Mentalization Based Therapy (MBT)

By John M. Grohol, Psy.D.

Mentalization based therapy (MBT) is a specific type of psychodynamically-oriented psychotherapy designed to help people with borderline personality disorder (BPD). Its focus is helping people to differentiate and separate out their own thoughts and feelings from those around them.

People with borderline personality disorder tend to have unstable and intense relationships, and may unconsciously exploit and manipulate others. They may find it difficult or impossible to recognize the effects their behavior has on other people, to put themselves in other people’s shoes and to empathize with others.

Mentalization is the capacity to understand both behavior and feelings and how they’re associated with specific mental states, not just in ourselves, but in others as well. It is theorized that people with borderline personality disorder (BPD) have a decreased capacity for mentalization. Mentalization is a component in most traditional types of psychotherapy, but it is not usually the primary focus of such therapy approaches.

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Anger Therapy

By Sonia Neale

Aristotle said: Anybody can become angry, that is easy; but to be angry with the right person, and to the right degree, and at the right time, and for the right purpose, and in the right way, that is not within everybody’s power; that is not easy.

When I entered therapy thirteen years ago, I was very angry; only I didn’t know it. I thought everyone else was the problem. My limbic system was out of kilter and went Chernobyl if I was crossed in any way; be it by my family, my mother, my co-workers, the vacuum cleaner, the dish-washer or the video machine, I would have a well-deserved brain snap. I could literally feel the poisonous, toxic hormones exploding, flooding and melting down my brain in a mushroom cloud of fear, loathing and impending catastrophe.

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Therapy and Lifestyle Changes

Classic psychotherapy does not help most patients with bipolar disorder. Nevertheless, many newer approaches are proving to be very useful. Trained mental health professionals can:

• Educate patients about bipolar disorder and its treatments
• Help them comply with drug regimens
• Monitor the patient’s on-going status
• Intervene early in manic and depressive episodes to reduce the severity of the attack

In addition, trained professionals can help patients:

• Adjust to the reality of the illness and understand the negative consequences of mania — particularly important for patients who consider their mania to be positive, creative, and exhilarating
• Cope with feelings of guilt and remorse that occur after manic episodes
• Deal with feelings of imperfection and despair

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Cognitive Behavioral Therapy Success Stories – #7

by Anonymous

Lesbians Everywhere: A gay spiker confronts her pure-O theme about getting an answer to her sexual orientation question

This particular tale of OCD begins with a crush on a boy named Sam.

I was a very happy girl. I was about to graduate at the top of my high school class, spent bags of time with my friends, and was enjoying my crush, of course. Sam, however, didn’t like receiving my attention as much as I liked giving it. About four months after we met, I heard from a mutual friend that Sam was gay.

I was a bit depressed and slightly embarrassed. Sam hadn’t turned out to be the love of my young life. Mostly, though, I felt relieved to know his true colors, and hoped that he (and I) would be happy with future boyfriends.
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Cognitive Behavioral Therapy Success Stories – #6

by Anonymous

From prisoner to gate keeper…A woman exposes her children to perceived risks so that she might liberate herself from the confines of OCD and pursue a career in psychology.

During my second pregnancy, at age 18, I experienced the onset of OCD. This 18 year time lapse is due to the following reasons. During this time period there was progressive expansion of peculiar feelings, fears and behaviors and I had no concept that these symptoms related to any disorder. I didn’t even know there was such a disorder as OCD. I thought I was overprotective (giving away my children’s puppy to keep them from harm), a worrier (spending fruitless hours problem solving what hazards threatened them), and a little off the wall (I wouldn’t let them visit friend’s houses who had pets).
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Cognitive Behavioral Therapy Success Stories – #5

by Anonymous

A responsibility OC combats her obsessive concerns for harming others while managing medical school.

I was born with OCD. My mother tells me that as a toddler I would pull out my hair. This was probably baby trichotilomania, which is associated with OCD. For almost 30 years OCD caused me mental anguish that I’m sure only few people can appreciate. My story is probably not an unusual one for sufferers of OCD. It’s replete with pain and confusion, difficulties with family and friends, and extreme fears that strike others as ridiculous and bizarre. Professionals misdiagnosed me more than once.
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Cognitive Behavioral Therapy Success Stories – #4

by Anonymous

I was a happy little baby until it was time for first grade. I woke up everyday with a knot in my stomach that was only relieved by vomiting. I was scared of the teacher, of my fellow students, and of doing poorly. My first obsessive incident soon followed, and although I don’t remember, my father tells me that I used to throw fits every morning because I could not decide what to wear. Dad took away all of my outfits except two and the problem was solved. Unfortunately, there was more to come, as I began to develop physical habits; I breathed strangely, I did things with my feet as I walked, I crossed my eyes and I made noises in my throat. I did these things because I wondered “should I make a noise?” Or maybe I shouldn’t make a noise. Do I need to make a noise? I would make one and feel fulfilled for about three seconds. Then the voices would return, and the process would continue every second of every day. My parents and I began therapy but only discussed my nervousness and my daily separation from my mother.
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Cognitive Behavioral Therapy Success Stories – #3

by Anonymous

I am grateful for the opportunity to give a testimonial about my therapy with Steven Phillipson. I’m not a person given to hyperbole. But to say that Steven Phillipson changed my life is no exaggeration. My big problem was responsibility OC: an intense feeling of responsibility for the safety of others (and myself). I would check kitchen gas jets countless times to see if they were off. I would warn family members and friends about possible adverse effects from illnesses or drug combinations — and repeat my warnings many times for fear they didn’t understand my point. I would feel an urge to call the city transportation department every time I saw a pothole or a broken traffic light. Of course I knew that my thoughts and actions were problematic and undesirable. But I was powerless to change course.
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Cognitive Behavioral Therapy Success Stories – #2

by Professor Mike

I am presently fifty-four years old and have suffered from OCD since I was fifteen. Although originally a native New Yorker, I have been a college professor in the Deep South for at least twenty years. During my life my OCD has focused on different issues: e.g., concerns about scratches on eyeglass lenses, whether eyeglasses were properly adjusted, wristwatch straps that might cut off circulation, inappropriate noises in the environment. This last concern became so severe that eventually chronic obsessing about the origin of neighborhood noises prompted at least one relocation.

I have seen several psychiatrists. None of these really offered a therapy that worked. I have tried the following drugs at one time or another: elavil, limbitrol, sinequan, Ativan, Valium, Xanax, Prozac, Zoloft. Although some of these drugs relieved the anxiety and depression which accompanied my OCD, none eliminated the root cause of my distress which were obsessive thoughts and rituals. They also had bad side effects. Currently I take no drugs.
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Cognitive Behavioral Therapy Success Stories – #1

by Margarita, a graduate of Dr. Phillipson’s Behavior Therapy Group

My OCD. This is how I refer to this “Disorder.” I put it in quotes because I have a very hard time accepting that it is a condition that I did not bring on myself. I mean, I always thought that my obsessiveness was me — brought on by me. But I guess it doesn’t matter whether it is a mental condition, or a way of thinking which became a habit. What is important to me, is that I take steps to change.

By steps, I mean risks. I learned of the concept of risk taking for treating OCD in my therapy sessions with Dr. Steven Phillipson, a clinical psychologist at the Institute for Behavior Therapy, in New York City. The key element of the treatment is learning to live with uncertainty. It is taking the risk of not ruminating (problem solving) about things that I am afraid might happen. If you will notice, most obsessions concern things that we are not sure about. For example, I can obsess endlessly about people that I think may not like me. The subjects of my obsessions are usually people I don’t know well but that I come in contact with on a regular basis (e.g. neighbors), so I could never really know whether they do or do not like me. With therapy, I learned to say “Yes, maybe the neighbors don’t like me, but I’m not going to take the risk of ruminating about it, and I will not attend to any other thoughts related to these people.”
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