Orri is running a research project in collaboration with University College London (UCL) titled, “Measures of mentalizing in patients with eating disorders”. It is a study of differing groups of participants with a range of social, physical and mental conditions, and an exploration of these elements and their roles in mentalizing and eating disorders.

The study has gone through UCL ethics and is led by Dr Sara Morando, Researcher and Consultant Psychiatrist and Dr Paul Robinson, Consultant Psychiatrist and Professor. Sandra Cauvi, Research & Development Associate at Orri, is assisting with the study.

What is Mentalization?

Mentalization is defined as “the ability to understand one’s own and others’ mental state, thereby understanding one’s own and others’ intentions and feelings”.

For example, if you are with a friend and he/she accidentally stumbles and falls, your immediate response would probably be to shrink at the thought or say to yourself, “ouch! That would be awful!”. But what is really awful if you are safe? The reason is that without hurting yourself, you can imagine what pain it would cause your friend. You can understand without them telling you that it wasn’t their intention to do it and that stumbling and falling might bring many feelings for them, not just pain but also frustration, surprise, and maybe embarrassment.

“Mentalization plays an enormous role in the healing process of psychotherapy, but on an even larger level, it plays a uniquely important and intensely intrinsic role in the way we are human together, not only with each other but also with ourselves”. 

Peter Fonagy

Peter Fonagy, psychoanalyst and clinical psychologist, describes this capacity to imagine other people’s minds as something even more complex than empathy. Empathy, according to Fonagy, is something you can feel for a person based on your capacity to imagine what the other person is feeling. That capacity, however, that imagining the other person’s experience evokes your empathy is mentalization. The essential thing about mentalization is that it comes as much from your knowledge about other people as it comes from profound knowledge about yourself.

Young people can’t mentalize; it is difficult for them to understand that someone has a different mind. When we are around 4 or 5 years old, we can already realise someone else thinks or feels different from us. Reading someone else’s mind is complex, but that’s why mentalizing exists and is an essential skill to learn in the first years of life.

Different situations in life can reduce our mentalizing capacity. For example, being preoccupied with something that takes all your attention, like body image and anxiety, can interfere with your mentalizing. You end up being so preoccupied that there is no more space to think about what the person is feeling and how others are feeling.

Not surprisingly, many mental health conditions can reduce the mentalizing capacity; for example, depression, anxiety, autism, ADHD, eating disorders (EDs) and other psychiatric disorders have been shown to reduce the mentalizing ability.

We talk about this more in a previous blog.

What is Mentalization-based Therapy for Eating Disorders?

MBT-E is the “systematic focus on the enhancement of these competences”. The approach has roots in psychodynamic psychotherapy and more specifically in relational practices and attachment theory.

MBT-E provides a space for clients to feel safe enough to challenge engrained beliefs and behaviours, and forge secure attachments with the psychotherapist which is the starting point – or “secure base” – for forming relationships outside of the therapeutic dynamic.

What is involved in the study?

Two tests allow us to measure mentalizing capacity, through reading the mind in the eyes and the reflective function questionnaire. Apart from those, we will also use the Eating Disorder Examination Questionnaire (EDE-Q); Depression, Anxiety and Stress Scale (DASS); Adult ADHD self-reported scale questionnaire (ASRS-v1.1); McLean Screening Instrument for Borderline Personality Disorder (BPD); and RAADS-R test for autism.

We hope to discover if the mentalizing capacity is reduced in persons with an eating disorder – if the mentalizing capacity changes during day treatment; and if there are differences in mentalizing and how much is determined by symptoms of an eating disorder, autism, ADHD and BPD.

To prove so, we have Orri clients participating in the study, through admission to treatment and discharge. We then compare the results to a healthy control group.

We are very excited about the results we may come up with and of being actively researching on eating disorder recovery. We’ll keep our online community posted with our results. You can sign in to Orris’s newsletter for further updates.

At Orri, we treat, learn, and teach, and we really look forward to bringing new evidence to innovate and improve the treatment of eating disorders, for all. To find out more about our treatment, click here.


Do you have any questions? Get in touch with us!