Internal Working Model — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePsychotherapyInternal Working ModelMRCPsych Paper B

A psychotherapist using Bowlby's attachment framework formulates that a patient's early experiences of inconsistent caregiving led them to expect that other people will be unavailable and that they are unworthy of care. Which concept best describes these enduring representations of the self and others?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Internal working model

Explanation lettering: D = shown as A · C = shown as B · B = shown as C · A = shown as D

B is correct. In Bowlby's attachment theory, an internal working model comprises cognitive-affective representations of the self, attachment figures and relationships, developed through early caregiving experiences. These models shape expectations such as whether others will be available and trustworthy and whether the self is worthy of care. A secure base is the caregiver function that permits exploration while providing safety. The attachment behavioural system organises proximity-seeking when threat or distress occurs. Mentalisation is the capacity to understand behaviour in terms of mental states. Transference involves experiencing a current therapeutic relationship through patterns derived from earlier relationships; it may express an internal working model but is not Bowlby's term for the underlying representations.

Reference: Royal College of Psychiatrists and Health Education England, Delivering inpatient children and young people's mental health care: a multidisciplinary competence framework, section 2.3, 2021. https://www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/delivering-inpatient-children-and-young-people-s-mental-health-care-a-multidisciplinary-competence-framework/delivering-inpatient-children-and-young-people-s-mental-health-care-competence-framework-full-list-of-competences.pdf?sfvrsn=1f03c596_2