ABSTRACT
As part of a shared formulation of functioning, the first operation to be undertaken in metacognitive interpersonal therapy (MIT) is to trace mental states identifiable in patients' autobiographical memories. A therapist should be careful to avoid focusing the conversation on the abstract ideas, intellectualisations or generalised statements the patient brings. The therapist should avoid other operations aiming at change, such as encouraging critical distance or trying adaptive forms of functioning. When an MIT therapist provides any intervention, the therapist should be aware of the possible consequences that the intervention may have on the therapeutic relationship. Some personality disorder (PD) patients need to be encouraged to switch from intellectualising and abstract concepts to autobiographical narratives throughout therapy, while others are better at it and overcome the problem after a few sessions. Many patients gradually improve their ability to talk about themselves, after a bit of exercise.
