The mentalizing organization – how can current psychotherapy research inform leadership?

This article discusses the role of culture and communication in the development and success of humans as a species, and how an understanding of these factors can inform leadership and organizational practices. The concept of mentalization, or the ability to understand and interpret the mental states of oneself and others, is introduced as an important aspect of social learning and culture. The author argues that mentalization develops through attachment relationships and care, and that an attitude of "epistemic trust," or openness to new knowledge, is crucial for flexibility and adaptability. The text also discusses the negative impacts of rigidity on individual development and organizational culture, and the potential benefits of applying principles from psychotherapy research on mentalization and epistemic trust to leadership and organizational practices.

The concept of a "mentalizing organization" refers to an organization that places a focus on understanding and interpreting the mental states of its members, in order to foster a culture of openness, flexibility, and adaptability. This approach is based on the idea that mentalization, or the ability to understand and interpret the mental states of oneself and others, is a crucial factor in social learning and culture. According to some researchers, modern psychology often focuses on the communication instinct and attributes psychopathology to rigidity in the ability to learn from the social environment. By applying principles from psychotherapy research on mentalization and related concepts, such as epistemic trust (an openness to new knowledge), to leadership and organizational practices, it may be possible to create and maintain a well-functioning organization that is capable of adapting to change and fostering a culture of learning and innovation.

Before you read the article, I advice you to challenge yourself on the following questions:

1. Which of the following is NOT a characteristic of a fully functioning personality, as described by Carl Rogers?

A) Openness to experience
B) Flexibility
C) Adaptability
D) Rigidity

2. What is the term that refers to the ability to understand and interpret the mental states of oneself and others?

A) Mentalization
B) Epistemic trust
C) Epistemic freezing
D) Attachment

3. What is the primary factor that has allowed humans to survive and prosper as a species?

A) Our ability to create abstract cultures and social entities
B) Our innate ability to interpret the mental states of others
C) Our culture
D) Our strong attachment to those who provide care and protection

4. What is the common factor among mentally healthy people who do not have a secure attachment figure?

A) They have strong attachments to their caregivers
B) They have a high level of openness to experience
C) They have a low level of conscientiousness
D) They have found at least one human mind they can trust and learn from

Answers are provided at the end of the article.

The mentalizing organization—how can current psychotherapy research inform leadership?

Homo Sapiens differs from other mammals in terms of the ability to create abstract cultures and social entities (Harari, 2015). Consequently, humans who share, and believe in, a core narrative or culture can co-create value at large scale. Without our shared culture and accumulated knowledge, humans are much less productive. As communication and culture plays a pivotal role in the supremacy of our species, one would assume that there be an inherited mechanism to ensure the transmission of our culture, both between individuals and generations. In this paper we investigate how current trends of focusing on the communication instinct in psychotherapy research can inform leaders on how to create and maintain a well functioning organization in terms of culture.

Interestingly, our ability to interpret others mental states, or simply having an interest in mental states and human minds in general, is not genetically given, but is in itself a result of social learning and culture (Fonagy, Luyten, & Allison, 2015). We have empirical indications of this, because the few examples we have of humans raised by animals have never been able to reignite the human potential for social learning (Passer & Smith, 2004). Humans are born extremely vulnerable compared to other animals, and it is primarily our culture that has allowed us to survive and prosper. As all mammals we are programmed to attach strongly to those who provide food, care for, and protect us. However, we also have a specific need for attaching to significant others who can inform us about our culture (Fonagy, Luyten, & Allison, 2018). There are examples of mentally healthy people without any secure attachment figure. Their common factor seems to be that they have found at least one human mind they have been able to trust and learn from. For this reason, modern psychology often focuses on the communication instinct, and largely attributes psychopathology to rigidity in the ability to learn from our social environment (Fonagy, Luyten, & Bateman, 2015).

Mentalization refers to the ability to understand and interpret behaviours of self and others as expressions of intentional mental states such as feelings, wishes, goals, desires or needs (Fonagy et al., 2002). It develops from early infancy, through attachment relationships and care. The attachment figure is a source for physical security, emotional support, mental attention, knowledge, and culture. Recently, the concept of epistemic trust (Fonagy, Luyten, Allison, & Campbell, 2018) was introduced to expand our understanding of the relation between attachment and mentalizing. An attitude of epistemic trust, in contrast to epistemic freezing, implies that the listener is ready to take in personally relevant knowledge about the social world. Carl Rogers (Rogers, 1961) described a fully functioning personality as being characterized by openness to experience, flexibility, adaptability, and spontaneity, and an absence of rigidity. It is an everyday experience that we encounter individuals without the flexibility to adopt alternative positions from the ones they find themselves occupying at a particular point in time. Such rigidity has been connected with high and maladaptive levels of conscientiousness and low levels of openness to experience (Widiger, Lynam, Miller, & Oltmanns, 2012). Rigidity, in this context, is what must be absent if the individual is to progress fluidly, flexibly, and adaptively across the phases of individual development. In the context of an organization, rigidity in individuals and culture are gross obstacles for adequate adaptation and capacity for change, i.e., changing the culture in an organization may take years (Kaufmann & Kaufmann, 2009, p. 273). As we recognize that psychotherapists who focus on training their patients’ ability for mentalizing have better results than comparisons (Kvarstein et al., 2015), understanding how they increase mentalizing and create epistemic trust may have beneficial consequences if transposed to and applied in leadership and organizations.

Our ability to mentalize, operationalized as reflective functioning (RF), can be measured scientifically, and is thought to be a rather stable ability under normal circumstances (Fonagy, Gergely, Jurist, & Target, 2002). Most normal humans loose good mentalizing under varying degrees of emotional stress, but in psychotherapy, patients displaying personality disorders are characterized by low epistemic trust and impaired mentalizing abilities (Fonagy, Luyten, & Allison, 2018). Before our adult ability to mentalize is fully developed, we all experience prementalistic modes (Fonagy, Gergely, Jurist, & Target, 2002). Therapists typically identify and address pretend mode (losing the emotional grounding), teleology (taking actions as evidence for inner states), and psychic equivalence (taking own convictions for reality as such). Applied to an organization, an employee interpreting a leader's action as a sure indication of her inner state, could exemplify a teleological stance, e.g., “I was not promoted, so she does not care about me”. This kind of interpretation is common in everyday life, but for the leader, being able to identify and address such processes are crucial. This process is more complicated for the leader than for most others. Similarly, to most people, the leader must be able to mentalize both self and others, but effective leadership also demands the ability to mentalize their own role, and the group dynamics. The next prementalistic mode, pretend mode, is a valuable asset for igniting creativity, but manifesting from a place disconnected from values, purpose, emotions, attachment, and meaning, may not be beneficial for an organization. Lastly, the fierce determination stemming from psychic equivalence can perhaps be helpful at sea during a storm, but may prove inefficient for modern teams and companies.

As social reality is largely a product of interpretations and shared attention, one could advocate the importance of encouraging a mentalizing culture within an organization. Allen, Fonagy and Bateman “propose boldly that mentalizing – attending to mental states in oneself and others – is the most fundamental common factor among psychotherapeutic treatments” (2008, p. 1). Mentalization-based treatment (MBT) is a dynamic psychotherapy that aims to increase the patient’s ability to mentalize by employing a shared, transparent, and playful exploration of mental states. This treatment is also described and defined in manuals that outline central strategies to foster mentalizing and epistemic trust (Bateman & Fonagy, 2016). When investigating this method, we find that one crucial fundament is transmitting the simple awareness that no one knows what is happening inside another person. Mental states are opaque and must be explored and interpreted. This means that the first principle a leader could incorporate in the organizational culture is the norm to value the investigation of inner states in itself. This may seem simple, and almost tautological, but there is a difference between a cultural norm where “everyone is allowed to express their own viewpoint” and one where “we would like to join you in understanding why you have your viewpoint”. That said, there is also a principle in MBT that unwarranted beliefs or untrue statements should be challenged, i.e., the culture should encourage exploring mental states, but that does not imply that any statement or viewpoint is true. Hence, addressing and correcting untrue statements in a compassionate manner fosters a mentalizing culture.

As in all methods aiming for an improved result, MBT also recognizes the importance of validation. For the leader, this may translate as the intent to first join the employee in her view of reality, i.e., to validate and confirm experiences before challenging them. Another principle is to give appraisal in terms of acknowledging good mentalizing, e.g., the leader could tell a shy employee who has asked for a meeting about some concern that “it was excellent that you double-checked with me before assuming I didn’t want to hear your opinion”. As teachers, therapists, and parents know well, the effect of modelling should never be underestimated. So, if the leader is transparent and interested in own mental states, and shares them in a genuine way, this will naturally promote a mentalizing culture. From MBT we also learn the importance of being open-minded, not-knowing and curious. One way this may manifest for the leader is by allowing the employee to arrive at own conclusions, by asking open questions. Research suggests that people frequently listen more closely to the answers they give themselves, than to those others provide. A leader championing mentalizing would also support a culture that assumes that misunderstandings actually happen all the time, and that the shared project is simply presenting the best interpretation of others’ viewpoints and then continually improve our mental representation of it.

One crucial aspect of cultivating mentalizing is identifying and counteracting prementalistic modes of thinking. All the above mentioned strategies can and should be part of avoiding these mental pitfalls, but the leader would be well advised to gradually accumulate interventions that can counteract typical manifestations of prementalistic modes. As each situation and relation is unique, such strategies must be tailored by the leader herself, but we can provide some examples to guide this process. Addressing pretend mode, one example could be that the leader experiences that asking “how is it for you to have all these ideas for our company” makes the employee more present in the current situation, and less focused on a fantasy. Similarly, statements like “You know what I mean”, could be met by saying “Well, actually I am not completely sure that I do”. Another example could be given in addressing psychic equivalence. If an employee is certain that someone is “always like this”, the mentalizing leader may listen for, and point out, an interest in any contradictions implied in such a perceived reality, e.g., a statement like “he never listens to me” could be met by saying “I notice that I become interested in understanding why you say he never listens to you, but still you report that he asked you what your opinion on our new project is”. Another leader may find that directing the attention toward mental states in itself may often help, e.g., if an employee screams at the leader, the leader may find it beneficial to respond with something like “I very much would like to understand you, and help, but it is very difficult for me to understand what you are saying when you scream at me”. This will shift the focus towards mental states, which is the core strategy to counteract teleological mode.

The awareness of mentalization and how to foster a mentalizing culture seems essential for current psychotherapy. As a species we are social beings who depend on others for knowledge about the world. Rigidity in social knowledge is typically unproductive. Hence, it seems that most organizations could benefit from cultivating a mentalizing stance. For the leader, the process of mentalizing includes the dimension of interpreting relational events in terms of the role and the larger organization. Psychotherapy provides the leader with three concepts representing non-mentalizing or prementalistic modes. Given the validity of the argument above, we would suggest that leaders could benefit from accumulating interventions or strategies to counter such mental modes. The interest and focus on mental states in itself, is often a valuable intervention for leaders wanting to promote a mentalizing culture.

Answers to the quiz

    1. D) Rigidity
    2. A) Mentalization
    3. A) Our ability to create abstract cultures and social entities
    4. D) They have found at least one human mind they can trust and learn from

References

Allen, J. G., Fonagy, P., & Bateman, A. W. (2008). Mentalizing in clinical practice. Arlington, VA, USA: American Psychiatric Pub.

Bateman, A., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: a practical guide. Oxford University Press.

Fonagy, P., Gergely, G., Jurist, E., & Target, M. (2002). Affect Regulation, Mentalization, and the Development of the Self. New York: Other Press.

Fonagy, P., Luyten, P., & Allison, E. (2015). Epistemic petrification and the restoration of epistemic trust: A new conceptualization of borderline personality disorder and its psychosocial treatment. Journal of Personality Disorders, 29(5), 575–609.

Fonagy, P., Luyten, P., Allison, E., & Campbell, C. (2018). Reconciling psychoanalytic ideas with attachment theory. Guilford Press. 

Fonagy, P., Luyten, P., & Bateman, A. (2015). Translation: Mentalizing as treatment target in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 6(4), 380–392.

Harari, Y. (2015). Homo sapiens: A brief history of mankind. New York: HarperCollins Publishers. 

Kaufmann, G. og Kaufmann, A.(2009) Psykologi i organisasjon og ledelse. Bergen: Fagbokforlaget Vigmostad & Bjørke AS.

Kvarstein, E. H., Pedersen, G., Urnes, Ø., Hummelen, B., Wilberg, T., & Karterud, S. (2015). Changing from a traditional psychodynamic treatment programme to mentalization-based treatment for patients with borderline personality disorder–Does it make a difference?. Psychology and Psychotherapy: Theory, Research and Practice, 88(1), 71–86.

Passer, M. W., & Smith, R. E. (2004). Psychology: The science of mind and behavior. McGraw-Hill.

Rogers, C. R. (1961). On becoming a person: A therapist’s view of psychotherapy. London, UK: Constable.

Widiger, T. A., Lynam, D. R., Miller, J. D., & Oltmanns, T. F. (2012). Measures to assess maladaptive variants of the five-factor model. Journal of Personality Assessment, 94(5), 450–455.

What is Blockchain?

Bitcoin and Blockchain – A New Backbone for Human Trust

MBT – Gyldendal

MBT Mentaliseringsbasert terapi av Sigmund Karterud, Espen Folmo og Mickey Kongerslev, Gyldendal

Mentalizing and MBT

A movie about Mentalization-based treatment (MBT) featuring Anthony Bateman and Espen Folmo

LOOK UP

LOOK UP — The science of cultural evolution