Transcription
One of the things that I have found helpful also, um, with mentalizing, um, is the mentalizing modes, right? Theological, uh, pretend, and, um, psychic equivalence. Terrible terms, they are. Hard to remember. Low-level, ineffective mentalizing modes, they were called. Sometimes called non-mentalizing modes. You gave them names which were given not by me, so don't blame me. Psychic equivalence, theological mode, pretend mode. These are normal, by the way. We all have them. You know, they're kind of lower levels of sort of brain function, if you like, which can be created through just anxiety and so on, or by stress and so on.
And in psychic equivalent mode, things become more concrete. Thoughts become facts. Images or a memory becomes a current reality rather than something there and then. So, and, and because sort of what's in, in my mind is reality, is can be very painful. MH. So, for example, if I feel I'm bad, I am bad. It's not just a thought that, oh, maybe I was a bit bad yesterday, you know. It's not modified in any way because in psychic equivalence, it is a reality. I know I'm bad. I am bad. I experienced myself bad. You can't persuade me I am. Everything's bad. So we have actually a certainty in it. So once you begin to be so certain about everything, would you just please question yourself a little bit? Take a step back. Think, really, most things are not 100% okay.
So this is really important in trauma because we could have an experience or an image of something about prior trauma. But in psychic equivalence, that image is current and present and now. It's not past and then. So I react to it, right? I run or I respond in some way or panic and so on because it's psychic equivalence. So we call this inside-out working, right? The one thing I would just want to add, I thought was interesting that I was reading with, that you are doing, I don't know, differently for trauma, um, is instead of exposure therapy where you're exposing a person, you're having a person control when they bring the thought to the fore and when they remove it. So that they can, can begin to, I think, master, yeah, moving it in to. I, I know that's a little different, but I, but it would be, I would assume, a treatment, you know, where you're aware of the modes you're in. But just, I just bring that in with trauma because we have so many, obviously, people who, who watch this who trauma. And I thought that was so interesting. You're trying to help them maintain mentalizing whilst actually, um, reworking the trauma experiences, yeah. But they have to maintain the mentalizing. So you, as it were, help them be able to keep themselves on track, keep themselves online, but whilst they're then presenting the trauma experience, right? Interesting, yeah. And we do this as, as I've mentioned, in, in actually a group rather than individually, um, so that they're doing it with people who have the same, similar experience because I get, get a sense, I hope, if I'm that patient, that these people actually will be able to see it from my point of view because I can see them as having had similar experiences, yeah.
So that's the psychic equivalence mode. Then there's the theological mode, which in a way is easiest simply to see it as the reverse. So this is outside-in. So this is what happens out there in reality, in the physical world, tells me about what's going on inside, basically. So what your mental state is, is really what you do. That's it. And everything's processed in that sort of way. So if you're late coming to see me, you didn't want to be here and you don't care about me. Otherwise, you would have been on time. And it's no good you telling me, well, the car broke down and this, this, that, and the other, and this and that happened, and this happened. I don't care. I know what that means. So I process things through that all the time. And of course, we all do that to some degree, you know. You, we assume what people's mind states might be through what they do. Do, but we don't totally rely on it. We tend to feed in from different channels, as it were. One of which is the teleological channel, okay? So you are what you do. You're not what you say. You're what you do. And this is incredibly common in antisocial personality disorder as well, yeah. It, you're action man. You're, you're a doing person. MH. Okay. It, and you do it, and people should do it, and so on. So they very much operate on that way.
Typical example in a group, I thought someone was being really overly, um, threatening and so on, and I brought that up and so on. And he said to me, I wasn't being threatening. I said, well, before you just say I wasn't being threatening, let's take it from my perspective. I actually had a sense that you were, and you know, from this. And so he says, that's not threatening. I said, hang on a minute. For me, I just want you to see me for a minute, please. Do you see what I mean? I'm trying to get him to consider the other's mind state here, where it might be coming from. And so he's just trying to dismiss it and get rid of it. So I'm trying to push it back in. But then, of course, he turns to one of the other members of the group and says, was I being aggressive? And the other person said, uh, no, of course you weren't. And he turned to me, said, no, he wasn't. I said, can I just still have this about me for a minute? Interesting. How, how come I saw that? Could you ask me that? So we do do these sorts of interactive play, sort of stuff, a little bit with them. So hang on a minute, because actually, you have to respect my position as well. So we do quite a lot of this, um, but anyway, what was so intriguing was that, uh, I then said, I said, all right, so you tell me then, help me see that that wasn't aggressive, so that that could be really helpful to me. So, so he says, well, look, he said, if he was being aggressive, he would have got off his chair. I said, really? What, what? He said, you get off your chair, that's aggression. Now he's reading everything theologically. Do you see what I mean? If he got off his chair, that means he's got an aggressive mind. But the fact that he's, you know, raised his voice and he's prodding his finger and he's doing this, that's not aggression. Do you see what I mean? So, so they tend to operate on that. I said, ah, so that's what you go on. Because I'll tell you what I'm going on, and then we can have some discussion around actually how we perceive these, how we pick them up, and how we might operate that and work together in these ways. Interesting.
But that brings us to the third mode we mustn't lose that, which was pretend mode, which, um, if you like, we tend to call bubble mode, or I do, anyway. You know, it's, it's when the person goes into their own mind and they're within their own mind. So it's, as it were, a unit in itself, alone in itself. MH. And it's untethered to the outside. So it doesn't link, okay? So in that sort of sense, it can't learn from another mind, anything like that, because it's within its own bubble. You know, we, we, and we can all go into bubbles sometimes, you know, those times when you kind of zone out or phase out, you know, you're going to. But this is when you're in it the whole time. You're still talking, and you're still saying things, but you're not really there. Mhm. You're not actually grounded in a reality. Y. In some form. So your mind actually starts to have unfettered imagination. Mhm. You know, it can just explain things in the most imaginative ways, none of which have any grounding in reality. So we can think about other people's motives, why they're doing things, why they, uh, where they're coming from, because of what they do, and all sorts of things. But it doesn't ever get tested out in a reality base.
If I am interacting, acting with someone who is in pretend mode, could be me for that matter, but yeah, I'm not trying to point the finger here, but, um, um, what you feel, they're not there. Okay. That was my question. Yeah. Yeah. Sorry, that's a bit of a non-mentalizing intervention, a guess, a guess assumption, sort of thing. But it's easier to know someone else is than you are oneself than one's self is it? So with other, you tend to pick up that, uh, somehow they're not there, or you're not really there for them. And how would I know it with me? If I'm in pretend mode, how would I know? Yeah. What are some of the signs? Yeah. That's a bit of a problem. Um, are you aware that you're bullshitting yourself? Are you aware that you're talking the talk, but you never really walking the walk? You know, you're just a sort of, uh, mirage, if you see what I mean, in a sense, you know. And can you be aware of that? I think we are often aware of that, by the way. I think we can have a different subjective experience of ourselves that we realize is not quite, I'm not quite living it, you know, it's not all connected with reality. Yeah. It's not all connecting up and then linking and coupled with reality. It's too far in fantasy, right? Yeah. With regard to things like grandiosity, it's, you know, you're holding, you know, if you have a vision of winning an Academy Award or something, and you're not, um, you know, and you're sort of, you live in the vision of that, even though your life doesn't reflect actions that would guide you, maybe even not to that. I mean, in other words, what is, does a narcissistic psychopathology more often land in pretend mode than a borderline psychopathology, or it doesn't really work that way? Yeah. I'm not sure it quite works as sort of nicely as that, but, but, but, um, but you're picking up something which I think is really important, that in some, uh, problem areas, that it, these things can be really structured in. So the, the pretend mode is actually part of our whole structure. It doesn't fluctuate. But in borderline personality, it's sort of in general, pretend mode in and out, and it fluctuates to some degree. Whereas in narcissistic personality, I don't think it does. It, it's ingrained into this sort of self-experience. MH. I do live the fact that I'm a Hollywood film director and really I'm getting there, but people haven't yet realized my abilities and so on. So it doesn't keep itself grounded. Um, but you'd see if it didn't match any anchor in reality, then people are going to start questioning it, aren't they? Really, is he really? He thinks he is, but he's not, you know, that sort of thing. Um, it will tell you, but it also brings up how painful that position can be, that I am this person, but nobody else sees me like that. M. So I'm isolated. I'm alone. Okay. Hence bubble. Hence bubble. And bubbles tend to be rather solitary, right? So pretend mode is not going to bring you into a mentalizing relationship. No, because you can't build connection through that. No. What you can build, if you've got narcissistic sort of functioning, is a relationship with someone, and it may, as it were, even look like a mode, but it can be very restricted because that person has to see me in a particular way and mustn't see me any other way. So there's no mutuality of generation of experience. So I'm really a Hollywood director in my mind, and my brilliance and my abilities, they're just not yet quite recognized, and they're not quite seen by others and so on. But you actually help me because I'm getting there, you know, cuz you see as that. Mhm. Right. Okay. Now, if we try to break that, i.e., break my self-representation as a person who is a great film director, MH, what have I got? Well, right. So you have to be very careful. This is not just smacking around the head and say, yeah, you've got to stop this delusion. This is a whole way of structural functioning for the individual. So it's a tough nut to crack, in a sense.
So basically, but pretend mode, it sounds like as a, and I say this because I feel like it's interest, it's helpful for people watching who are in the struggle, you can use tools of assessment to begin to notice when you're doing things there, where you can begin to make adjustments. But it sounds like all that is to say, it sounds like pretend mode is the hardest one. It is. The to assess that you're in it. It is. Yeah. It is one of the hardest. And, and it's one of the hardest for someone else to, as it were, help you get out of it. Interesting. Right. Yeah. Because in a sense, the person in pretend mode, you've got to get them really interested in your mind. So if you're in pretend mode and s, in a way, my mind doesn't come into it. This kind of not around. And so, of course, I'm not really in there, am I? Do you see what I mean? I'm not in the room. But I've got to kind of get myself in there somehow, or you've got to let me in somehow. So I've got to duck and dive and dodge a bit, you know, know. And we call it sort of challenge, do this, do that, bit of humor, anything that might get yourself there. So the person thinks, oh, there is another human being here today. You see, I mean, there, you've got to get in there. And it's only once you've got in, and that might loosen prmo a little bit, could you do a little piece of work, and then you may be out again. Mhm. Wow. So you have to keep at it. Yeah. Yeah. Patients will recognize some bits of it, by the way, just so you know. So as soon as you start overthinking, okay? You know, we talk to patients, look, when you get into overthinking, you start thinking, well, he just got up then, and that's because you were bent over that and did this, and then somebody did that, you know, there's no grounding in it. You start over-explaining stuff, you know. And we, we, we call it hypermentalizing. You know, you just start doing far too much of it, okay? So just beware, as soon as you start thinking you're explaining things to yourself, but it's actually quite complex, think maybe I'm bullshitting here.