2020 Workshop Series

How to promote mentalising in working with Trauma and Dissociation

Presented by Dr Stuart Mitchell

Consultant Clinical Psychologist & Psychoanalytic Psychotherapist


Mentalising is the ability to perceive and comprehend one’s own and others’ behaviour based on feelings, thoughts, beliefs and wishes that explain those actions. Clients with Complex PTSD and dissociative disorders tend to have chronic difficulties with reflective functioning, mentalising and trust in attachment relationships, ranging from mild to severe (Bateman and Fonagy, 2016; Luyten & Fonagy, 2019). Their mental representations of themselves and others are often based on negative schemas or beliefs related to trauma. For example, “I was born bad;” “I am responsible for the abuse;” “People are never safe, and only want to hurt me.” Therapists may, through focusing on the effects of trauma on the attachment system and capacity for epistemic trust, help clients restore their mentalising capacity and so foster greater trust, safety, stabilisation and personality integration. Whilst most current approaches to therapy with complex trauma and dissociative disorders will consider mental states, embodiment, reflective functioning, reality testing and attachment safety, we consider that an understanding and explicit focus on attachment, epistemic trust and mentalising processes will enhance therapeutic practice with this client group, regardless of therapeutic orientation.

Level: Intermediate

Intended Audience: Psychological therapists, counsellors and psychotherapists working with Trauma and Dissociation Dr Stuart Mitchell

Max audience size:

Learning outcomes

1) Understand and describe the concept of mentalising and its relevance to psychotherapy and trauma-focused work
2) Explain how mentalising, and non-mentalising may operate with clients experiencing complex trauma and dissociation using case examples
3) Describe at least two ways of helping clients to restore and promote better mentalising when it is lost or weakened.


Dr Stuart Mitchell is a trained Clinical Psychologist, Psychoanalytic Psychotherapist, EMDR, MBT and DBT therapist. He is an MBT skills trainer and accredited MBT supervisor. Stuart leads the Personality Difficulties and Complex Trauma Pathway in a large NHS Trust in the North East of England. He has attended training with Suzette Boon, Kathy Steele, Janina Fisher and Dolores Mosquera in recent years, and been working with personality difficulties, complex trauma and dissociation for over 20 years. He has published on Trauma Informed Care, Mentalising and personality difficulties.