The IMMERSE blog

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Do you remember what you were doing last Wednesday at 3:40 pm? How many times have you used your phone today? Have you noticed yourself trying to understand your or other's people intentions, behaviors, or emotions today? Whatever the answers to these questions are, three things are certain. First, you might struggle to remember what you were doing at 3:40 pm last Wednesday. Second, if you own a mobile device, it is highly probable that you have used it multiple times today. Third, after reading the last question, you may have just unnoticeably become aware of your intentions, behaviors, or emotions — and, perhaps, those of others. At first, all these questions might appear completely unrelated. However, all of these questions are interconnected, and we study them in the IMMERSE project.

The IMMERSE project is an ongoing multidisciplinary project that brings together a group of researchers from four European countries (Belgium, Germany, Scotland, and Slovakia) to translate the implementation of an app (a 'Digital Mobile Mental Health' tool) into routine mental health care. If it sounds like a very big project, you grasped the correct idea.

I was driven to this project for its approach to studying mental health, digital challenges, and the potential opportunities to explore how our minds face adversity and stress. I also liked the idea of studying how we cope with the challenges of daily life. Nevertheless, before I continue this blog about my PhD, it is crucial to understand what kind of app we have developed, how the study is designed, and what mentalization is.

The digital mobile mental health tool created in the IMMERSE project (Therapy Designer) collects Ecological Momentary Assessment (EMA) data from study participants. This is done via notifications received in the mobile app, where participants are asked to complete brief questions multiple times a day. These questions are about their mood, their context, and other psychological abilities (including mentalization). The idea behind EMA comes from ecological psychology. Ecological psychology is based on the idea that our emotions, thoughts, and coping strategies occur in a specific context. Thus, our well-being and mental health change depending on our proximal and distant environment. I believe that acknowledging individuals' agency alongside with the influence of their proximal contextual factors could help us understand how our minds have unique capacities to face adversities and cope with stress.

The digital tool (TherapyDesigner) of the IMMERSE study captures momentary changes in daily life. In an era where we use mobile phones every day to connect with other people, expand our memory capacity (e.g., saving your contacts in your phone rather than memorizing the phone number of all your acquaintances), and — in some cases — to even track our fitness activity; we could also use it to record and explore the changes promoting resilience or well-being. Perhaps, what you were doing last Wednesday at 3.40 pm was something that is consistently influencing your well-being.

Thus, using Ecological Momentary Assessment could help us explore some psychological abilities and their changes over time. However, this is not the only way that the IMMERSE project is exploring those changes. As part of the study, participants will complete some psychological tests assessing different psychological abilities four times during the study period. One of these abilities is mentalization. This ability relates to the questions I asked you at the beginning; the questions about reflecting on intentions, behaviors, and emotions.

Mentalization concerns our capacity to see others from the inside and ourselves from the outside; it is a capacity that helps us predict our and others' behaviour and intentions. It is a capacity that helps us make sense of the relational world around us (Bateman & Fonagy, 2019). In psychology, scholars propose this ability to be a stable trait. However, we are not always actively mentalizing about ourselves and other. In fact, since mentalization is a profoundly social capacity, it will be highly dependent on stress and other social factors. Our degree of mentalizing will fluctuate throughout the day, and we will rarely stay in a mentalizing or non-mentalizing state for long periods. Therefore, mentalization is something that we use at different times of the day and it helps us navigate relational settings.

If you asked a room full of people what they think about the active ingredients for people to be resilient or vulnerable to mental health difficulties, surely you would have multiple answers. However, somehow those answers might reflect mentalization abilities, the changing context, and the challenges of studying them. I found this awareness of ourselves and others intriguing, and I believe that mentalization - how it changes over time and in different contexts - is a primary ability that actively influences our well-being and mental health. Interestingly, there is scientific evidence suggesting that mentalization abilities are weakened in people facing mental health difficulties, as well as evidence suggesting that mentalization is as a key factor promoting recovery in any psychotherapeutic process (Babl et al., 2022; Lüdemann et al., 2021; Luyten et al., 2020).

By now, I hope you can see how the three questions I posed at the start of this blog join together to form my PhD project. I am exploring how mentalization changes, how we imagine our and others' behaviours and intentions in social settings, how mentalizing abilities change over time, and how they interact with other abilities (such as coping strategies) to be active ingredients to build psychological well-being and resilience. As complex as it sounds, studying our mind in context is the best approach to fully understanding the mechanisms of change in mental health interventions and how those mechanisms could promote resilience over time. If you have read this blog until this point, I hope you could have perceived the promising impact of using our phones to track our mental health, the positive impact of integrated mobile technology to explore complex mental health, and the numerous possibilities of studying the change of mentalization in daily life within the IMMERSE project.

References

1. Babl, A., Berger, T., Decurtins, H., Gross, I., Frey, T., Caspar, F., & Taubner, S. (2022). A longitudinal analysis of reflective functioning and its association with psychotherapy outcome in patients with depressive and anxiety disorders. Journal of Counseling Psychology, 69(3), 337–347. https://psycnet.apa.org/doi/10.1037/cou0000587
   
   
2. Bateman, A., & Fonagy, P. (Eds.). (2019). Handbook of mentalizing in mental health practice, second edition. American Psychiatric Association Publishing. https://www.ebook.de/de/product/37093812/handbook_of_mentalizing_in_mental_health_practice_second_edition.html
   
   
3. Lüdemann, J., Rabung, S., & Andreas, S. (2021). Systematic review on mentalization as key factor in psychotherapy. International Journal of Environmental Research and Public Health, 18(17). https://doi.org/10.3390/ijerph18179161
   
   
4. Luyten, P., Campbell, C., Allison, E., & Fonagy, P. (2020). The mentalizing approach to psychopathology: State of the art and future directions. Annual Review of Clinical Psychology, 16(1), 297–325. https://doi.org/10.1146/annurev-clinpsy-071919-015355