaden). Additionally, individuals with string mentalization skills tend to be more resilient to stress and are able to gain beneficial perspectives on their lives compared to those with insecure attachment and thus, lower mentalization abilities. Those with secure attachment and robust mentalization also tend to form attachments with caring and supportive individuals and are able to effectively manage stress in adverse situations because they are able to mentalize well and shift their perspective in order to better manage their stress/adversity to develop a more adaptive environement for themselves.

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Hyperactivation vs. Deactivation strategies- Ian L.

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Hyperactivation vs. Deactivation strategies- Ian L.

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An individual who uses attachment hyperactivation strategies to manage their internal states and interactions with others tends to form attachments with other quickly and easily. This hyperactivation leads to inappropriate and intense attachments and inhibits the neural systems responsible for assessing the trustworthiness of others. In contrast, attachment deactivation is characterized by emotional distance during interpersonal stress. As stress levels rise, individuals employing attachment deactivating strategies will often detach from others and distance themselves from situations to avoid the emotions associated with the increased stress.

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According to the Bateman and Fonagy article, hyperactivation strategies are common among people with BPD and might include attaching to others easily and quickly. This might look like falling in love very quickly, and then experiencing feelings of betrayal. These relationships are intense in nature. Alternatively, deactivation strategies include distancing and isolation during stressful conditions.

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Robust mentalization and secure attachment - Michela 

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Robust mentalization and secure attachment - Michela 

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How I understand these two concepts relating is through mutual reinforcement. Secure attachment can help to initiate mentalization skills, but also vice versa. If someone has the ability to use mentalization techniques to enhance the quality of their relationships with others, especially caregivers and romantic partners then it could help to make their attachments more secure. Both mentalization and secure attachment are helpful for the ongoing process of maintaining healthy relationships both emotionally and socially.

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Robust mentalization and secure attachment- Jill R

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Robust mentalization and secure attachment- Jill R

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Mentalization is the ability to understand ourselves and our mental states. This is related to secure attachment because those who are securely attached are able to continue mentalizing under stressful conditions. This process becomes cyclical because the ability to maintain mentalization reinforces feelings of secure attachment. The cycle of mentalization and reinforced secure attachment allows individuals to have healthy relationships.

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Casey, I like how you highlighted the importance of modeling as the role of the therapist; identifying shortcomings within the therapeutic space; and the patient being the expert on their own life, in your response. I feel that these are all important concepts to remember and put into practice in our clinical work. I believe that demonstrating humility within the therapeutic space, and openly surrendering to the fact that we may not always correctly interpret our client's thoughts and feelings is critical to both strengthening and maintaining the therapeutic alliance.

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Gaby, I like how you divided your response into the topics addressed in the paper. I found your explanation of the broaden and build cycle helpful in my understanding! I also found it interesting that you separated the topics of stress resilience and resilience and perspective. I might have expected these two topics to fall under the same category, but your explanation shows me that there is a difference between how secure attachment --> mentalization --> resilience is different from resilience --> enhanced perspective on adversity.

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Casey, I like that you not just explained how attachment hyperactivation and deactivation look in the patient's outside life, but also how it shows up in the therapeutic space. I think this is an important thing to highlight because it supports the need for mentalization based treatment, as the strategies employed by Bateman and Fonagy in their treatment seek to help patients, such as those with BPD, whose hyperactivation/deactivation strategies impact their ability to make progress in therapy.

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Hi Ian! I appreciate how you stress the reciprocal nature of robust mentalization and secure attachment. The relationship between the two really lends to understanding the broader world of the patient and how they form connections with others, as you mention. I think it is important to consider an individual's experiences and abilities when conceptualizing a case with these concepts. It seems like it can shed a lot of light into understanding a patient's interpretation of the events occurring in the environment around them

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When looking at MBT and addressing specific challenges for individuals with BPD, the article mentioned interpersonal relationships. When thinking about those with BPD, these individuals have a tough time with interpersonal relationships and can be characterized as unstable and having intense interpersonal relationships. MBT in particular helps those with BPD develop their understanding of their emotions and perspectives as well as those who they are engaging in an interpersonal relationship with. Its also important to help them work on their communication skills and reduce misunderstanding with those they are engaging in a relationship with.

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Hyper activation and Deactivation- Kait L 

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Hyper activation and Deactivation- Kait L 

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Hyperactivation attachment can be described as looking for that intense bond between another person and seeking proximity and closeness with new relationships. Looking at deactivation attachment, this strategy involves suppressing ones needs and emotions to avoid any sort of perceived threat. This may look as though they are being avoidant, not spending time with a person and just overall being distant.

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Attachment hyperactivation occurs when an individual attaches to others very fast. These attachments are very intense, and the individual may have a hard time judging the trustworthiness of the person they are attached to (Bateman & Fonagy, 2013). These individuals will have a tendency to also trust their therapist very quickly (Bateman & Fonagy, 2013). On the contrary, individuals who utilize attachment deactivation strategies are emotionally distant when they are stressed. On the outside, they appear calm, but their blood pressure may be increasing internally, and they could be feeling quite a bit of distress (Bateman & Fonagy, 2013).

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In mentalization-based treatment, the goal of the therapist is to consider their own state of mind and understanding of the patient’s experiences as the patient is describing them. By doing this, the therapist is offered an alternative perspective to the patient’s experience (Bateman & Fonagy, 2013). The first key component of the therapist’s stance is that they maintain a sense of not being all-knowing about a patient’s experience. In other words, the therapist’s take on the patient’s experience is no more superior than their own perspective (Bateman & Fonagy, 2013). The second and third key components are that the therapist takes the time to analyze what the differences may be between their perspective and the patient’s while accepting that both perspectives can exist equally (Bateman & Fonagy, 2013). The fourth key component of the therapist’s stance is that they continuously ask questions about the patient’s experiences to gain as much detail as possible. The final key component is that the therapist always lets the patient know when they do not understand any aspect of the patient’s reports (Bateman & Fonagy, 2013).

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The specific challenges that you brought up in your response made me think of a particular client I had this year at practicum who was diagnosed with BPD. A lot of her stressors were interpersonal and she was seeking help for how to properly communicate with her husband and children. A lot of what we worked on was trying to understand her husband's perspective, which is one of the challenges you mentioned!

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I agree with you that secure attachment is correlated with the increased ability to process emotional situations (mentalization). Going back to early childhood, these individuals most likely had inconsistent emotional responses on the part of their caregivers. As a result, they do not know how to handle emotions as they grow and develop.

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I'm glad you mentioned the importance of improving the communication skills of individuals with BPD. Strong, effective communication skills are a essential to the functionality of any interpersonal relationship, in addition to being able to fully understand one's own, and the other party's emotions. Communication skills training can easily be incorporated into treatment using the MBT approach

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Hey Gaby, I appreciate how each point is thoroughly detailed and elaborated upon, particularly in relation to early experiences with caregivers and their connection to creating a secure attachment, and how this, in turn, enhances the development of mature mentalization capacities. I think your breakdown helps in comprehending the material and considering the impact of mentalization and secure attachment on individuals in a clinical context.

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Hi Alexa! I appreciate how you stressed the importance of the therapist being mindful of their own state. This is generally such an important part of therapy but it seems to be stressed in the role of the therapist in MBT. I think it is so important to be mindful of our own state of mind, especially because it seems that it is important to appropriately model mentalization in this type of therapy!

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Hi Alexa - One thing I really appreciate about what you wrote is this idea that the therapist should not maintain a sense of "all-knowing" especially when it comes to the patient's experience. I believe this is so important in MBT but in all forms of treatment because it is true that the client is the expert on themselves not the therapists! Well done.

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Bateman and Fonagy (2013) discuss how in mentalization-based treatment, the therapist plays an important role in creating the therapeutic alliance by using strategies such as active engagement, validation, and empathy. The therapist then helps the patient to explore and understand their own and others mental states. An important element of the therapist is managing the patient's various arousal levels to allow for mentalizing abilities during the therapy sessions. By providing consistent empathy and support to the patients, the therapist will help the patient feel understood and secure, which is essential for the effective treatment of BPD. A key element of the therapist's stance is to adopt the “not-knowing stance” by having a non-judgmental and curious attitude, and accepting that they don’t always know everything about what the patient is experiencing. This stance helps patients feel safe to explore difficult emotions and experiences in a safe environment. The therapist also models a curious and open approach to understanding mental states, which patients can learn to adopt. This modeling helps patients learn to approach their own and others mental states in the same way. Additionally the therapist should have a knowledge of and appreciation for the different perspectives that exist between the therapist and the patient, and be able to not only accept these differences but also acknowledge and further inquire about them. (Bateman and Fonagy, 2013)

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Hey Casey, I really liked that you highlighted how the therapist can serve as a model for utilizing mentalization through their interactions with the client, allowing for the client to understand how to view things from different perspectives. I think this is an important, and often overlooked, aspect of the therapeutic process.

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Attachment hyperactivation strategies involve forming very intense and quick attachments to others which can then result in intense disappointment. Individuals using hyperactivation strategies tend to idealize relationships and therapists initially but can quickly become dismissive and hostile when their needs are not met.

In contrast, attachment deactivation strategies are used by individuals who emotionally distance themselves to maintain mentalization during stress. While they may appear calm, they often experience significant distress internally. Under higher levels of stress, deactivation strategies can fail, leading to an even greater sense of insecurity and increased internal distress.

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Casey, I like how you highlighted the 5 key components very clearly, and also commented on how the therapist is involved in the process of modeling behavior to the patient. I also like the quote that you brought up regarding patients being an expert in their own lives. This post also makes me think about the importance of humility as a quality of a therapist, because we are working with patients who are experts on their own life and experiences. This shows how important it can be for the therapist to not only be able to remain humble but also be able to admit their wrongdoing or mistakes, which can be a very challenging thing when you are expected to be an expert in the room.

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Gabby, I like how you outlined these different components of the interconnectedness of mentalization and secure attachment. I thought it was interesting to read how resilience comes into play in the relationship between these variables. It makes a lot of sense that a stronger sense of resilience in the face of stress is seen more in individuals with a high level of mentalization.

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Robust Mentalization and Secure Attachment (Kylee S.)

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Robust Mentalization and Secure Attachment (Kylee S.)

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Robust mentalization refers to the ability to either continue mentalizing under stressful conditions and/or quickly recover from temporary lapses in mentalization. Furthermore, mentalization involves one’s ability to understand both their own and others mental and emotional states as well as regulate oneself when alternative perspectives are present. According to Bateman and Fonagy (2013), robust mentalization is related to secure attachment via a reciprocal process called “broaden and build.” Building refers to when cycles of attachment security aid in the development of feelings such as personal agency and affect regulation. Broaden refers to the ability to develop more adaptive environments. During childhood, children with secure attachment have parents that are attuned to their emotional and physical needs. Associated with this attunement, the child is able to adequately explore their own thoughts and feelings, which allows the child to further understand their own internal emotional states. Nevertheless, secure attachment is related to robust mentalization because the individual has developed an overall sense of inner security and ability to verbalize negative feelings and experiences. Furthermore, those with secure attachment generally show higher levels of mentalization, which is related to better resilience in stressful situations, effective coregulation of stress, and an overall good capacity to explore both the internal and external world. Conversely, those with less secure attachment are less capable in regard to reflecting on their own and others’ internal worlds, which negatively impacts their interpersonal functioning.

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Hyperactivation vs Deactivation Strategies (Kylee S.)

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Hyperactivation vs Deactivation Strategies (Kylee S.)

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Both hyperactivation and deactivation strategies are commonly employed by individuals with borderline personality disorder. Hyperactivation strategies refer to when individuals with borderline personality disorder attach to others extremely easily and quickly. However, this attachment frequently leads to disappointment because the individual’s attachment is excessively and inappropriately intense and the neural system is unable to adequately assess the trustworthiness of others. This disappointment manifests as a quick reversal in hyperactivation strategies such as becoming dismissive and hostile toward others. On the other hand, deactivation strategies refer to when individuals emotionally distance themselves in order to keep mentalization at the forefront longer. Despite the initially calm presentation of individuals that use deactivation strategies, these strategies tend to fail which results in strong feelings of insecurity, heightened negative self-representations, and higher levels of internal distress. Nonetheless, the primary differences include hyperactivation strategies involving quick attachment and deactivation strategies involving emotional detachment.

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Hi Kait, I completely agree that the primary connection between MBT and individuals with BPD involves the challenges these individuals primarily endure within the context of interpersonal relationships. I particularly enjoy your characterization of interpersonal relationships for those with BPD as unstable because of their difficulties understanding not only their own emotions but also the internal emotional states of others. The article mentions that individuals with BPD tend to have difficulties reflecting upon the motives of others. This might contribute to disappointment associated with the failure of hyperactivation strategies. As an individual with BPD becomes quickly attached, the individual frequently misconstrues or inaccurately evaluates the actions of others leading to their disappointment and hostility. Moreover, I also enjoy that you mentioned that MBT emphasizes the development of communication skills in addition to stabilizing one’s emotional expression and increasing their understanding of internal emotional states.

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Hyperactivation vs. Deactivation - Ilannah

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Hyperactivation vs. Deactivation - Ilannah

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From my understanding, attachment hyperactivation and deactivation are patterns of behaviors that may be used in response to stressors that are related to one’s attachment, taking part in shaping one’s relationships and emotional regulation regarding those relationships. Attachment hyperactivation strategies look like the development of a rapid, intense attachment to others, leading to over-idealization, the overlooking of negative aspects of the relationship, and difficulties in setting boundaries/maintaining healthy expectations. Attachment deactivation strategies, on the other hand, involve the emotional distancing of oneself from others, avoiding the closeness that is sought by those experiencing attachment hyperactivation. This avoidance functions as a mode of protection from emotional harm, giving that individual a sense of control. This would present as emotional detachment in relationships, a tendency to be self-reliant and hyperindependent, and having difficulty trusting others/forming meaningful emotional connections.

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How does robust mentalization relate to secure attachment? - Ilannah

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How does robust mentalization relate to secure attachment? - Ilannah

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Robust mentalization and secure attachment go hand in hand, for those with a secure attachment are most likely to have robust mentalization abilities. When one has experienced a secure attachment in early childhood, they are provided a sense of security that allows them to explore and come to understand their own emotions and the emotions of others without fear of rejection or abandonment. In receiving things such as emotional support and validation, as well as responsiveness to their needs by their caregivers, this allows a child to engage in reflective processes that will help enhance their mentalization abilities over time. Additionally, in a secure attachment, the behavior of the caregiver  (i.e., attuning to needs, validating experiences, assisting in making sense of feelings) models mentalization behaviors for the child and allows them to pick up on this concept and skill of mentalization, leading to greater mentalization abilities in the future. Those who develop robust mentalization skills are therefore better at navigating challenging situations, navigating social interactions, effectively emotionally regulating themselves, and maintaining fulfilling, stable relationships.

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Hi Casey, I enjoy how you included all five aspects of the therapist stance within your discussion post. All five of these key components directly relate to the main therapeutic goal of aiding the client in developing the ability to mentalize as well as validating their feelings and experiences. One interesting difference regarding the therapist in MBT and other therapeutic modalities involves the limited and cautious use of interpretation and transference. Because the emphasis is on the client developing the ability to understand their own and others' internal emotional states, statements such as “It sounds like you are feeling…” are discouraged because it is important for the client to identify their own feelings and emotions. I found this to be an incredibly interesting component of the therapist stance that aligns with the concept you mentioned about the client being the expert of their own life. Furthermore, I agree that modeling is a critical component of MBT because the therapist must also demonstrate their own curiosity and capacity to mentalize in order to help the client invoke their own curiosity and mentalizing abilities.

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How does robust mentalization relate to secure attachment? -Marina 

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How does robust mentalization relate to secure attachment? -Marina 

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Bateman and Fonagy (2013) comment on disorganized attachment styles demonstrating deficits in mentalization. However, the opposite is true with secure attachment styles. According to the article, robust mentalization is defined as one's ability to swiftly recover and adapt to stress. This can lead to one becoming more adaptive under high-stress environments, enhancing a strong sense of agency, security, and emotional regulation. Individuals with great levels of robust mentalization are resilient when facing adversity, leading to the cultivation of support systems.

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Attachment hyperactivation and deactivation strategies -Marina 

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Attachment hyperactivation and deactivation strategies -Marina 

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Attachment hyperactivation and deactivation strategies manifest differently across individuals. The hyperactivation strategies may demonstrate themselves as forming an intense attachment fairly quickly. This can lead to feelings of disappointment, as the individual may be unable to determine which relationships are worthy of this bond. These heightened experiences and emotions can lead to the individual utilizing deactivation strategies. Here, one may distance oneself emotionally to maintain one's emotions from a distance.

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Hi Marina! great points on how attachment hyperactivation and deactivation strategies work. I like how you explained that intense attachments can lead to disappointment and push individuals towards emotional distancing as a coping mechanism. Understanding these strategies can be very helpful, especially when it comes to couples therapy!

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I appreciated reading your insightful post about the differences between the two, Ilannah! You did an excellent job explaining the two concepts in a detailed manner. Your thorough explanation made me think of a young female client I currently see at my practicum site. This applies to her case regarding relationships and how she perceives them. She engages in both strategies depending on the outcome of her partner.

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Hi Casey! I appreciate the foundation you provided regarding the role of the therapist and the key components. I feel practicing humility during sessions is not talked about nearly enough. Through our clinical classes and clinical training, we are taught to embody the practice of being the "expert" and feeling as if we have to know everything for the sake of the patient. However, presenting a sense of curiosity in sessions is important as we gain more insight and knowledge into our clients' lives.

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I appreciate your “vice versa” framing here, as I was thinking the same thing as I thought through the relationship between mentalization and secure attachment. The modeling of mentalization from caregivers allows for a child to pick up that skill and therefore become further securely attached, and one’s secure attachment would then allow them to pick up on mentalization. This makes me think of one of my clients and how mentalization is not a skill that was adequately developed due to having an insecure attachment style. I was speaking with them recently about allowing themselves to rely on the few individuals that they have come to trust as opposed to maintaining their hyper-independence, as these relationships may be conducive to building her mentalization skills and allow her to feel more inclined to seek connections with others. Appreciate your insights!

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Robust mentalization and secure attachment- Lavender 

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Robust mentalization and secure attachment- Lavender 

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Robust mentalization is the ability to maintain a clear perspective on the mental states of oneself and others, during stress and recover quickly from a lapse in mentalization. This process is strongly linked to secure attachment. Secure attachment is the foundation of mature mentalizing capabilities. Individuals with secure attachment show resilience in stressful situations, being better able to mentalize under stress essentially. Individuals with secure attachment have good ability to build strong connections in relationships and regulate stress and adversity, the essence of mentalization.

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Attachment hyperactivation is typically used by individuals who display an anxious attachment style. These individuals tend to form quick, intense attachments to others. They idealize their relationships, whether romantic or platonic, however when people do not live up to their expectations, they rapidly devalue these relationships, becoming hostile. When it comes to mentalization, these individuals need more time to reengage this process. Deactivation strategies are in contrast to hyperactivation. Individuals with an attachment deactivation style are able to maintain mentalization longer by avoiding close relationships and staying emotionally distant. In stressful situations these individuals may feel insecure and show biological indicators of stress however report not feeling distressed or bothered by these factors. There is a dissociation between their subjective feelings of stress and external reaction compared to internal state.

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I appreciate your inclusion of the five key components to the therapists’ stance in MBT, as I feel that all five of these would be advantageous to model for a client struggling with BPD, attachment, and/or mentalization. I would argue that these components are important and necessary when considering building strong, long-lasting connections with others and it gives the client a personal understanding of how to engage with others based on how they’re being treated in session. This modeling in the therapeutic space is something I’ve come to realize that I’ve been subconsciously doing with a client of mine who struggles with insecure attachment and often utilizes attachment deactivation skills. I felt that it was imperative to demonstrate to my client that despite their adverse childhood experiences and resulting negative automatic thoughts and self-talk, there are people who are willing to listen and respond without judgment, who are genuinely interested and curious about their life and goals, and is willing to take the time to understand them and their complexities, so it's been interesting reading more about this therapeutic stance that I've been taking without background knowledge of MBT. I worried often that my client would feel that it is simply my job to care and behave in this way (which is how they’ve described other therapists in the past), but as we are wrapping up our sessions together, we have talked about how my efforts have been received and how it has allowed them to become more curious about putting themselves out there to make new connections, realizing that not everyone is “bad” or out to get them. Thanks for your insights!

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Hi Alma, I like how you brought up the fact that the therapist and patient may have different perspectives and the importance of the therapist to acknowledge these differences. I believe this also helps the therapeutic alliance grow in validating the patients’ feelings and perspective. The therapist is also showing the patient that they are able to express their emotions/thoughts without fear of judgement.

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Hi Kait, I agree with that the focus of MBT with patients with BPD should be on interpersonal relationships. In order to help the individuals it is important for the therapist to maintain structure where their relationships may not have had in the past which may help foster a strong attachment relationship and therapeutic alliance.

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MBT with individuals diagnosed with BPD- Priya A.B.

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MBT with individuals diagnosed with BPD- Priya A.B.

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Individuals who have BPD often have even more elevated emotional instability once they start getting close to someone or are looking to/are in a relationship. In general, those with BPD have difficulty with relationships as well as their own sense of self. MBT aims to address this by establishing core techniques and structure. The structured treatment aids by adding a sense of stability. Some key things that are focused on are enhancing compliance, honing in on a specific goal/having a focus area, having a thorough integration with the patient's other services, being long-term, and developing a strong patient-therapist relationship. This treatment takes place for around 18 months. These core techniques will hopefully help the patient develop a sense of comfort in relationships and experience a more consistent, stable, healthy relationship through patient/therapist interactions. The therapist will help the patient by aiding them in seeing relationships through different lenses and having a proper balance of emotions when being let into the space without the patient feeling overwhelmed.

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Hyperactivation and deactivation strategies - Nourleen G.

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Hyperactivation and deactivation strategies - Nourleen G.

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Attachment hyperactivation and deactivation strategies are ways people cope with relationship stress. Hyperactivation leads to forming fast, intense bonds, which often result in idealizing the other person and later feeling disappointed. On the other hand, deactivation involves keeping emotional distance to stay in control, looking calm on the outside but feeling stressed inside. Hyperactivation features quick attachments and boundary problems, while deactivation is characterized by self-reliance and challenges in forming close relationships.

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Attachment hyperactivation is when anxious clients form attachments to individuals very easily and quickly. These attachments are often extremely quick and inappropriate as they do not allow time to develop a relationship properly. This attachment causes them to have a distorted perception of trusting individuals as they develop quick relations with anyone. On the other side of the spectrum, there are also deactivation strategies. In a sense, this is the reverse of hyperactivation, where the person detaches from a relationship and discards it. They are very dismissive and critical. This leaves the person feeling highly distressed and insecure.

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Hey Michela,

I liked the connections you made with robust mentalization and secure attachment through mutual reinforcement. Including the part about relationships with caregivers was really important as I feel that oftentimes, there is a focus on romantic relationships and how to improve that aspect while there is still the ability to work on and fix caregiver relations at many ages. It is interesting to look at the attachments individuals have made with their caregivers and how it may show up while an individual develops other relations in their lives.

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Robust mentalization and secure attachment - Nourleen G.

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Robust mentalization and secure attachment - Nourleen G.

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Robust mentalization and secure attachment reinforce each other. Secure attachment helps develop robust mentalization skills, which aid in understanding and managing emotions, especially during stress. This positive cycle improves emotional regulation and creates adaptive environments, further enhancing attachment security. People with secure attachment and good mentalization are more resilient, better at handling stress, and form supportive relationships. In contrast, insecure attachment often leads to poor mentalization, making stress and relationship management harder.

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Hey Alma,

I liked how thoroughly you developed the role the therapist has in having a space for the patient's emotions in session. Especially with clients that are diagnosed with BPD, it is important to develop skills around building better relationship attachments. These clients often have limited to no healthy relationship experience and have trouble finding an environment where they feel secure expressing their emotions. Through time a patient will hopefully be able to retain these skills and apply them forward.

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Role of therapist in MBT and key components of their stance- Kelly M

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Role of therapist in MBT and key components of their stance- Kelly M

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The role of the therapist in MBT is to provide an "alternative perspective". The therapist is expected to verbalize more of their own experience of the client's experience. This in turn, allows the client and therapist to work jointly in the therapeutic task of mentalization.

Some key components for the therapist's stance include; humility deriving from a sense of not-knowing, patience in taking time to identify differences in perspectives, legitimizing and accepting different perspectives, actively questioning the patient about their experience- asking for detailed descriptions of experience, and careful eschewing of the need to supply understandings for things that do not make immediate sense.

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Attachment Hyperactivation vs Deactivation Strategies- Kelly M

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Attachment Hyperactivation vs Deactivation Strategies- Kelly M

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The difference between attachment hyperactivation and deactivation strategies is that attachment hyperactivation strategies are apparent by BPD patients with more of an anxious presentation. They attach easily to others and end up disappointed due to inappropriate attachments and being overtrusting. Attachment Deactivation strategies display more emotional distance and i(biological) internal distress. Individuals that primarily us Attachment Deactivation strategies tend to be able to mentalize longer than clients that primarily utilize attachment hyperactivation strategies who take longer to recover with mentalization.

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I really liked that you related these 2 concepts to relationships, especially romantic and caregiver relationships which tend to be the most impactful for many individuals. It seems like there is a domino effect where if one technique is a strength there is opportunity for the other to also be a strength. I think this speaks to the complexities of relationships and how more than one strategy can be beneficial.

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Hi Priya! I really liked the way you framed your answer because many times providers will treat clients with BPD as people that need to be cured. In your response you emphasized on balance, which I believe is a much more beneficial (and empathetic) and realistic approach to treatment. Our relationships with clients are very impactful and can be a way to offer insight into their other relationships.

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Kelly - You do a great job of highlighting the role of therapist in MBT. I agree that this sense of humility is crucial as well as patience. It is important as therapists that we recognize it takes time really getting to know our clients and what they mean when they say certain things. We must never be afraid to ask clarifying questions so we can continue to better understand their experiences. Well done!

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Robust Mentalization and Secure Attachment - Lilit

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Robust Mentalization and Secure Attachment - Lilit

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Robust mentalization relates to secure attachment because secure attachment typically cultivates the development of robust mentalization skills. When caregivers/parents consistently respond to their child's needs and feelings, the child learns to understand and regulate their own emotions and this process supports the development of a sense of self and the ability to form healthy relationships during their lifespan. I'm reminded of a client I worked with - 28 yo female with BPD who grew up in an emotionally neglectful environment where her primary caregiver struggled with substance abuse. The way she grew up has had a significant impact on her ability to mentalize. We worked together to help her understand her own emotions and interpersonal experiences, because she struggled with impaired mentalization.

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How does robust mentalization relate to secure attachment? -Rabeel

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How does robust mentalization relate to secure attachment? -Rabeel

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According to the concept put forward by Bateman and Fonagy, mentalization is the ability to comprehend and interpret one's own conduct as well as that of others in terms of underlying mental states, such as feelings, intentions, desires, and thoughts. The ability to continuously retain this mentalizing talent over time and in many circumstances is known as robust mentalization. A person who has a secure attachment has a strong, positive emotional link with their primary caregiver that is based on support, dependability, and trust. Strong mentalization fosters precise interpersonal knowledge, emotional control, and relationship coherence, all of which are beneficial for the establishment and upkeep of stable attachment bonds.

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Explain the difference between attachment hyperactivation and deactivation strategies. -Rabeel 

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Explain the difference between attachment hyperactivation and deactivation strategies. -Rabeel 

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Depending on their attachment style, people may use attachment hyperactivation or deactivation as means of dealing for attachment-related stressors.  Hyperactivation can frequently exhibit protest behavior or severe emotional reactions in an attempt to maintain or recover connection with their attachment figure when faced with attachment-related challenges. Deactivation can result in people emotionally, physically, or psychologically distancing themselves from their attachment figures during stressful attachment-related moments as a self-defense technique, repressing their demands for support or connection.

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Attachment Hyperactivation and Deactivation Strategies - Lilit

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Attachment Hyperactivation and Deactivation Strategies - Lilit

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To manage their attachment-related internal states, individuals with BPD utilize hyperactivation and deactivation strategies. Those who use hyperactivation strategies tend to form attachments quickly and intensely - often driven by fears of abandonment and need for connection. Whereas those who use deactivation strategies tend to emotionally distance themselves in response to interpersonal stressors - experiencing high levels of internal stress while appearing calm.

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Hi Kelly, I really enjoyed reading your discussion post. I appreciate that you mentioned how the client and therapist work together, collaboratively, towards the goal of metalization. I resonate with all of the key components of the therapist’s stance - especially humility and the not-knowing stance. It's rooted in maintaining curiosity about the patient and their mental state, which I think is the basis of all therapeutic work.

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Difference between attachment hyperactivation and deactivation strategies - Michela

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Difference between attachment hyperactivation and deactivation strategies - Michela

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My understanding of attachment hyperactivation strategies are when individuals get overly attached to others very quickly. Hyper meaning over, beyond or above - explains the extent to which the individual is opening up and connecting. It is above average or beyond the normal scope. However, this does not seem to be super healthy or helpful since the bond can be often weaker since formed so fast. On the other hand, attachment deactivation is when individuals retreat in social and relational situations and do not emotionally attach to others leaving themselves more isolated and alone. Like Alma said well - although it appears that individuals who use this strategy are calm and collected, they may be experiencing internalized stress or distress.

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People with secure attachment have frequently received responsive and consistent care, which has helped them to build a solid mentalizing capacity, claim Bateman and Fonagy. Their capacity for mentalization enables individuals to control their emotions, manage challenging social settings, and uphold intimate relationships. On the other hand, people with insecure attachment may have uneven mentalization, which can result from inconsistent or insufficient caring throughout early development. This can make it difficult for them to comprehend the motivations of others and their own emotional reactions.

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Hyperactivation attachment strategies pertain to becoming invested rapidly in new relationships, and that attachment is met with a level of intensity associated with a new partner.

Deactivation strategies are concerned with emotional distance oneself from a relationship. This may be spending less time with a partner or person, distancing physically from the person, and generally isolation from a person more.

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How does robust mentalization relate to secure attachment? 

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How does robust mentalization relate to secure attachment? 

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Robust mentalization and secure attachment are closely related. Secure attachment aids in developing and fortifying mentalization, which allows individuals to swiftly recover from mentalization lapses. In addition, residing in environments that foster secure attachment at a young age helps children develop emotional regulation skills, resilience, and ultimately independence. Individuals who have secure attachments are able to sustain mentalization during stressful times due to their ability to self-regulate and general understanding of other people's mental states.

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Explain the difference between attachment hyperactivation and deactivation strategies. 

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Explain the difference between attachment hyperactivation and deactivation strategies. 

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Attachment hyperactivation refers to the desire for closeness and leads to dependency on others. It is more common among individuals who have more attachment needs, while deactivation is more common among individuals who are independent and emotionally distance themselves to feel in control. Individuals who are under stress and use deactivation strategies may result in internal conflict, while hyperactivation may lead to weaker mentalization.

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Strong metalization promotes trust and emotional stability in children by empowering caregivers to react to their needs in a sensitive manner. Because they have had attuned caregiving, securely connected people are better at controlling their emotions and empathizing with others, which strengthens their mentalizing skills and attachment security throughout their lives.

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An increased desire for intimacy and continual reassurance, frequently fueled by a fear of being abandoned, is a hallmark of attachment hyperactivation. In addition to idealizing relationships, people who employ this tactic may also be anxious and have strong reactions to rejection. Deactivation techniques, on the other hand, entail emotionally separating oneself and repressing attachment needs in order to prevent vulnerability, which results in a self-sufficient and occasionally aloof approach to relationships.

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Secure attachment is based around feeling as though one's needs can be met in a healthy manner both in their early relationships with caregivers and throughout their lifespan as they make bonds with friends, romantic partners, etc. Similarly, mentalization encourages the kind of behaviors which are implicit in a strong caregiver relationship by attuning to the feelings and needs of one's child in the context of a caregiving relationship.

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Hyperactivation attachment is when someone dives into a new relationship and forms a strong bond earlier than may be typical for most people's rate of attachment. Deactivation strategies are behaviors which attempt to distance oneself from a given attachment, usually in response to a discomfort with the rate at which another individual may be attaching to them.

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Treating individuals with BPD requires a deep level of attunement to their emotional state and the precipitants to their mood. Typical behavioral intervention may rely on the individual to track what behaviors and events led to their emotional experience which can be challenging. MBT allows someone to better understand how their actions may be influencing their emotional experience.

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MBT from the perspective of the therapist requires an openness to accept that they may not understand a client's feelings or needs. The clinician must keep an open mind to differing perspectives and inquire if they do not understand. However, it is important to focus on the "what" rather than the "why" of a client's experience in MBT.

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Hyperactivation strategies involve intensifying emotional responses and seeking closeness to manage distress, often seen in those with anxious attachment styles. These individuals may become preoccupied with relationships and misinterpret others’ intentions as negative when mentalization fails. Deactivation strategies, common in avoidant attachment styles, involve distancing and suppressing emotional needs to avoid vulnerability. When unable to mentalize effectively, people using deactivation may withdraw or disconnect emotionally to maintain a sense of control.

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Robust mentalization supports secure attachment by enabling individuals to accurately interpret their own and others' thoughts and feelings, fostering trust and stability in relationships. Those with strong mentalization skills can manage emotional challenges and remain open to understanding others’ perspectives, which promotes resilience in close relationships. This capacity helps them to regulate distress without resorting to hyperactivation or deactivation. Ultimately, robust mentalization nurtures a secure attachment style, as it encourages balanced, healthy interpersonal connections grounded in mutual understanding and emotional responsiveness.

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Strong mentalization and secure attachment are related in the sense that secure attachment can often help foster the ability to mentalize. If a caregiver is attuned to a child’s needs from a young age, a child learns that their emotional experiences are understandable, which helps them to understand both their own and other’s experiences. Someone who is regularly having their emotional needs met likely displays secure attachment, which means that they are able to be supported in regulating their emotions and can trust others to support this. Having the ability to regulate one's own emotions and have empathy for other's experiences are common features of securely attached individuals, which are also indicative of a strong ability to mentalize.

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Mentalization-based therapy focuses on the ability to distinguish mental states in oneself and others and understand how those states may influence behavior. BPD is characterized by emotion regulation challenges and unstable relationships that can be traced to impaired metallization abilities. By improving an individual’s ability to understand their own mental state and those of others, people with BPD can become more aware of their reactions and behaviors to show up in their relationships in a more regulated way.

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Hyperactivation vs. deactivation - Sofia G.

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Hyperactivation vs. deactivation - Sofia G.

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Hyperactivation strategies are where the person attaches to others quickly and easily. This often causes disappointment because the person forms inappropriately strong attachment to others and also inhibits the neural systems used to judge the trustworthiness of others. In contrast, deactivation strategies are where the person emotionally distances themselves when enduring interpersonal stress. People using deactivation strategies may appear to be calm but internally show biological stress indications like higher blood pressure.

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Robust mentalization and secure attachment - Sofia G.

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Robust mentalization and secure attachment - Sofia G.

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Mentalization is the capacity to understand the mental state of ourself and others. This relates to secure attachment because secure attachment allows for the ability to mentalize under high levels of stress. Thus, people with strong levels of mentalization typically show resiliency under stressful circumstances.