A Movement-Informed Mentalization Lens Applied to Psychodynamic Psychotherapy of Children and Adolescents with High Functioning Autism Spectrum Disorder

Abstract

Deficits in decoding and encoding emotion and intention are inherent in children and adolescents with Autism Spectrum Disorder (ASD). The interface of neuro-deficit, epigenetic influences, relational challenges, weaknesses in social-cognition, and affective dysregulation are embedded in keystone theoretical perspectives, further informed by recent research findings. Highlighting the importance of developmental potentials and nonverbal behavior, as well as facilitating parental resolution and reflectivity in the wake of diagnosis, a mentalization-framed therapeutic approach is described wherein the child exercises holding the therapist’s mind in mind, while developing a richer portrait of a mentalizing and relating self. Verbal exchanges invite perspective taking, inducing the patient to help the therapist know what is unknown and vice versa. Such inducement is explicit and implicit. Interpersonal coordination of nonverbal processes in the therapeutic context enables progress toward ‘embodied mentalization.’ A therapist’s challenge includes awareness of one’s own (and the patient’s) bodily experiences and kinesthetic identifications that promote experiences of empathy and collaborative trust. These allow the patient to feel capable of knowing and being known. The Kestenberg Movement Profile (KMP) illuminates such bodily processes and their possible meanings. De-vitalized and/or rigidified states can secondarily serve defenses. Video-feedback is sometimes warranted within the context of therapy.