Mentalisation-Based Therapy of Non-suicidal Self-Injury and Eating Disorders: MBT-ED

Abstract

Mentalisation-based therapy (MBT) has been suggested as a rational approach to patients with eating disorders, and its success in reducing non-suicidal self-injury (NSSI) in patients with borderline personality disorder (BPD) suggests its use in those with eating disorders and NSSI. In fact, patients with eating disorders, and some with NSSI, often have problems with mentalising, and many have attachment issues which are addressed in MBT. MBT-ED (MBT for eating disorders) was developed and tested during a randomised controlled trial. Experiences during the study using a combination of weekly group and individual therapy suggested that the approaches used during MBT in BPD could be adapted to address eating disorder symptoms. Breaks in mentalisation due to increasingly unbearable emotional states can often be linked to the onset, worsening or recrudescence of eating disorder symptoms, while in BPD treatment, such breaks in mentalisation have long been familiar antecedents to NSSI. It was also found that symptoms could often be traced back to problems in relationships, and tracing these sequences, if present, was found to be helpful by patients. Because of its intuitively relevant theoretical basis, the straightforward training and the increasing evidence base, MBT may well prove a useful approach in the treatment of eating disorders and NSSI.