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"I Could be Wrong": Men's passage through uncertainty and change in mentalization-based treatment for personality
Ulrik Hagen Hamre1, Per Einar Binder2, Elisabeth Lied Gikling3
1Addiction and Substance Use Clinic, Haukeland University Hospital, Bergen, Norway.
Objective:
This study explores how men with co-occurring personality disorder (PD) and substance use disorder (SUD) experience change following mentalization-based treatment (MBT), addressing a gap in research that has primarily focused on women.
Method:
Semi-structured interviews were conducted with 10 men who had participated in MBT-SUD. Transcripts were analysed using reflexive thematic analysis within a hermeneutic-phenomenological framework.
Results:
Five interconnected themes captured participants' change experiences: (1) I could be wrong-developing cognitive flexibility and self-reflection; (2) I know what it takes-acquiring emotion regulation skills and confidence; (3) It doesn't have to be anything more-reduced interpersonal hypersensitivity; (4) I understand what others need-enhanced interpersonal awareness; and (5) Something's happened, and I don't know what-varied and sometimes ambiguous transformation. Two distinct change pathways emerged: a stepwise developmental process and a more global transformation.
Conclusion:
Men in MBT-SUD reported improved capacity to reflect on and differentiate between their own and others' mental states. However, change pathways varied, and not all participants experienced therapeutic benefits.
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