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Psychiatry & Psychotherapy Podcast

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

Psychiatry & Psychotherapy Podcast

David J Puder

Science, Health & Fitness, Medicine

4.81.3K Ratings

🗓️ 17 May 2024

⏱️ 95 minutes

🧾️ Download transcript

Summary

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.

Transcript

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0:00.0

Welcome back to the podcast. I am joined today with Dr. Howard Steele. He is a full professor

0:19.7

in psychology at the department in the new school for social research in New York City.

0:27.2

He has written multiple books on attachment. He is the chief editor of a journal article

0:34.9

called Attachment and Human Development. He was co-author in the initial reflective

0:41.6

function manual with Fonegi and he is, I would say, he's the top voice on reflective

0:52.0

function. He teaches it every year. He teaches a course on reflective function and if you've

0:58.5

been listening to this podcast for a while, you know that I have been interested in mentalization

1:04.0

based therapy, which Fonegi and Bateman created. Interestingly, I found out recently that Fonegi

1:10.5

and Dr. Steele co-authored the reflective function manual. This manual is something I became

1:16.0

very interested in because there was an article that I got exposed to I found, which was really

1:22.4

looking at what separates the best therapists versus average therapists. In this article,

1:29.1

they split therapists into three groups. They looked at their outcomes with their patients through

1:33.6

the OQ45 point, which is one of the best ways of tracking session to session change in someone.

1:41.7

So they were following a bunch of therapists' patients and they split them into three groups

1:47.6

and they found that the therapists with the highest reflective function had the best outcomes.

1:54.8

And it was 70.5 percent of what made the best therapist the best therapist. This was kind of like

2:01.3

for me, you know, usually in research when we look at common factors, we see correlations of

2:07.1

point three. This is huge. This was a huge sort of like, oh wow, I got to look at this manual.

2:13.5

And Steele was one of the authors of the manual. And so we've been in conversation about

2:19.0

reflective function. And I thought, why not bring in the expert himself, who has written books

2:25.7

on this, who does courses on reflective function. So Dr. Steele, welcome to the podcast.

2:31.5

Thank you so much for being here today. So maybe just to kind of like

...

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