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Mentalizing Imagery Therapy: Theory and Case Series of Imagery and Mindfulness Techniques to Understand Self and Others

  • Felipe A. Jain
  • Peter Fonagy


Facilitating mentalization, or the ability to understand mental states and their link to behavior, is increasingly viewed as a common mechanism of action across effective psychotherapies. Here, we present an overview of a new set of contemplative psychotherapeutic techniques, mentalizing imagery therapy (MIT), which uses guided imagery and mindfulness practices to facilitate mentalization. MIT aims to reduce negative psychological symptoms by stimulating an understanding of mental states and their links to behavior in self and others, including in challenging interpersonal situations. Case discussions of MIT in personality disordered and depressed patients are used to illustrate theoretical points and the specific practical benefits of MIT. We conclude that there are promising indications that the imagery and mindfulness practices of MIT, which are specifically targeted to facilitate insight in the context of attachment relationship challenges, may help to improve mentalization and reduce symptoms of depression and anxiety. Both in practice and with respect to its articulated goals, MIT promotes a distinct set of capacities from other mindfulness or compassion-based therapies. Further research is required to determine the clinical efficacy of MIT in controlled trials.


Mentalization Mindfulness Meditation Guided imagery Personality disorders Depression 


Author’s Contributions

FJ: designed and executed the study, conducted the data analyses, and wrote the paper. PF: collaborated in the writing and editing of the manuscript. All authors approved the final version of the manuscript for submission.


Felipe A. Jain was supported by grants from the National Institute on Aging #1R21AG051970, the Morris A. Hazan Memorial Foundation, the Friends of the Semel Institute, and an institutional Ruth L. Kirschtein National Research Service Award #5T32MH017140. Peter Fonagy is in receipt of a UK National Institute for Health Research Senior Investigator Award # NF-SI-0514-10157. The authors report no conflicts of interest.

Compliance with Ethical Standards

All procedures for cases drawn from clinical trials were carried out in accordance with University of California, Los Angeles (UCLA), Institutional Review Board #13-001877 and #14-000150. Cases drawn from clinical practice were reported in compliance with procedures of the Massachusetts General Hospital Institutional Review Board for case reporting limited to medical records.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Written informed consent was obtained from all subjects enrolled in research pilot trials.


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Authors and Affiliations

  1. 1.Department of PsychiatryMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Psychoanalysis UnitUniversity College LondonLondonUK

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