The role of epistemic trust in the relationship between attachment and mentalization: a systematic review

Epistemic trust can be defined as the ability to rely on social and cultural information from others. It allows to integrate the new knowledge in the vision of self and world, promoting the learning from experience. Recently, the issue of epistemic trust is gaining growing interest in literature thanks to the recognition of the significant implications that it may have for treatment effectiveness but not only, as evidenced by the extension of it field of research and application to different contexts and psychopathological conditions. However, this makes it increasingly difficult to identify a unique relational dynamic between epistemic trust, attachment and mentalization. In addition, this issue is still predominantly addressed on the theoretical level, while empirical studies are still scarce, and this allows each researcher to make a different hypothesis. Therefore, this systematic review aims at exploring the role of epistemic trust in the relationship between attachment and mentalization, looking also at factors able to affect this bond. The keywords were the following: “mentalization”, “attachment” and “epistemic trust” and its dimensions and dysfunction. Articles were included if they explicitly focused on the relationship between attachment, mentalization and epistemic trust, and if they were research articles. Studies were excluded if they addressed only one or two of the three constructs, and if they were theoretical articles, opinion articles, commentary, book chapters and interviews. Results predominantly showed a relation of interdependence between these variables, although from studies that empirically investigated this topic an interesting, contrasting datum emerges: there seems to be a relationship of interdependence only between mentalization and epistemic mistrust or credulity, but not between mentalization and epistemic trust. These findings highlight the need to empirically deepen the link between these three variables and suggest therapists to pay attention not only to the creation of a secure therapeutic relationship and the improvement of mentalizing abilities, but also to clients’ epistemic trust, especially to its disrupted forms.