Relación entre modelos operantes internos y nivel educacional materno, con la teoría de la mente en niños chilenos de 3 y 4 años: rol mediador del lenguaje mentalizante materno / Relationship between Internal Working Models and Maternal Educational Level, with the Theory of Mind of Chilean Children Aged 3 and 4: Mediating Role of Maternal Mentalizing Language

Resumen La teoría de la mente (ToM) es la capacidad de reconocer los propios estados mentales y predecir los de otros, habilidad fundamental en el desarrollo socioemocional/cognitivo en preescolares. El presente estudio buscó describir la ToM de niños chilenos de 3 y 4 años, analizar las diferencias en su desarrollo según la edad y el rol mediador del lenguaje mentalizante (LM) materno, considerando el sexo de los niños, los modelos operantes internos (MOI) y el nivel educacional materno. La muestra fueron 110 niños con sus madres. Se aplicó un cuestionario sociodemográfico, pruebas para evaluar la ToM, el LM y los MOI de las madres. Un 50.9% de los niños se ubicó en el quintil 1 de la ToM y ninguno logró llegar al quinto. Las habilidades de la ToM con un mayor nivel de logro diferenciaron entre pretender y realidad (60.0%) y la de diferenciar la perspectiva visual propia y de otro (50.9%). Un 59.1 % de los niños no logró inferir deseos a través de la mirada, un 83.6% no logró la habilidad de acceso al conocimiento, y un 100% no logró la falsa creencia. Los resultados muestran diferencias significativas entre niños de distintos rangos etarios en el desarrollo de la ToM, sugiriendo una creciente dificultad de adquisición de sus habilidades. Además, un mayor LM de las madres se relacionó con mayor desarrollo de la ToM en los niños, con un rol mediador en la influencia de los MOI y nivel educacional materno sobre la ToM.

Abstract The theory of mind (ToM) is the ability to recognize one's own mental states and infer them in others, fundamental in socio-emotional/cognitive development in preschoolers. This study sought to describe the ToM of 3- and 4-year-old Chilean children, to analyze the differences in their development according to age, and the mediating role of maternal mentalizing language (ML) considering the sex of the children, the internal working models (IWM) and maternal educational level. The sample considered 110 children with their mothers. A sociodemographic questionnaire, tests to evaluate the ToM, the ML and the IWM of the mothers were applied. 50.9% of the children were in quintile 1 of the ToM and none managed to reach the fifth. The ToM skills with a higher level of achievement were differentiating between pretending and reality (60.0%) and differentiating one's own visual perspective and another's (50.9%). 59.1 % of the children did not manage to infer wishes through the gaze, 83.6% did not achieve the ability to access knowledge, and 100% did not achieve the false belief. The results show significant differences between children of different age ranges in the development of ToM, suggesting a growing difficulty in acquiring their skills. In addition, a higher ML in mothers was related to a greater development of ToM in children, with a mediating role in the influence of IWM and maternal educational level on ToM.

Mentalização do self e do outro: conceito, fundamentos e aplicações clínicas / Mentalizing self and others: concept, foundations and clinical applications

Este estudo teórico tem como objetivo apresentar o conceito de mentalização e discutir suas raízes teóricas, seu processo de desenvolvimento e suas aplicações clínicas. Mentalização é um constructo que vem sendo formulado ao longo das últimas décadas, inicialmente no Reino Unido e nos Estados Unidos, e que é, ainda, pouco conhecido na literatura científica brasileira. Oferece um modelo acerca do estabelecimento da realidade psíquica, e alicerça-se especialmente nas contribuições da teoria do apego, em sua vertente psicanalítica contemporânea. Na medida em que descreve um processo mental chave para o funcionamento psíquico saudável, e também para suas perturbações, oferece subsídios importantes para compreensão dos estados psicopatológicos, com destaque para os estados borderline e para aqueles resultantes de traumas psíquicos, especialmente os relacionados aos maus tratos. Uma abordagem terapêutica derivada desse constructo, denominada tratamento baseado na mentalização, foi desenvolvida, inicialmente, para pacientes com transtorno de personalidade borderline e, posteriormente, expandida para outras situações clínicas e outras populações, como crianças, adolescentes e famílias. A abordagem vem sendo objeto de inúmeras pesquisas, e conquistando uma base consistente de evidências.(AU)

This theoretical study aims to present the concept of mentalization and discuss its theoretical roots, developmental process and clinical applications. Mentalization is a construct which has been formulated over the last decades, at first in the United Kingdom and the United States and is still little known in the Brazilian scientific literature. It offers a model on the establishment of psychic reality, and it is mainly based on the contemporary psychoanalytic approach of attachment theory. As it describes a key mental process for healthy psychic functioning, as well as its disorders, it offers important insights for understanding psychopathological states, especially borderline states and those resulting from psychic trauma, especially when related to maltreatment. A therapeutic approach derived from this construct, called mentalization-based treatment, was developed initially for patients with borderline personality disorder, and later expanded to other clinical situations and other populations, such as children, adolescents, and families. The approach has been the subject of many scientific studies and has achieved a consistent evidence base.(AU)

Este estudio teórico tiene como objetivo presentar el concepto de mentalización y discutir sus raíces teóricas, su proceso de desarrollo y sus aplicaciones clínicas. Lo concepto se ha formulado en las últimas décadas, inicialmente en el Reino Unido y los Estados Unidos, y todavía es poco conocido en la literatura científica brasileña. Ofrece un modelo sobre el establecimiento de la realidad psíquica y se basa especialmente en las contribuciones de la teoría del apego en su enfoque psicoanalítico contemporáneo. Al describir un proceso mental clave para el funcionamiento psíquico saludable, así como sus trastornos, ofrece información importante para comprender los estados psicopatológicos, especialmente los estados límite y los que resultan del trauma psíquico, especialmente los relacionados con el maltrato. Un enfoque terapéutico derivado de esta abordaje, llamado tratamiento basado en la mentalización, se desarrolló inicialmente para pacientes con trastorno límite de la personalidad, y luego se expandió a otras situaciones clínicas y otras poblaciones, como niños, adolescentes y familias. El enfoque ha sido objeto de mucha investigación y ha ganado una base de evidencia consistente.(AU)

Observando la mentalización en psicoterapias con adolescentes: Diseño de un sistema de observación de la interacción terapéutica / Observing Mentalization in Psychotherapies with Adolescents: Design of an Observational System for Therapeutic Interaction

Resumen Objetivo: Basado en la falta de medidas que permitan evaluar la mentalización como variable de proceso en psicoterapias con adolescentes, el siguiente estudio apunta a presentar el diseño de un sistema observacional para evaluar el despliegue de esta variable tanto en pacientes como en terapeutas. Método: mediante el proceso de codificación abierta de la teoría fundamentada y análisis temático de tres niveles, se analizó el despliegue de la mentalización tanto en terapeutas como en pacientes en 10 episodios de ruptura y 10 episodios de resolución elegidos aleatoriamente de cinco psicoterapias con adolescentes. Resultados: A partir del análisis efectuado se desarrolló un sistema observacional de seis dimensiones emergentes (foco en los estados mentales, opacidad de los estados mentales, comunicación contingente, causalidad de los estados mentales, naturaleza dinámica de los estados mentales y foco en el momento presente) denominado "Sistema de Observación de la mentalización en Psicoterapia con adolescentes" (OMP-A) que permite evaluar cuantitativamente la mentalización de terapeutas y pacientes. Discusión y conclusiones: el OMP-A es un instrumento que responde a debilidades de otros sistemas para evaluar mentalización en psicoterapia con adolescentes, permitiendo la observación de aspectos lingüísticos y paralingüísticos del mentalizar y toma en consideración aspectos particulares que caracterizan las intervenciones con adolescentes. Se discute su posible uso para la formación y supervisión en psicoterapia, y los desafíos metodológicos para desarrollos futuros.

Abstract Objective: Based on the need for measures for assessing mentalization in adolescent psychotherapy, this study aims to design an observational system to evaluate the deployment of reflective function in both patients and therapists during psychotherapy sessions. Method: 10 episodes of rupture and 10 episodes of resolution randomly chosen within 5 videotaped and transcribed psychotherapies were analyzed using grounded theory "s open coding procedure and a three-level thematic analysis. Results: An observational system with 6 emergent dimensions (focus on mental states, opacity of mental states, contingent communication, causality of mental states, dynamic nature of mental states and focus on the present moment) and a 5-point scale was developed. Discussion and conclusions: The "Observational System for mentalization adolescent psychotherapy" (OMP-A) is an instrument that responds to certain weaknesses of other instruments by considering linguistic and paralinguistic aspects of mentalization and particular aspects that characterize interventions with adolescents. It "s possible use for training and supervision is discussed as well as some methodological challenges for future research.

Reflective function and identity in adolescents with clinical and nonclinical symptoms / Função reflexiva e identidade em adolescentes com sintomas clínicos e não clínicos

Abstract Introduction Reflective function is developed in the context of secure attachment and corresponds to the ability to understand one's mental states and those of others. Thus, identity develops, which relates to the experience of self as unique, continuous and coherent. Objective To identify reflective function and identity features in adolescents with clinical and nonclinical symptoms of mental health problems. Method Participants were 188 Brazilian high school students aged 14-17 years: 30.3% with clinical symptoms and 69.9% with nonclinical symptoms. Results Adolescents with clinical symptoms showed lower levels of reflective function and greater disintegration of identity. Conclusion Adolescence is a vulnerable time for mental health problems associated with reflective function and identity. Early identification of symptoms is a matter that needs attention to prevent future consequences.

Resumo Introdução A função reflexiva é desenvolvida no contexto do apego seguro e corresponde à capacidade de compreender os seus próprios estados mentais e os dos outros. Assim, desenvolve-se a identidade, que se relaciona com a experiência do eu como única, contínua e coerente. Objetivo Identificar função reflexiva e características identitárias em adolescentes com sintomas clínicos e não clínicos de problemas de saúde mental. Médoto Os participantes foram 188 estudantes do ensino médio com idade de 14 a 17 anos: 30,3% com sintomas clínicos e 69,9% com sintomas não clínicos. Resultados Adolescentes com sintomas clínicos apresentaram menores níveis de função reflexiva e maior desintegração da identidade. Conclusão A adolescência é um momento vulnerável para problemas de saúde mental associados à função reflexiva e identidade. A identificação precoce dos sintomas é uma questão que precisa de atenção para evitar consequências futuras.

Influence of Growth Group Therapy on Interpersonal Skills among College Students / 中国医科大学学报

Objective To explore the effects of growth group therapy on psychological factors related to interpersonal relationships in college students. Methods Volunteers from a medical university and a non-specialized university in Shenyang participated in growth group therapy once a week for 12 weeks. Before and after the intervention, the 48 volunteers completed the RFQ-54, emotion regulation questionnaire (ERQ), self-esteem scale (SES), and coping style questionnaire (CSQ). Results The RFQ-C, cognitive reappraisal, and SES scores were significantly different before and after intervention (20.54±8.88 vs 23.19±10.85, P ＜ 0.05), (27.27±5.22 vs29.19±4.69; 29.67±4.59 vs 31.48±4.20, P ＜ 0.01), as were the scores of the CSQ subscales, such as problem-solving, seeking support, withdrawal, rebuking oneself, and fantasy (0.72±0.17 vs 0.80±0.15; 0.60±0.25 vs 0.71±0.24; 0.35±0.21 vs 0.28±0.18; 0.36±0.25 vs 0.28±0.20; 0.48±0.23 vs 0.39±0.19, P ＜ 0.01). Conclusion Growth group therapy is effective in college students. It can improve abilities of mentalizing, emotional regulation, self-esteem, and coping in college students.

Are Mentalizing Abilities and Insight Related to the Severity of Obsessive-Compulsive Disorder

OBJECTIVE: The aim of this study is to investigate whether insight and mentalizing abilities are related to the severity of Obsessive Compulsive Disorder (OCD) in treatment resistant OCD. We look at the association between treatment resistance, insight, and mentalizing ability. METHODS: The study was conducted with 71 OCD patients; 30 of them met the criteria for treatment resistant OCD, whereas the other 41 (57.7%) were labeled as responder group. All patients were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Reading the Mind in the Eyes Test (RMET), Brown Assessment of Beliefs Scale (BABS), Mini International Neuropsychiatric Interview, Beck Depression Inventory, and Beck Anxiety Inventory. RESULTS: The resistant group received higher depression and anxiety mean scores and had significantly longer illness duration. The RMET score was significantly higher for responders. The Y-BOCS insight score and the BABS score were significantly higher for the resistant group. BABS scores were negatively correlated with RMET total scores. RMET scores were found to be significant predictor of insight even when other potential factors were controlled for. CONCLUSION: Results suggest that better mentalizing abilities may be a predictor of better treatment outcome in patients with OCD.

The brain mechanism underlying the understanding of action intention and mentalizing / 中华行为医学与脑科学杂志

Mentalizing is the vital cognitive basis of understanding of action intention.However,there are few studies on the complex relationship of them.The present study,firstly,discusses the concepts and the brain mechanisms of empathy and understanding of action intention,indicating the temporal dynamic features of mentalizing as well as understanding of action intention.Secondly,based on Intention Processing Network,the process of mentalizing in understanding of action intention is in hierarchy and division.During which,ventral medial prefrontal lobe plays a vital role on integrating and transforming the cognitive and affective information.Empathy and mentalizing transform into each other through ventral medial prefrontal lobe.So empathy probably mediates the relationship of mentalizing and understanding of action intention.Empathy,mentalizing and understanding of action intention can be integrated under the framework of hybrid models.Future studies should examine the relationship between empathy and understanding of action intention by empirical researches.

Mentalización y teoría de la mente / Mentalization and the Theory of Mind

El objetivo de esta revisión bibliográfica es delimitar y conceptualizar la Teoría de la Mente (ToM), como un proceso de carácter metacognitivo y socioemocional que permite reconocer las intenciones, creencias y emociones de los otros, así como las propias, favoreciendo una efectiva interacción humana. Se analizan las distintas teorías explicativas de este concepto, especialmente la postura modular y sus niveles de complejidad, métodos de evaluación y la relevancia en los estudios actuales en Latinoamérica sobre fenómenos conscientes y psicopatología.

The aim of this bibliographic revision is to delineate y conceptualize the Theory of Mind (ToM) as a metacognitive and socio-emotional process that allows people to recognize feelings, believes, and intentions in other people and inside themselves. We analyze different explicative theories, in particular the modular point of view, and review its complexity, kinds of evaluation and its relevance in Latin-American studies on conscience phenomena and psychopathology.

Two systems for empathy in obsessive-compulsive disorder: mentalizing and experience sharing

Objective: To investigate empathic abilities in patients with obsessive-compulsive disorder (OCD) compared to control subjects. OCD is characterized by persistent obsessions and compulsions. Previous studies have proposed specific emotion recognition deficits in patients with OCD. The ability to recognize emotion is part of the broad construct of empathy that incorporates mentalizing and experience-sharing dimensions. Methods: Twenty-four subjects with a diagnosis of OCD and 23 control subjects underwent empathic measures. Results: Patients with OCD compared to control subjects showed deficits in all mentalizing measures. They were incapable of understanding the mental and emotional states of other people. On the other hand, in the sharing experience measures, the OCD group was able to empathize with the emotional experience of other people when they expressed emotions with positive valence, but were not able to do when the emotional valence was negative. Conclusion: Our results suggest that patients with OCD show a difficulty in mentalizing ability, whereas the deficit in sharing ability is specific for the negative emotional valence.

Capacidade de mentalização materna e prematuridade: repercussões de uma intervenção em UTIN / Maternal mentalizing capacity and prematurity: effects of na intervention in NICU / Capacidad de mentalización materna y prematuridad: efectos de una intervención en UCIN

As interações mãe-bebê e suas repercussões na construção do psiquismo são abordadas pela Teoria do Apego, destacando-se a capacidade de mentalização materna como determinante na formação de um apego seguro. Este estudo objetivou compreender como uma intervenção psicoterápica, realizada com duplas mãe-bebê prematuro, durante a internação em UTIN, repercute na capacidade de mentalização materna, mediante pesquisa qualitativa de intervenção, exploratória e descritiva, de estudo de casos múltiplos, com avaliações antes e após a intervenção. Participaram duas díades mãe-bebê prematuro, internado em UTIN. Utilizaram-se como instrumentos antes da intervenção ficha de dados sociodemográficos e clínicos, entrevista de história de vida da mãe; e, após, entrevista de história da internação. Analisaram-se os dados por meio de dois eixos temáticos: a) Representações maternas sobre si mesma; b) Representações maternas sobre o bebê. Verificaram-se mudanças na capacidade de mentalização materna, o que favoreceu o vínculo mãe-bebê e a possível aplicação de intervenções voltadas às relações iniciais mãe-bebê prematuro em UTIN.

Mother-infant interactions and their impact on the formation of the psyche are studied by the Attachment Theory, highlighting the maternal mentalizing capacity as a determinant in the formation of a secure attachment. This study aimed to understand how a psychotherapeutic intervention performed with mother-premature baby pairs during hospitalization in NICU affects the maternal mentalizing capacity through a qualitative intervention research, with exploratory and descriptive character, which surveyed multiple cases and assessments before and after the intervention. The research included two mother-premature neonate dyads hospitalized in NICU. Before the intervention, the instruments used were: Socio-Demographic and Clinical Data Sheets and Live History Interview with the mother; after, the instrument used was the Hospitalization History Interview. Data were analyzed according to two themes: a) maternal representations of herself; b) maternal representations of the baby. There were changes in maternal mentalizing capacity, favoring the mother-baby bond and a possible implementation of interventions aimed at the early relationship mother-premature baby in NICU.

Las interacciones madre-hijo y su impacto en la formación de la psique son estudiados por la teoría del apego, destacando la capacidad de mentalización materna como factor determinante en la formación de una unión segura. Este estudio tuvo como objetivo comprender cómo una intervención psicoterapéutica realizada con doble materno-infantil temprana durante el ingreso en la UCIN, afecta la capacidad de mentalización materna por la intervención investigación cualitativa, estudio exploratorio y descriptivo de casos múltiples, con las evaluaciones antes y después de la intervención. Se incluyeron dos díadas madre-hijo temprana ingresados en UCIN. Se utiliza como instrumentos antes de la intervención: Hoja socio-demográficas y clínicas de datos, Entrevista Historia de la Madre de la Vida; y después de: Entrevista Historia de internamiento. los datos se analizaron a través de dos temas: a) las representaciones maternas de la misma; b) las representaciones maternas del bebé. No hubo cambio en la capacidad de mentalización materna, lo que favorece el vínculo madre-bebé y la posible implementación de las intervenciones dirigidas a las primeras relaciones temprana madre-bebé en la UCIN.

Sofrimento nos laços pais-filhos: práticas educativas fundadas na mentalização na proteção da infância / Suffering in the parent-child relationship: mentalizing interventions in youth protection / El sufrimiento en la relación padre-hijo: intervenciones basadas en la mentalización adaptadas a la protección de la infancia

A maioria das crianças e dos adolescentes que vivem sob a proteção da juventude viveram traumas complexos ligados à negligência, aos maus tratos e às diversas formas de abusos. Sugerimos que esses jovens, bem como seus pais, apresentam dificuldades quanto à capacidade de mentalização e demonstram um funcionamento psíquico característico dos modos de pensar pré-mentalizantes. Este artigo apresenta a operacionalização dos diferentes modos de pensar (teleológico, de equivalência psíquica e fictício). São apresentados os princípios subjacentes a um programa de intervenção baseado na mentalização que poderão ser utilizados pelos educadores que trabalham com crianças e adolescentes em situação de vulnerabilidade...

Children and adolescents under the responsibility of the youth protection have experienced complex traumas concerning neglect, mistreatment, and various forms of abuse. The authors suggest that, as their parents, they show significant difficulties to mentalize as well as a pre-mentalizing mode of psychic functioning. This article presents the operationalization of the different pre-mentalizing modes of thought (teleological, psychic equivalence, and pretend-mode). This study also presents the underlying principles from a mentalizing intervention program that can be used by educators who work with vulnerable children and adolescents...

La mayoría de los niños y adolescentes bajo la custodia del servicio de protección de la infancia han vivido traumas complejos relacionados con el abandono, el maltrato y diversas formas de abuso. Los autores sugieren que éstos presentan, al igual que sus padres, deficiencias significativas en cuanto a la capacidad de mentalización y un funcionamiento característico de los modos pre-mentalizadores. Este artículo presenta una operacionalización de los diferentes modos de funcionamiento mental, teleológico, equivalente y ficticio; y expone igualmente los principios subyacentes a un programa de intervención basado en la mentalización y dirigido a los educadores que trabajan con estos niños y adolescentes...

Autolesión no suicida en adolescentes peruanas: Una aproximación diagnóstica y psicopatológica / Non suicidal self-injury in Peruvian adolescents

Una aproximación diagnóstica y psicopatológica a la autolesión no suicida es planteada a partir de la recolección de datos de un grupo de diez adolescentes peruanas que sufrían esta patología. Se revisan las aproximaciones del DSM 5 a este diagnóstico, las que dan lugar a su configuración como una entidad que requiere mayor estudio para ser considerada como independiente de la sintomatología del trastorno límite de personalidad. Se formulan algunas tesis acerca de su psicopatología y las características que la singularizan frente a ese trastorno y la llamada conducta suicida. A partir de una formulación cognitivo-conductual, se examina el papel de esta sintomatología autolesiva como refuerzo automático y social, tanto en su vertiente positiva como la negativa. Ulteriormente se toman en cuenta las once creencias irracionales de Ellis como un instrumento para dilucidar la adaptación a la realidad de las pacientes que conformaron el grupo explorado. Finalmente se esbozan algunos alcances en torno a la terapia dialéctico-conductual de Linehan, mentalizing de Bateman y el uso del aripiprazol y los inhibidores selectivos de recaptación de serotonina (ISRS) en estos casos.

A psychopathological and diagnostic approach regarding non suicidal self-injury is proposed as a result of an exploratory study of a group of ten Peruvian adolescents suffering that condition. The DSM 5 status for this category is taken into account, as well as its relationship with entities like suicidal behavior and the borderline personality disorder diagnosis. On the basis of a cognitive-behavioral formulation, the meaning of this self damaging pathology in terms of automatic and social reinforcement, both positive and negative, is elucidated in order to clarify further developments. One of them being the use of Ellis’ irrational beliefs as a tool to evaluate the sense of reality of the patients. Some comments about Linehan’s dialectical behavioral psychotherapy, Bateman’s mentalizing and aripiprazole or selective serotonine reuptake inhibitors (SSRIs) in the treatment of these patients are proposed.

Revised Reading the Mind in the Eyes Test (RMET) - Brazilian version

Objective: To translate and adapt to Brazilian Portuguese the Revised Reading the Mind in the Eyes Test (RMET), in both paper-and-pencil and computerized versions. The RMET is a well-accepted instrument for assessment of Theory of Mind (ToM), an important component of social cognition. Methods: Following a guideline for translation of material for clinical populations, this study had three main phases: 1) formal translation and semantic adaptation to Brazilian Portuguese; 2) an acceptability trial with health professionals as judges evaluating picture-word matching; and 3) a trial using the paper-and-pencil and computerized versions (experiments built in E-Prime 2.0.10 software) with healthy participants to test whether the instrument has similar outputs to those expected in versions in other languages. Results: RMET was adequately adapted to Brazilian Portuguese. This version showed acceptability and outputs similar to versions of the instrument in other languages, including the original one. We kept the same number of images as the original English version. Conclusions: Considering the scarcity of cognitive assessment instruments adequately adapted to Portuguese and the importance of social cognition in many psychiatric disorders, this work adds an important resource to Brazilian research and is administrable in both paper-and-pencil and computerized versions. .

Mentalización en psicoterapia: discusión sobre lo explícito e implícito de la relación terapéutica / Mentalizing in psychotherapy: discussion on explicit and implicit of the therapeutic relationship

La capacidad de mentalización es un logro del desarrollo y su cualidad está influida por las relaciones tempranas con las figuras de apego. La mentalización juega un rol central en la psicoterapia tanto como actividad mental de terapeuta y paciente como también en la tarea de promover esta capacidad en pacientes carentes de ella. En este trabajo se describe la utilidad de la mentalización para la psicoterapia, enfatizando la actividad del terapeuta al generar mentalización en el paciente, pero se discuten los mecanismos de integración entre lo explícito e implícito de este proceso. Se propone que mientras la mentalización explícita puede variar según el entrenamiento y formación del terapeuta, la mentalización implícita depende mucho más de la amplitud de conciencia (mindfulness) del terapeuta sobre sus estados mentales y su habilidad en expresar y poner en juego estos estados mentales en la psicoterapia.

The capacity for mentalizing is a developmental achievement and its quality is influenced by the early relationships with attachment figures. Mentalizing plays a central role in psychotherapy, both as a mental activity of therapist and patient, as well as in the task of promoting the development of this capacity in patients who lack it. In this work the usefulness of mentalizing for psychotherapy is described, emphasizing the activity of the therapist in the generation of mentalizing in the patient, but the mechanisms of integration between the explicit and implicit of this process are discussed. I propose that while explicit mentalizing can change according to therapist degree of training, implicit mentalizing depends much more on the therapist's amplitude of consciousness (mindfulness) about his mental states and his ability to express and bring these mental states into psychotherapy.