Distract and Return Later & The Rewind: Mentalizing Tools!
How to bail on arguments you'd rather not be having
The Frontier Psychiatrists is a health-themed newsletter. Included in health are fewer arguments. It’s more about the ability to get through conflicts in your day. I teach a technique called mentalizing. This column is about that. I have a book on the topic on Amazon (sponsored link).
All of us have been in conversations where we feel like we’re getting nowhere. I’ve probably been in more of these than most people. I’ll drop a definition of mentalizing for those who are just joining us:
Mentalizing involves the ability to interpret/understand behavior (one's own and that of others) as psychologically motivated in terms of underlying intentions and mental states, such as thoughts, feelings, wishes, and intentions.
One of the important things to understand about mentalizing is that it’s not always adaptive for people to mentalize. Times, when mentalizing is inappropriate, include:
1. when facing a tiger.
Never spend time wondering if the tiger is hungry. Run. The risk of being eaten is never worth it. The one time you’re right, the tiger’s mental state “not hungry” is outweighed by all the other times you are dinner.
Always run.
This happens in everyday situations like attempted muggings. The only point is to get out alive. When you’re in danger or facing things about which you can’t productively be curious, don’t mentalize. Everyone’s tiger is different, but nobody should get eaten alive. When other people’s feelings are out of control, sometimes you won’t get anywhere by talking to them.
I was walking to school with my children the other day. They wanted to listen to a Bluetooth speaker, and both wanted to hold the Bluetooth speaker. At the time, Trent was six. Quinn was also six. They are twins. They have not yet learned the lesson of “it’s not worth fighting about” in life. I tried being a good parent:
“As long as you fight over who holds the speaker, I won’t play any music through it.”
Trent responded robustly, “But I want to hold it, and Quinn can hold it tomorrow.”
Quinn has a whiny voice sometimes when she wants to get something. “But I want to hold it. I want to hold it now. I want to listen to Roar by Katy Perry,” she whined annoyingly.
As an aside, I understand that you’re judging me for my daughter’s musical choices. And you’d be right to do so. This is a terrible song for adults. But it’s catchy. It’s got a certain sing-song quality that made it popular, and for six-year-olds, this is just candy for your brain. My son, for reference, is much more of a fan of REM, including songs like Orange Crush and They Might Be Giants tunes like Dr. Worm. I consider myself a successful parent when my children wake me up at 6 AM by blasting They Might Be Giants or REM. I’ll even take Roar by Katy Perry.
Distract and Return Later
Now, back to the main discussion, but you’ll notice that I just distracted you, as readers, pretty successfully. You probably forgot all about the fact that this is a chapter about distraction, and I did that by distracting you, by giving you something else to think about. The kids are cute. They’re reliably distracting.
At the time of these events with my children, I wasn’t being successful and distracting them; no amount of music was playing, and they were hammering each other back and forth. Trent: “You’re just making it worse.” Quinn: “But I want it.” Repeat.
I had a choice to make. I could either keep up my good-parent bona fides and have my children scream at each other the whole way to school, or have the school think I’m a terrible parent who brings crying children in the door. Or, I could bail on the whole situation in a way that wouldn’t undercut my parental authority.
My way of distracting them and returning later was to choose to play music that had nothing to do with anything they wanted, but was music they could listen to instead of fighting.
It was time for Miles Davis, Kind of Blue, and the song “So What” to the rescue!
And it worked. They calmed down. We walked to school. We would revisit the issue of who gets to hold the Bluetooth speaker on Monday, like we do every morning.
The Rewind
After successfully using the distraction technique, I added another one to ensure they arrived calmly in class. The next technique I use is called The Rewind. The Rewind is a reliable technique. When you’re good at recognizing mentalizing, it’s a fantastic skill. It’s still a pretty good skill when you're new to mentalizing. If a person has gotten either too hot or too cold in the conversation thus far, you try to bring them back, verbally, to the last time they were known to be mentalizing whatever story they are telling you.
So, in the above example with my kiddos, I might say:
“Hey Trent, hold on. Before we left the house, you told me the speaker was charged. How do you know? Can you describe how you checked?”
Trent: “It was 98 percent charged. I always check the percentage charge. That is how I know. Your Tesla has 93%. It’s important to remember that.”
Dr O: But what happened next…?
Mentalizing skills pop back online when minds are directed to think about when they were mentalizing in the past. The opposite is also true. Things that are unmentalizable—trauma or abuse, for example—are not the subject of much therapeutic work with this specific approach when I’m doing therapy. If you were to rewind the patient to a time of abuse or trauma, you’d essentially be rewinding into a fire pit. That is why other techniques are needed to work on trauma (like EMDR, MDMA therapy, and the like). I don’t recommend trying to have these loaded conversations about intense topics like trauma for the general public. When you Rewind, Rewind to when people were curious! It will save you some very difficult conversations that go nowhere.
What we talk about matters. Don’t bother with things you or someone else can’t be curious if you have the choice. If we are trying to restore mentalizing skills, either a time in the past when you were curious and mentalizing or the present moment as it’s occurring are the safest time frames for good results.
Remember — Rapid Acting Mental Health Treatment is Returning! This time, to Los Angeles on May 18th!
It’s held at the swanky Skyline Loft at 224 East 11th Street #601 Los Angeles, CA 90015.
Yes, that is when the APA is in town. Yes, I have to book the airline tickets myself.
The point of these events was to take a conceit—fast-paced discussions about treatments and tools that challenge our conceptions of what is possible in mental health care.
Our speakers include:
Grady Hannah, Co-Founder, Executive Team Member, Attentio AI, Co-Founder NightWare
Kellie Newsome, NP, co-host Carlat Psychiatry Podcast
Carlene MacMillan, M.D., DFAACAP, FCTMSS, Chief Product Officer at Radial
Daniel Karlin, M.D. Chief Medical Officer, MindMed
Jay Sanguinetti, Ph.D., Founder and President, Sanm.ai
Sandhya Prashad, M.D., Medical Director Houston Ketamine Therapeutics & Houston Deep TMS Therapy, President at American Society of Ketamine Physicians
Sarah Norman, Executive Director, BrainFutures . Former CMS
Chris Aiken, M.D., Director, Psych Partners. Editor of The Carlat Report
Oded Kraft, Co-founder, CEO and President at GrayMatters Health
Dominik Middelmann, Co-Founder & CEO MDHub
Jonathan Downar, MD, Co-Founder, Ampa Health
Chris Dougherty, Founder and Chief Strategist at Hydra Strategies