Tag Archives: pretend mode

More About Pretend: Searching for Dragons


In a conversation at the lunch table, I had the opportunity to work with a little friend of mine, Jack, on growing his flexibility. Jack was sitting with Billy, Emma, and Catherine. Two of the children, Billy and Catherine, were talking about dragons. Billy said that they shot water out of their mouths, and Catherine said that they used to shoot fire. I could not resist asking Catherine how the dragons had made that transition. She responded matter of factly that she didn’t know. Jack then piped up that dragons didn’t exist. My heart sank a little, because I could see that this rather peremptory claim would not have a good effect on his friends. In fact, Billy looked a little crestfallen, but he supported his initial statement by explaining that his brother knew a lot about dragons and said they did exist. Jack again stated that they did not exist and added that if Billy wanted him to believe him, Billy should “prove it” by showing him a dragon. This, of course, put Billy on the spot, and he was silenced for the moment. I made one attempt at calling Jack’s attention to Billy’s discomfort, but he had dug his heels in and continued to insist on the need to “prove” the existence of dragons if you were going to talk about them at all. I contented myself with saying that I thought it was just as much fun to pretend as to learn about things that were real. Jack responded scornfully.

Then Catherine spoke up and said that there were dragons in China. Jack again refuted this statement. I began to feel that both he and I were getting a bit stuck, so I changed my tack. I told him that if he wanted me to prove to him that dragons did exist, he could come with me to China, and I would show him one.  He protested that I was talking about pretend but he only was interested in what was real. I restated my position that pretend was fun and that kids were stronger if they could have fun with what was real and also what was in pretend. I then told him to hurry and pack his suitcase, because our flight to Shanghai left from Logan Airport in half an hour (taking into account that in pretend there are no security lines) and then announced that we had arrived at Logan, pointing out to him the United Airlines sign above the gate that said Flight 100 to Shanghai in bright red letters.

I asked, did he want to go with me? He said, no. Then Billy said that he wanted to come with me, and Catherine said she wanted to come with me, and Emma said she didn’t want to come with me. So I said, OK, I will go with Billy and Catherine and leave you two here to hold the fort, and we will find a Chinese dragon and bring him home to you. Then Emma changed her mind and said she wanted to come with us too. So I tried again to persuade Jack to come with us. He said no, that we had to prove to him that dragons were real.

I was not going to leave Jack alone in Cambridge while the rest of us had a wonderful adventure in the colorful, twisty streets of Shanghai. I insisted that we could have both pretend and real dragons, and when Jack started to contradict me, I said to the kids at the table, “Oh, now I know that Jack is tricking us. (I don’t think I mentioned that Jack is extremely intelligent.) I remember a time when Jack and I were talking about a disagreement, and he told me he that he knew two people could have two different opinions about something and both of them could be right. I glanced up at him and saw that he was smiling. I sighed internally with relief. The spell of negativity had been broken. At this point, the other children had been distracted by classroom events. I was left with the realization that it might take us many trips to the airport before we boarded that flight to Shanghai and explored that magical city together, looking for dragons.

Read this blog in Spanish. 

Peter Fonagy Presentation II


The Way Humans Learn About Their Culture

The way this kind of learning occurs helps us understand how the knowledge communicated between parent and child becomes “what is known” and “how it is done” in a large group of people, and then what about this gets passed down over generations. This does not occur through intentional, cognitive learning, but instead happens through the use of “ostensive communication cues”. These cues include such behaviors as eye contact, turn taking patterns, and specific tones of voice such as the falsetto voices mothers use to talk to their babies referred to as “motherese”. Fonagy explains that what establishes these ostensive cues most reliably is the same thing that generates secure attachment – sensitive, attuned behavior towards the baby, giving the baby the sense that the adult is trustworthy and therefore that the information is reliable. Fonagy stresses that all human life is built on social knowledge, and that if you deprive the child of “epistemic trust”, you deprive him of the possibility of benefiting from what he needs to succeed in the society into which he was born. Relationships are absolutely crucial to the transmission of cultural knowledge. 

The Implications of Mentalization for Helping People Grow (in psychotherapy or other ways)

When you are with someone who is not mentalizing, it is impossible to have a rational discussion with him. That is because he has a rigid position that is heavily influenced by his own internal beliefs and he cannot bring an open mind to the conversation. For example, if he perceives himself as a victim, he will see everything that happens to him as victimization by a cruel world, and if you try to explore with him how he might have contributed to the outcome by some of his actions, he will not agree and will probably feel victimized by you. This is fairly characteristic of many adolescents, and actually occurs in all of us if we are stressed to an extreme enough degree. One of the ways I see “normal” people let go of their mentalizing is when that person is a parent who is desperately worried about his child. In that case, the internal perception of helplessness in an uncaring world (if people really cared, they would do something!) is so overwhelming that the parent cannot imagine a situation in which there is nothing to be done but wait. Another situation is in high conflict divorces in which each parent perceives him or herself as the victim of the other, and cannot empathize with the other at all. 

Fonagy stressed the need to insist on a mentalizing process in therapeutic or other helping engagements. This means that if the person you are working with insists on taking a “non-mentalizing”, or irrational and highly personalized point of view, you must focus on bringing the conversation into a mentalizing one instead of just “hearing out” a lengthy non-mentalizing explanation from the other person. That is because the “hearing out” is deceptive in that it involves the person reestablishing his rigid point of view instead of presenting an opinon that is open to alternative perspectives. Fonagy points out that when your interactive partner is not mentalizing, you stop mentalizing!

Most of the patients Fonagy has studied from the point of mentalization have a diagnosis of Borderline Personality Disorder, but he makes the point that we are all vulnerable to lose our capacity to mentalize under extreme stress. This personality disorder (BPD), he thinks, is a developmental problem, in other words, the failure to develop a competency (mentalization) that it is possible to still develop. Twin studies suggest that it is heritable and it is also associated with early maternal separation and abuse (Belsky, Caspi, Arnseneault, Bleidorn, Fonagy et al, 2012, Dev. and Psychopathology).  This suggests that children with a family history of mental illness (any kind) and early parental separation, neglect, or abuse, should be the primary focus of attention of mental health clinicians.

Fonagy reiterates the genetics and early environmental influences activating the attachment system and disrupting mentalization, giving way to a disorganized sense of self and three problematic activities:

1. Psychic equivalence – in which a person thinks that just because they are thinking something, it is automatically true. Flashbacks are an extreme example, and intolerance of alternative perspectives is a more ordinary one.

2. Pretend mode – the mental world is decoupled from external reality. For example, a woman can be completely convinced that a man in her office is infatuated with her even though he has never given her evidence of this.

3. Teleological mode – physical action is seen as the only way to modify someone else’s mental state. An example is when a person insists on concrete evidence of your caring for them – including extra sessions or telephone calls or physical touching.

Fonagy recommends certain techniques for helping your interactive partner (patient, client, etc) to mentalize:

1. Take a stance of active questioning and “not knowing”. That means that you do not presume to know what is going on until the other person explains it to you. While “not knowing”, you gently insist on alternative perspectives. (“Of course, I don’t know, but when I think about it, it occurs to me that X might be happening instead of Y.”) 

2. Monitor your own mistakes. That means acknowledging your inability to really know what is in the other’s mind and apologize for your mistakes.

3. Empathy.

4. Curiosity about the other’s experience.

5. Staying in the present instead of moving to the past.

6. Lower arousal by bringing it back to you: “What have I said that bothered you?”

7. Quickly step back if the person seems to be losing control.

8. Highlight the experience of “feeling felt”.

9. Identify a break in mentalizing and “rewind” to the moment before.

10. The main idea is to “create a space” in which the rhythms of mentalizing can occur, a safe place where you collaborate in creating a more flexible and adaptive meaning about what is bothering the person.

Fonagy has a new book out about how to understand mentalizing and how to practice it: 

Anthony W. Bateman and Peter Fonagy, Handbook of Mentalizing in Mental Health Practice, American Psychiatric Association, 2012.

Read this blog in Spanish.