Psychiatry & Psychotherapy Podcast

Reflective Functioning: The Key to Attachment with Dr. Howard Steele

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.

01:35:28

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Howard Steele

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Quick takeaways

Therapists with high reflective function achieve superior therapeutic outcomes, impacting therapy success significantly.

Reflective functioning plays a crucial role in understanding personal history and childhood experiences, influencing current psychological state.

High levels of reflective functioning in mothers predict secure attachments in children, highlighting the importance of reflective function in promoting healthy relationships.

Deep dives

Importance of Reflective Functioning in Therapeutic Outcomes

Therapists with high reflective function achieve superior outcomes, as indicated by a study that split therapists into three groups based on their reflective function levels. The group with the highest reflective function demonstrated the best therapeutic results, showing a significant impact on therapy success.

Understanding Distorted Self-Perception and Relationship Issues

01:21

Comparing Mentalization-Based Treatment and Dialectical Behavior Therapy

01:13

Secure Attachment and Reflective Functioning

01:17

Understanding Transference and Attachment in Psychotherapy

01:54

Intro

2min

Exploring Reflective Functioning

20min

Understanding Opaqueness in Mental States

2min

Understanding Reflective Functioning Scores in Therapy

2min

Reflective Functioning in Literature and Therapy

20min

Reflective Functioning and BPD: Insights and Treatments

8min

Exploring Emotion Beneath Anger in Emotionally Focused Therapy

3min

Reflective Functioning and Attachment in Parenting

20min

The Fluidity of Reflective Functioning

8min

10.

Exploring Attachment and Reflective Functioning

9min

In this episode, we discuss “reflective function,” which is a precursor to the concept of mentalization. Reflective function is best understood not as synonymous with mentalization, but as a scale from -1 to 9, based off certain adult attachment interview questions that measure the person’s ability to describe their own and others’ internal states, motivations, and articulate a nuanced and unique understanding of life from 0 to 12 years old. This scale was developed by attachment researchers at the University of London, including Dr. Howard Steele and Dr. Peter Fonagy.

By listening to this episode, you can earn 1.5 Psychiatry CME Credits.

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