Psychiatry & Psychotherapy Podcast Reflective Functioning: The Key to Attachment with Dr. Howard Steele
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May 17, 2024 
In this insightful discussion, Dr. Howard Steele, a leading expert in attachment theory, unpacks the concept of reflective functioning—a key element in understanding emotional and relational dynamics. He explains how this scale measures our ability to articulate our internal states and those of others. Topics include the role of reflective functioning in treatment outcomes, its implications in parenting, particularly among mothers facing adversity, and its connection to mental health issues like borderline personality disorder. Steele highlights how improving reflective capacities can lead to healthier attachments and deeper emotional insights.
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Reflective Functioning Explained
- Reflective functioning, like psychological mindedness, involves understanding others' motivations.
- It's measured on an 11-point scale (-1 to 9), developed by Steele and Fonagy.
Examples of Low Reflective Functioning
- Patients with low reflective functioning often deflect self-reflection, saying "You tell me.".
- Those incarcerated for violent crimes often exhibit extremely low reflective functioning.
Reflective Functioning and Mental Illness
- The CASEL Hospital study showed patients with BPD had lower RF (2.7) than depression (3.8).
- Howard Steele clarifies that the 2.5 RF average was from inpatients, not prisoners.