Mentalizing Imagery Therapy: Theory and case series of imagery and mindfulness techniques to understand self and others

Mentalizing imagery therapy (MIT) combines guided imagery and mindfulness practices to help people understand mental states—their own and others'—and how those states drive behavior, a capacity called mentalization. MIT is designed to reduce negative psychological symptoms, especially in patients with personality disorders or depression, by improving insight during challenging interpersonal situations. The authors describe MIT as distinct from other mindfulness or compassion-based therapies in both its methods and goals. While case discussions suggest MIT may improve mentalization and reduce depression and anxiety, the authors note that controlled trials are needed to establish clinical efficacy.

Study at a glance

Abstract

Facilitating mentalization, or the ability to understand mental states and their link to behavior, is increasingly viewed as a common mechanism of action across effective psychotherapies. Here, we present an overview of a new set of contemplative psychotherapeutic techniques, mentalizing imagery therapy (MIT), which uses guided imagery and mindfulness practices to facilitate mentalization. MIT aims to reduce negative psychological symptoms by stimulating an understanding of mental states and their links to behavior in self and others, including in challenging interpersonal situations. Case discussions of MIT in personality disordered and depressed patients are used to illustrate theoretical points and the specific practical benefits of MIT. We conclude that there are promising indications that the imagery and mindfulness practices of MIT, which are specifically targeted to facilitate insight in the context of attachment relationship challenges, may help to improve mentalization and reduce symptoms of depression and anxiety. Both in practice and with respect to its articulated goals, MIT promotes a distinct set of capacities from other mindfulness or compassion-based therapies. Further research is required to determine the clinical efficacy of MIT in controlled trials.