Dimensions of mentalisation: outlining levels of psychic transformation

The authors of this paper use the term 'mentalisation' as a supra-ordinate concept that encompasses processes of representation, symbolisation and abstraction. Mentalisation is defined as a preconscious or ego function that transforms basic somatic sensations and motor patterns through a linking activity (Freud's notion of Bindung). This binding proceeds from initial associations of somatic/motoric substrata with mental representations, on to the multiplication and organisation of these representations, thus allowing the emergence of mental contents and structures of higher levels of complexity (symbolism and abstraction). Inspired by the contributions of Marty, Luquet and Bion, the authors propose a conceptual model of formal levels of mental elaboration. Mentalisation is defined as consisting of two theoretically separate and independent dimensions. Each presents levels of a hypothesised and gradually increasing mental elaboration. The first dimension considers different channels of drive-affect expression: somatic and motor activity, imagery and verbalisation. The second specifies five descriptive levels of affect tolerance and abstraction: disruptive impulsion (acting out), modulated impulsion (catharsis), externalisation, appropriation and abstract-reflexive meaning association. A clinical case illustrates how the two dimensions may influence listening and interpreting. Some metapsychological aspects of the process of mentalisation are discussed.