Presently, there is no denying that the human requirement for intimacy and attachment stands as a fundamental and primary need, and neglecting it can have detrimental psychological consequences (Baumeister and Leary, 1995). The capacity to develop close relationships with others is a crucial factor contributing to adults’ mental health and overall well-being (Hook et al., 2003). Moreover, intimacy plays a vital role in establishing productive and effective relationships. Ryff (1989) posited that a high-quality relationship is characterized by the parties’ ability to engage in interactive and reciprocal experiences of empathy, love, intimacy, and understanding (Fung, 2011).

Various definitions of intimacy exist, with Descutner and Thelen (1991) outlining three essential components that they contend must coexist for the concept of intimacy to be applicable. These components encompass content (the sharing of personal information), emotional valence (having strong feelings about sharing personal information), and vulnerability (holding a high regard for the other person). Similarly, Ghorbani (2018b) has proposed a similar definition of intimacy, framing it as trust that facilitates understanding and being understood. This trust creates a conducive environment for individuals to share their emotions and personal thoughts. Consequently, intimacy provides a platform for emotional closeness, allowing individuals to articulate their deepest thoughts and feelings. However, there are instances where individuals may lack the capacity for emotional intimacy, often rooted in adverse childhood experiences. The anxiety stemming from sharing personal thoughts and feelings with a significant other can lead to the repression of this capacity, resulting in an avoidance of intimacy. Termed the fear of intimacy by Descutner and Thelen (1991), this concept encompasses individuals who harbor apprehensions about becoming emotionally close to important ones despite their desire for intimate relationships. This fear is not confined to specific relationships and can manifest in connections with romantic partners, friends, colleagues, and others. Individuals experiencing this fear encounter challenges in sharing their personal thoughts and feelings, particularly with those they hold in high regard (Senese et al., 2020).

The fear of intimacy can be comprehended through the lens of dynamic psychotherapy, particularly in the context of childhood trauma. In the early stages of life, individuals may encounter frustration in attempting to fulfill their needs, realizing that immediate and unquestionable satisfaction of all needs is not always feasible. At times, this frustration exceeds the child’s mental capacity, resulting from numerous overwhelming psychological, physical, and sexual injuries emanating from attachment figures, typically parents (Neborsky and Ten, 2018). Confronted with these complex, conflictual, and frequent emotions, the child may find it challenging to tolerate them. Consequently, intense emotions give rise to anxiety, leading the individual to employ various destructive defense mechanisms to cope with both the anxiety and the emotions that initially triggered it. This defensive process ultimately instills a fear of establishing emotional closeness with others (Davanloo, 2001). Hence, childhood trauma encompasses all forms of child abuse, including neglect, physical abuse, sexual abuse, emotional abuse, and domestic violence (Bücker et al., 2012).

Aligned with the experience of childhood trauma, individuals may lose the ability to perceive their inner and outer worlds, opting to hide and repress emotions rather than engage in processing and reflection (Bateman et al., 2023). This mental process, termed mentalization, was initially proposed by Fonagy and Target (1997) within the framework of attachment theory. Mentalization denotes a person’s capacity to comprehend and envision the intentions and reasons underlying behaviors and feelings, both their own and those of others, fostering emotional regulation (Bateman et al., 2023). Furthermore, the ability to verbalize one’s feelings and intentions toward others constitutes a pivotal component of mentalization (Ensink et al., 2017).

Conversely, within the framework of self-knowledge, the cognizance of inner states is elucidated through the concept of integrative self-knowledge. Ghorbani (2018a) outlines the components of integrative self-knowledge, including attention, awareness, tolerance for processing ongoing experiences, reflection on current experiences with connections to past experiences, awakening blocked past experiences, and attributing meaning to them from a new perspective. This process involves creating a coherent life narrative and formulating intentions and motivations in line with individual needs and values. Integrative self-knowledge is bifurcated into experiential and reflective self-knowledge (Ghorbani et al., 2008). “Experiential self-knowledge” involves processing current experiences as they occur. In contrast, “reflective self-knowledge” engages in active information processing about oneself in past experiences, analyzing one’s own experiences through higher cognitive functions to provide a broader perspective for guiding behavior (Ghorbani, 2018a, p.158). These two components are considered as present- and past-oriented self-experience (Ghorbani et al., 2008). As these past and present experiences become integrated, the individual can form a coherent narrative of their life and envision a desired and stable future for themselves. This leads to a cohesive sense of self and, consequently, the experience of mental well-being (Ghorbani, 2018a).

The evidence substantiates the connection between research variables, indicating that individuals who have undergone various childhood traumas tend to avoid intimate relationships in adulthood. This relationship is underscored by studies demonstrating that childhood trauma correlates with an adult’s fear of intimacy, leading to adverse psychological consequences such as loneliness, depression, anxiety, and negative self-evaluation (Riggs, 2014; Ji et al., 2015; Rohner et al., 2019; Senese et al., 2020). Furthermore, individuals with fear of intimacy often exhibit low self-esteem, emotional isolation, and dissatisfaction in their communication with significant others (Descutner and Thelen, 1991; Doi and Thelen, 1993).

In addition, based on research literature, one of the most pivotal mental processes associated with trauma is mentalization (Fonagy et al., 2007; cited by Ensink et al., 2017). Challenges in mentalizing have been identified as a key process through which trauma experiences can be linked to an elevated risk of developing psychopathology (Taubner and Curth, 2013; Wais, 2022). Conversely, psychological trauma impedes attachment relationships and constrains the capacity for mentalization Fonagy et al. (2018); cited in Wais (2022). Besides, numerous studies highlight the mediating role of mentalization in mitigating the detrimental impacts of childhood trauma. Mentalization is considered a critical component that, over time, can effectively contribute to self-reconstruction and enhanced emotional capacity in individuals who have experienced early adversities (Macintosh, 2013; Taubner and Curth, 2013; Ensink et al., 2017; Wais, 2022). Despite the disruption of healthy relationship patterns established during childhood, the acquired mentalizing ability can play a pivotal role in facilitating therapeutic interventions and enhancing emotional capacity, subsequently reducing the fear of intimacy (Lorenzini et al., 2018). Research indicates that fear of intimacy correlates with impaired interpersonal connections and diminished relationship satisfaction (Descutner and Thelen, 1991; Janong, 2001). Consequently, enhancing mentalizing capacity can potentially alleviate the fear of intimacy by fostering better interpersonal functioning. Additionally, Fonagy et al. (2018) underscore the interconnectedness of emotion regulation and attachment with mentalizing capacity. Given that individuals grappling with fear of intimacy often struggle with emotion regulation (Janong, 2001), it follows that enhancing mentalizing capacity could play a pivotal role in mitigating fear of intimacy through improved emotion regulation skills (Figure 1).

Moreover, our childhood experiences and their impact on our development play a crucial role in shaping our self-image throughout our lives. Indeed, these early encounters serve as a fertile ground for cultivating self-awareness (St Clair, 2004). Viewed from this vantage point, our sense of identity and coherence evolves primarily through our interactions with primary caregivers (Ahrens et al., 2012). When a child’s self-perception is shattered by traumatic experiences during childhood, they often internalize feelings of worthlessness, low self-esteem, unlovability, and inadequacy (Zhong, 2023). This barrage of negative emotions, directed toward both themselves and their parents, leads to a disruption of their sense of coherence (Kohut, 2013). Consequently, a diminished capacity for self-awareness over time is likely to foster fear of intimacy, leading individuals to resort to harmful psychological defense mechanisms. Conversely, research indicates that heightened self-insight within interpersonal dynamics corresponds to a diminished fear of intimacy, particularly in individuals who have experienced childhood trauma (Davis et al., 2001). On the other hand, previous research has shown that fear of intimacy has significantly adverse effects on mental health, such as increased anxiety, depression, and reduced self-esteem (Descutner and Thelen, 1991). In contrast, integrative self-knowledge has been recognized as highly efficacious in enhancing overall mental well-being and effectively reducing anxiety and depression in various studies (Bijari et al., 2016; Ghorbani, 2018a). Therefore, enhanced Integrative self-knowledge capacity can contribute to alleviating the symptoms associated with fear of intimacy. Throughout life, the most intimate relationship is with oneself; however, individuals may, at times, experience alienation from themselves, resorting to mechanisms that work against their own well-being (Ghorbani, 2018b). Therefore, the fear of intimacy is not solely apprehension about establishing close connections with others; it also arises from existential fears (Firestone and Firestone, 2004). Despite these implications, there remains a notable research gap regarding integrative self-knowledge, its influence on fear of intimacy, and its role as a mediator in the context of childhood trauma (Figure 2).

The mediating variables in this study, mentalization, and integrative self-knowledge are also closely interconnected. Mentalization intersects with self-reflective capacity, mindfulness, and integrity (Luyten and Fonagy, 2015), forming the fundamental pillars of the integrative self-knowledge process. Furthermore, mentalization serves as the cornerstone for individual identity and self-awareness, nurturing a sense of agency, coherence, and continuity (Allen et al., 2003). This aligns precisely with the dual aspects of integrative self-knowledge, which involve an ongoing awareness of internal processes, assimilation of past experiences, and attribution of new perspectives to current experiences. This process fosters a sense of autonomy and agency within individuals (Ghorbani, 2018a). Indeed, the concepts of mentalization and integrative self-knowledge share significant commonalities, as both are essential for the development of a coherent sense of self.

The fear of intimacy is known to have numerous detrimental effects on the mental health of adults. However, research in this particular domain remains limited. Importantly, the roots of the fear of intimacy can be traced back to early traumatic experiences (Repic, 2007), with individuals affected by it often exhibiting resistance to change. Despite the implementation of experiential treatments, studies suggest minimal effectiveness in addressing this issue (Manbeck et al., 2020; Nabizadeh et al., 2020). Those grappling with fear of intimacy tend to rely on various immature defense mechanisms to alleviate the strain of their overwhelming experiences, which have become syntonic to their core self. As a result, the change process for these individuals unfolds gradually, necessitating an in-depth investigation considering many factors. Notably, a significant research gap exists in the exploration of influential or protective factors that may act as mediators between traumatic childhood experiences and the subsequent fear of intimacy.

This study delves into the intricate relationships between childhood trauma, fear of intimacy, mentalization, and integrative self-knowledge. While existing literature underscores the detrimental impact of childhood trauma on adult relationships and mental health, a notable research gap persists in understanding the mediating mechanisms, particularly the roles of mentalization and integrative self-knowledge. By exploring these dynamics, this research aims to shed light on the nuanced pathways linking early traumatic experiences to adult fear of intimacy, paving the way for a deeper comprehension of the underlying processes and potential interventions to address this complex issue. Therefore, the primary objective of this research is to formulate a model elucidating the mediating roles of mentalization and integrative self-knowledge in the relationship between childhood trauma and the fear of intimacy.

The results of the path analysis revealed that mentalization serves as a complete mediator in the link between childhood trauma and the fear of intimacy (β = 0.14, p < 0.01). This finding aligns with prior studies emphasizing the crucial role of mentalization as a partial or complete mediator, including works by Wais (2022), Ensink et al. (2017), Taubner and Curth (2013), as well as Macintosh (2013). Specifically, Taubner and Curth (2013) demonstrated that mentalization serves as a complete mediator between early abuse experiences and aggressive behavior. Their conclusion highlighted mentalization as a protective factor, reinforcing the link between early abuse experiences and aggressive behavior. Additionally, research exploring mentalization as a protective and resilient factor in the context of psychological trauma in various populations, including children (Ensink et al., 2017; Borelli et al., 2018), adolescents (Venta et al., 2017), and adults (Berthelot et al., 2015; Ensink et al., 2015, 2023), supports these findings (Wais, 2022). Overall, mentalization is regarded as a crucial protective factor against diverse physical and psychological conditions in the context of trauma.

To elaborate on this finding, we can assert that one of the most pivotal mental processes associated with trauma is mentalization Fonagy et al. (2007); cited by Ensink et al. (2017). Challenges in mentalizing have been identified as a key process through which trauma experiences can be linked to an elevated risk of developing psychopathology (Taubner and Curth, 2013; Wais, 2022). Conversely, psychological trauma impedes attachment relationships and constrains the capacity for mentalization Ensink et al. (2017); cited in Wais (2022).

Mentalization comes into play when a maternal figure senses an emotion in the child and reflects it back to them. Fundamentally, the infant acquires an understanding of their emotional state through interactions with the mother. The caregiver’s presence, usually the mother, is crucial for the child’s mental growth. Fonagy et al. (2018) details how parents mirror a broad spectrum of emotions, ranging from tender affection to anger (Fonagy et al., 2018). In this context, if the emotions experienced during childhood are met with punishment and other negative reactions rather than being acknowledged, mirrored, and understood by the parents, the child may perceive closeness as perilous. Consequently, in adulthood, when attempting to establish intimacy, they may encounter anxiety and communication difficulties, reigniting past traumas (Abbass, 2015).

From a clinical perspective, it becomes crucial to identify the processes involved in post-traumatic recovery. Intense and overwhelming emotions, exceeding one’s capacity may coincide with physical harm (Frederickson, 2021). Furthermore, it is often necessary to grieve a former self without experiencing trauma. This involves accessing current experiences through the lens of past evolutionary processes, which require understanding and verbalizing emotions and mental states within a non-judgmental, secure, open, and accepting therapeutic relationship. This process is what fosters hope for future intimacy in traumatized patients (Wise, 2016).

Moreover, we hypothesized that integrative self-knowledge, as a mediating variable, can elucidate the relationship between childhood trauma and fear of intimacy. However, the path analysis results led to the rejection of this hypothesis (β = 0.00, p = 0.9), indicating that integrative self-knowledge, in a mediating role, cannot account for the connection between childhood trauma and fear of intimacy.

The scarcity of research on the mediating role of integrative self-knowledge in the context of childhood trauma and fear of intimacy is notable. Few studies have explored this aspect, making it challenging to assess compatibility with existing research. This study is one of the first to address this gap and represents a pioneering attempt to investigate this aspect. Nevertheless, this study may resonate with the conclusions drawn by Goodarzi et al. (2018), who suggested that integrative self-knowledge may not play a significant mediating role in the link between childhood trauma and borderline personality traits. Consequently, one could posit that integrative self-knowledge lacks robust mediation in its association with childhood trauma experiences.

The current study reveals that introducing the mentalization variable into the model neutralizes the mediating effect of self-knowledge in favor of mentalization. This indicates that mentalization incorporates aspects of self-knowledge and overlaps with self-reflective capacity, mindfulness, and identity integration (Luyten and Fonagy, 2015). These three components form the essential foundations of the integrative self-knowledge process (Ghorbani, 2018a). Mentalization refers to the understanding of one’s own and others’ experiences and behaviors through mental processes such as assumptions, attitudes, emotions, desires, knowledge, intentions, plans, dreams, hopes, and even false beliefs (Bateman and Fonagy, 2019). It serves as the cornerstone of individual identity and self-awareness, fostering a sense of agency, integrity, and continuity. Mentalization empowers individuals to recognize their behaviors and assume accountability for their decisions and actions (Allen et al., 2003), which is intertwined with integrative self-knowledge. Hence, mentalization lays the groundwork for subsequent self-knowledge. In fact, self-knowledge is better understood as the awareness of internal states rather than external ones. It empowers individuals to perceive differentiation, continuity, integrity, and interconnectedness within themselves (Ghorbani, 2018a).

In essence, mentalization emerges as a multifaceted construct, bridging both the internal and external dimensions, involving not only self-awareness but also the understanding of others (Bateman et al., 2023). Research indicates that childhood trauma also exerts a multifaceted influence on individuals, impacting both their internal and external worlds as well as their interpersonal relationships (Ensink et al., 2017). This suggests that childhood trauma may be more strongly associated with symptoms of fear of intimacy through its negative impact on children’s mentalization. As well, previous studies have underscored the significance of mentalization in the context of trauma (Taubner and Curth, 2013; Ensink et al., 2017; Wais, 2022), yet there remains a gap in research concerning the role of integrative self-knowledge in trauma contexts and its implications for interpersonal relationships and intimacy. The current finding underscores the paramount importance of the mentalization component, emphasizing the critical need for attention to this structure in both clinical and research settings. Future researchers should explore the mediating role of integrative self-knowledge in different models and within the trauma context to address the existing research gap.

Furthermore, our study’s findings demonstrated the non-significance of the direct effect of childhood trauma on fear of intimacy. This implies that, according to our research, childhood trauma is only indirectly associated with fear of intimacy through mentalization. This finding is consistent with various studies indicating an indirect rather than a direct relationship between childhood trauma or related factors, such as recalled childhood parental rejection and childhood maltreatment and fear of intimacy or intimacy perception (Williamson, 2009; Ji et al., 2015; Senese et al., 2020). It is also in line with research emphasizing the pivotal role of mentalization as a mediating factor in mitigating or eliminating the adverse effects of childhood challenges (Macintosh, 2013; Taubner and Curth, 2013; Ensink et al., 2017).

For instance, Senese et al. (2020) found that adults’ memories of parental acceptance and rejection in childhood are only indirectly linked to fear of intimacy in adulthood through psychological maladjustment after accounting for gender and age. Similarly, Ji et al. (2015) demonstrated in their study that childhood trauma and fear of intimacy are interconnected solely through feelings of inferiority, and the direct relationship between these two variables is insignificant. Taubner and Curth (2013) also concluded that mentalization serves as a complete mediator between childhood trauma and interpersonal problems in adulthood, establishing the link between childhood trauma and later aggressive behavior only indirectly.

The deepest sense of intimacy is often encountered within a mother’s embrace. However, when this sanctuary turns into a source of pain and threat, the initial emotional wound becomes a major impediment to adult intimacy (Abbass, 2015). Unconsciously, individuals tend to reenact their childhood traumas, setting the stage for mutual disappointment. Defense mechanisms developed during these early experiences later contribute to a pervasive fear of intimacy across various contexts (Repic, 2007). For many, adverse childhood experiences and subsequent failed adult relationships reinforce the belief that intimacy is either illusory, unreal or inevitably laden with pain and disappointment (Vangelisti and Beck, 2007). Childhood traumatic and stressful experiences cast a long shadow on human life, resulting in increased anxiety, impaired emotional regulation, depression, substance abuse, compulsive reliving of traumatic scenarios, and feelings of shame and guilt (Davis et al., 2001; Repic, 2007; Williamson, 2009; Miller-Perrin and Perrin, 2013; Abdul et al., 2018; Van Meter et al., 2020).

Conversely, evidence suggests that the activation of the attachment system correlates with the deactivation of mentalization. Neuroimaging studies (Nolte et al., 2013) indicate that brain regions linked to romantic and maternal attachment suppress activity in areas associated with cognitive control, including those related to mentalization and social judgments (Vrtička and Vuilleumier, 2012). Anything triggering the attachment system, along with stress-induced arousal, tends to diminish mentalizing performance. Attachment trauma can lead to chronic activation of this system. Hyperactivity of the attachment system in those who have experienced trauma may elucidate the diminished ability to mentalize in emotional situations (Luyten and Fonagy, 2015). Attachment trauma induces hyperactivity of the attachment system as the individual the child seeks in moments of anxiety (attachment figure) is the same person who initially caused fear (Fonagy et al., 2007). Failures in mentalizing during crucial moments hinder effective communication in attachment relationships (Luyten and Fonagy, 2015). Thus, experiencing attachment trauma in childhood, which compromises mentalization ability, perpetuates a persistent fear in emotional and intimate relationships. This process distinctly illustrates the sequence of relationship deterioration and the emergence of fear of intimacy due to childhood trauma and the breakdown of mentalizing ability. It underscores the pivotal role of mentalization as a complete mediator in this intricate dynamic.

Unexpectedly, our study revealed that integrative self-knowledge lost its significance in predicting fear of intimacy when mentalization was included in the model (β = −0.02, p > 0.05), despite initially showing a weak but notable correlation (r = −0.29, p < 0.01). This suggests that childhood trauma may impact fear of intimacy more through impaired mentalization than reduced self-knowledge. Previous research has consistently highlighted mentalization’s pivotal role in the context of trauma, while the role of self-knowledge in trauma and intimacy remains understudied.

Nevertheless, the initial negative correlation between self-knowledge and fear of intimacy, although lacking directly comparable studies, aligns with research on self-knowledge’s role in fulfilling basic psychological needs and enhancing life satisfaction (Ghorbani et al., 2010; Behjati et al., 2011; Ghorbani, 2018a; Hajifathali et al., 2021). As intimacy is a fundamental need (Baumeister and Leary, 1995), self-knowledge likely influences the ability to meet this need. Moreover, fear of intimacy is linked to adverse mental health effects like anxiety and depression (Descutner and Thelen, 1991), which self-knowledge has been shown to alleviate (Ghorbani et al., 2010; Behjati et al., 2011; Hajifathali et al., 2021). Moreover, evidence suggests that fear of intimacy is linked to adverse effects on mental health, including anxiety, depression, and low self-esteem (Descutner and Thelen, 1991). Conversely, multiple studies have affirmed the role of integrative self-knowledge in promoting mental health and alleviating anxiety and depression (Ghorbani et al., 2010; Behjati et al., 2011; Hajifathali et al., 2021). Therefore, integrative self-knowledge could be deemed effective in mitigating the symptoms associated with fear of intimacy.

Furthermore, object relations theory highlights how self-knowledge is constructed through interactions (Mitchell, 1991; Klein, 2010). The self is viewed as multiple and discontinuous (Mitchell, 1991). Our self-perception becomes discontinuous as our personality and identity form through engagements with diverse individuals, manifesting in different self-experiences with each person (Klein, 2010). Self-knowledge is derived from these interactions, leading to a stable identity core yet yielding diverse self-organizations centered around representations of both self and others.

Mitchell (1991) argues that our self-views are rooted in past relationships, as our connection with others shapes who we are. Viewing the self as existing across time, rather than a fixed point in space, implies it has multiple functions. Authenticity, expressed through spontaneously revealing genuine thoughts and emotions aligned with our interpersonal and internal emotional context (St Clair, 2004), underscores how past experiences of intimacy influence how we understand ourselves.

Reciprocity is key, as attributing distorted meaning to relationships, particularly with attachment figures, can disrupt self-perception and interpersonal relating. The more incoherent and fragmented one’s identity, the greater the relational confusion. Intimacy may then trigger memories of past painful relational experiences and an insecure, worthless self-view, prompting self-protective avoidance of closeness (Kohut, 2013; Frederickson, 2013; Abbass, 2015; McWilliams, 2020). Our self-understanding is interwoven with others, justifying why the multidimensional mentalization construct encompassing self-and other-oriented facets (Fonagy et al., 2018) more closely relates to intimacy components in attachment contexts than self-knowledge alone.

The findings of the present study demonstrate that mentalization fully mediates the relationship between childhood trauma and fear of intimacy. This implies that the direct effect of childhood trauma on fear of intimacy is neutralized when mentalization is introduced as a variable. Additionally, integrative self-knowledge failed to mediate the relationship between childhood trauma and fear of intimacy. Furthermore, the study revealed that once mentalization and integrative self-knowledge were included in the model, the direct effect of integrative self-knowledge on fear of intimacy became insignificant. The results also indicated a direct and significant relationship between mentalization and fear of intimacy. Ultimately, based on the current findings indicating the complete mediation of mentalization and the insignificance of the mediation of integrative self-knowledge, we can deduce that enhancing the capacity for mentalization is a crucial step in resolving emotionally resistant problems within psychodynamic psychotherapy sessions. This involves creating conditions in the psychotherapy room that allow for the processing, understanding, and experiencing emotions in a safe and receptive environment. The therapist’s ongoing reflection of the patient’s thoughts and emotions from moment to moment becomes a pivotal element in this process, potentially addressing emotional challenges that prove resistant to conventional therapy.

This study is subject to various limitations, which we would like to discuss in the following section. First, this study is limited by self-reported measures, which may result in common method variance. Second, the study included 303 participants. A larger sample size could contribute to greater generalizability. Third, regarding sample collection, it is essential to note that our results possess limited generalizability as we exclusively utilized samples from the normal Iranian population. Fourth, another aspect to consider regarding sample collection is the sampling method employed in the present study. The non-randomized, convenience sampling method utilized poses a challenge in generalizing the results. Fifth, the sample in the present study had an unequal number of men and women. Therefore, generalizing the effect of gender differences and predicting the contribution of gender differences to adult fear of intimacy may be problematic. Last but not least, the cross-sectional survey design of this study limits the ability to establish cause-and-effect relationships. Nevertheless, it is crucial to recognize that the choice of research design, whether cross-sectional or longitudinal, is influenced by the research objectives, questions, and available resources. For this study, a cross-sectional design was adopted due to constraints in resources and time. Although a cross-sectional approach does not allow for the assessment of causal relationships or changes in variables over time, it effectively identifies correlational relationships between variables. This preliminary insight is valuable for informing the design of future longitudinal studies.

The strengths of the study may include the following: One of the strengths of this study is its novelty. It is the first to examine the mediating roles of mentalizing and integrative self-knowledge—two important dynamic concepts—in the relationship between childhood trauma and fear of intimacy. Previous studies have not addressed the influence of these two variables on fear of intimacy. Another strength lies in the use of the Mentalization Scale (MentS) developed by Dimitrijević et al. (2017). Most previous research has relied on the Reflective Functioning Scale (RFS) to assess mentalizing capacity. However, the lack of a direct and unique assessment tool for this construct posed challenges for researchers (Choi-Kain and Gunderson, 2008). The MentS not only includes more comprehensive items to assess mentalizing but also provides a more precise, cost-effective, and time-efficient tool for researchers. Finally, the findings from this study can serve as a foundation for developing educational and therapeutic programs aimed at improving intimate relationships. Additionally, these findings can contribute to the expansion of psychodynamic and experiential therapies, encouraging therapists and clinicians to incorporate more effective interventions, such as mentalization-based interventions.

Notwithstanding the limitations of the current study, the results have several important research and practice implications. First, there is an urgent need for longitudinal research with large samples from diverse adult subpopulations to delineate the long-term consequences of childhood maltreatment and identify adults at risk of fear of intimacy and relational isolation. Such studies would not only inform practice but also provide essential evidence to support interventions aimed at reducing fear of intimacy in these subpopulations. Second, it is imperative to employ dynamic and experiential tools to accurately measure complex concepts like mentalizing. For instance, creating a clinical setting for qualitative interviews and experimentally assessing the symptoms of fear of intimacy is essential. Self-report tools alone often fall short of facilitating a thorough examination of such intricate concepts. To address this limitation comprehensively, future research should incorporate additional assessment methods. Qualitative approaches, such as third-party observation and focus group interviews, can enhance the generalizability and validity of the study’s conclusions. Finally, given the significant impact of mentalizing as a psychodynamic concept on reducing fear of intimacy, we recommend incorporating interventions aimed at strengthening mentalizing capacity into psychodynamic psychotherapy. These interventions could play a crucial role in mitigating fear of intimacy and improving relational outcomes.

The datasets presented in this article are not readily available because The data is confidential. Requests to access the datasets should be directed to manoucheri1978@gmail.com.

The studies involving humans were approved by the Department of Clinical Psychology, Azad University of Medical Sciences, Faculty of Medicine, Tehran, Iran. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

SR: Conceptualization, Investigation, Methodology, Project administration, Resources, Writing – original draft, Writing – review & editing. MM: Conceptualization, Investigation, Methodology, Project administration, Supervision, Writing – review & editing.