Agency and Its Role in Recovery: How Mentalization Helps People Reconnect with Purpose

In therapy, one of the most powerful shifts is the moment someone begins to experience agency again. Agency is the sense that you can influence your life, your relationships, and your internal experience. It is the opposite of feeling powerless or carried along by events and emotions.

Many people enter treatment feeling as though life is “happening to them.” This is especially common after trauma, chronic invalidation, or early attachment disruptions (Herman, 1992). In those environments, survival often meant adapting to others’ needs, downregulating one’s own emotions, or staying hypervigilant. Over time, these adaptations can obscure a sense of choice, direction, or identity.

What Is Agency?

Agency is the felt experience that:

• I have choices.

• My feelings matter.

• I can influence what happens next.

It does not mean controlling everything. It means acting in alignment with one’s values rather than fear, habit, or emotional overwhelm. Agency is foundational to well-being, motivation, and purpose (Ryan & Deci, 2000).

Why Agency Often Feels Lost

When emotional injury or relational instability shape a person’s early learning environment, the nervous system becomes organized around protection rather than exploration (Cloitre et al., 2013). This can lead to:

• Difficulty trusting one’s intuition

• Feeling stuck in repetitive interpersonal patterns

• Automatically accommodating others at one’s own expense

• Shame or self-blame that limits action

• A sense of observing life rather than participating in it

These patterns reflect adaptive survival responses, not deficits.

Agency in Personality Disorder and Trauma Treatment

Across contemporary models of personality disorder and trauma treatment, restoring agency is a core therapeutic aim. Individuals with borderline, narcissistic or other personality vulnerabilities often describe experiences of losing control internally, being overtaken by emotions or assumptions about others’ intentions, or feeling defined by relational dynamics or external factors rather than by a stable internal compass.

A central treatment goal is the development of an agentic self. This includes the ability to:

• Generate intentions

• Reflect on internal states

• Choose among options instead of reacting automatically

• Take ownership of meaning-making

• Navigate relationships with greater flexibility

Strengthening agency stabilizes identity, reduces reliance on protective but limiting strategies, and supports a more coherent sense of self.

Reconnecting With Purpose

Purpose does not appear all at once. It develops through repeated experiences of being an active participant in one’s life. As agency returns, people often notice:

• More clarity about what they want and do not want

• More emotional steadiness in relationships

• Increased ability to imagine new possibilities

• A deepening sense of meaning and direction

These changes often begin with very small steps such as a new boundary, a brief pause before reacting, or a moment of naming a feeling. These experiences rebuild trust in the self.

How Mentalization Supports Agency

Mentalization is the capacity to reflect on one’s own thoughts, emotions, and intentions while recognizing that others have their own internal experiences (Fonagy & Bateman, 2016). Under stress, this reflective capacity can collapse. When this happens, reactions feel urgent, automatic, or predetermined.

Mentalization-Based Treatment (MBT) helps by slowing experience enough to identify choice points:

• What am I feeling right now?

• What meaning am I giving this feeling?

• What else could be true?

• Given that, what do I want to do next?

Agency often returns through understanding rather than force of will. Over time, MBT strengthens:

• Emotional self-awareness

• Flexible thinking

• Perspective-taking

• Compassion for oneself and others

These capacities support the emergence of a coherent, agentic self. This allows a person to shape their life rather than simply endure it. Reality will not always align with what someone wants, but with agency they can move through it with more clarity and intention.

References

Bateman, A., & Fonagy, P. (2019). Handbook of Mentalizing in Mental Health Practice.
Cloitre, M., et al. (2013). The ISTSS Expert Consensus Treatment Guidelines for Complex PTSD.
Fonagy, P., & Bateman, A. (2016). Mentalization-Based Treatment.
Herman, J. (1992). Trauma and Recovery.
Ryan, R., & Deci, E. (2000). Self-determination theory and the facilitation of intrinsic motivation.