ABSTRACT
Mentalization normally comes about through the child’s experience of his mental states being reflected on, prototypically through secure play with a parent or older child, which facilitates integration of the pretend and psychic equivalence modes. Adults with a history of childhood attachment trauma often seem unable to understand how others think or feel. We have hypothesized that childhood maltreatment undermines mentalization. The collapse of mentalization in the face of trauma entails a loss of awareness of the relationship between internal and external reality. Attachment is normally the ideal ‘training ground’ for the development of mentalization because it is safe and non-competitive. The impact of trauma on mentalization is intermittent. A therapist needs to maintain a mentalizing stance in order to help a patient develop a capacity to mentalize. Mentalization involves both a self- reflective and an interpersonal component.
