Not Getting Much From Therapy? Could You Be in Pretend Mode?

I remember walking into a therapy session for myself, holding an array of papers in my hands. I had a plan. I needed this therapist to understand my story with highlighted documents. At that moment, I felt confident.

The therapist across from me interrupted early on. Initially, I felt invalidated. After reflection, I realized that in my preparation to share my narrative, I had forgotten that another person sat in the room. I was speaking a monologue within what could have been an echo chamber. While not well received at first, his move, in a way, rescued the session.

What is pretend mode?

Pretend mode is an insular way of communicating with someone wherein we only seek to communicate a narrative—one that may or may not be rooted in facts and emotions (Bateman and Fonagy, 2016). It's like explaining, sometimes filling in gaps. Like a fantasy, we create a story to make sense of things or place ourselves, others, or the world in a particular light. In mentalization-based therapy, pretend mode is considered a pre-mentalizing mode. In other words, it's a way of interacting that doesn't allow us to optimally relate with ourselves and others.

We become separated within our world; almost dissociated in a way. In a therapy session, this can be highly problematic as it blocks us from authentic reflection. Although it's usually a temporary state, it can cause difficulties.

While sharing stories is a central part of therapy in many ways, we must be able to "stay" in the space. If we can share a story while feeling, thinking, and interacting with the other in the room, we have a way to process it, whereas if we are rattling off our views as if reading from a script, we miss out.

Most of us interact in pretend mode sometimes, yet when habitually done in session, it can subtract from the value of the therapy.

Pretend mode can also affect other relationships in your life making it more difficult to relate genuinely with others. The therapy office is often a microcosm where we can witness patterns in relationships and make changes. Recognizing pretend mode when it pops up in therapy could help you also recognize when it shows up in other interactions as well as the purpose it may play and what you need to reconnect.

How do I know if I'm in pretend mode? Will my therapist tell me?

As a rule of thumb, if you could have the same conversation you are having with your therapist with an imaginary friend, you are probably in pretend mode. In other words, if you are speaking abstractly, or thinking but not feeling, the interaction between two people is disrupted as if it were only you there. Similarly, if you could guess exactly how a therapy session might go before the session, you are probably in pretend mode. Psychotherapy, ideally, is a space where individuals can discover and connect. Pretend mode blocks that.

Still, the truth is that we often don't know when we are in pretend mode, especially if this is a common way for us to talk to others. It just happens.

If your therapist is providing mentalization-based therapy, they should be able to recognize when you are in pretend mode and have transparent conversations with you about catching this way of relating. They are also likely to use curated strategies such as well-placed humor, a counterfactual question, or a respectful challenge to assist you in grounding.

Therapists not utilizing mentalization-based therapy may still notice times when you go into a pretend mode. Psychodynamic and interpersonal therapies approach ways of relating somewhat differently than mentalization-based therapy, yet there are parallels. Similarly, in therapies that resource mindfulness, contact with the present moment might also help to dissipate the pretend mode, though the therapist is unlikely to call it that.

If your therapist has not pointed this out to you, or you feel that you are reciting the same stories repeatedly, it may be an excellent topic to discuss in therapy. Not all therapists are familiar with pretend mode, and not all modalities acknowledge it in the same way.

Is narrative always bad?

No. Narrative is commonly used in psychotherapy to explore one's experience. In trauma-focused therapies, for example, a person might write a trauma narrative or create a statement of the impact a trauma has had on them. Still, even here, when you are sharing the narrative, the therapist will be watching out for signs of dissociation. Suppose you can read your trauma narrative with the same tone as a newspaper article. In that case, your therapist is likely to acknowledge this and assist you in reconnecting with the emotional aspects.

Similarly, many find it helpful to prepare a list of topics to discuss in therapy. Still, if those topics are discussed from a space of pretend mode, it can be difficult to get the most out of a session.

In Closing

While not often talked about in therapy, pretend mode can present a significant challenge in therapy. It is an excellent topic to explore if you notice signs of pretend mode in conversations with your therapist. Challenging pretend mode can vastly improve the quality of therapy.