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+ | '''Psychological mindedness''' (PM) is a concept which refers to an individual's capacity for self-examination, [[self-observation]], [[introspection]] and personal insight.{{Fact|date=March 2008}} It also includes an ability to recognize and see the links between current problems within [[self (psychology)|self]] and with others, and the ability to insight one's past particularly for its impact on present [[attitude (psychology)|attitude]]s and functioning. Psychologically minded people have average and above-average [[intelligence]] and generally have some insight into their problems even before they enter [[psychotherapy|therapy]]. Psychological mindedness is distinct from [[intellectualization]]s and obsessional [[rumination]] about one's inner problems. The latter is of no help in psychotherapy, rather it is a sign of [[resistance (psychology)|resistance]]. |
| − | Psychological mindedness bespeaks a capacity to tolerate psychological conflict and stress intrapsychically rather than by regressive means of conflict management or resolution such as somatization. Its role, like that of alexithymia, in the genesis of psychosomatic illness is becoming evident.<ref>{{cite journal |author=Shill MA, Lumley MA |title=The Psychological Mindedness Scale: factor structure, convergent validity and gender in a non-psychiatric sample |journal=Psychology and psychotherapy |volume=75 |issue=Pt 2 |pages=131–50 |year=2002 |pmid=12396760 }}</ref> |
+ | Psychological mindedness bespeaks a capacity to tolerate psychological conflict and [[Stress (medicine)|stress]] intrapsychically rather than by [[Regression (psychology)|regressive]] means of [[conflict management]] or [[conflict resolution|resolution]] such as [[somatization]]. Its role, like that of [[alexithymia]], in the genesis of [[psychosomatic illness]] is becoming evident.<ref>{{cite journal |author=Shill MA, Lumley MA |title=The Psychological Mindedness Scale: factor structure, convergent validity and gender in a non-psychiatric sample |journal=Psychology and psychotherapy |volume=75 |issue=Pt 2 |pages=131–50 |year=2002 |pmid=12396760 |doi=10.1348/147608302169607 }}</ref> |
| − | + | [[Concept]]ual definitions of PM have included variant, but related descriptions. Some definitions relate solely to the self, “a person’s ability to see relationships among [[thought]]s, [[emotion|feeling]]s, and actions with the goal of learning the meanings and causes of his [[experience]]s and [[behavior]]s”.<ref>{{cite journal |author=Appelbaum SA |title=Psychological-mindedness: word, concept and essence |journal=The International journal of psycho-analysis |volume=54 |issue=1 |pages=35–46 |year=1973 |pmid=4724251}}</ref> Conte (1996) extended the concept beyond self-focus, as involving “... both self-understanding and an interest in the motivation and behavior of others”.<ref>Conte HR, Ratto R, Karusa TB (1996). [http://jppr.psychiatryonline.org/cgi/content/abstract/5/3/250 The Psychological Mindedness Scale: Factor structure and relationship to outcome of psychotherapy]. ''Journal of Psychotherapy Practice and Research'', '''5'''(3), 250–259.</ref> Finally, Hall’s (1992) definition introduces the multidimensional nature of PM. She defined it as “reflectivity about psychological processes, relationships and meanings [that] is displayed by ... both interest in and ability for such reflectivity across affective and intellectual dimensions”<ref>{{cite journal |author=Hall JA |title=Psychological-mindedness: a conceptual model |journal=American journal of psychotherapy |volume=46 |issue=1 |pages=131–40 |year=1992 |pmid=1543250 |doi=}}</ref> |
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| − | == |
+ | == PDM description == |
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| − | According to Mary Beth Boylan<ref> Boylan, M. B. Psychological Mindedness as a predictor of treatment outcome with depressed adolescents, online: [http://etd.library.pitt.edu/ETD/available/etd-04062006-102837/unrestricted/MMBoylanETD.pdf]</ref> the ''absence'' of psychological mindedness may be subsumed under the construct of [[alexithymia]]. The construct encompasses a cluster of cognitive and affective characteristics that are virtually the obverse of several central features of PM. The alexithymia construct emerged from clinical observations over several decades that certain patients respond poorly to psychoanalysis and other insight-oriented psychotherapies because of a limited ability to describe and differentiate affects.<ref name="TaylorTaylor">Taylor GJ, & Taylor HS (1997). Alexithymia. In M. McCallum & W.E. Piper |
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| + | The [[Psychodynamic Diagnostic Manual]] (PDM) describes psychological mindedness as an individual's ability to observe his or her own internal life. The PDM details a four point sliding scale between high to low psychological mindedness, or 'healthy-to-impaired functioning'. |
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| − | (Eds.), ''Psychological mindedness: A contemporary understanding.'' pp. 77–104. |
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| − | Munich: Lawrence Erlbaum Associates</ref> As noted by Taylor and Taylor,<ref name="TaylorTaylor"/> Horney (1952) described these patients as lacking emotional awareness, having a paucity of inner experiences, minimal interest in dreams, concreteness of thinking, and externalized style of living. Alexithymia is a narrower construct in that it is predominantly focused on the emotional domain; whereas, PM encompasses all three (cognitive, emotional, and behavioral) dimensions of human experience. Taylor and Taylor note: the prospects for successful psychotherapy are greatly reduced for individuals who score high on measures of alexithymia, as such individuals are factually oriented, unanalytical in their thinking and are unable to elaborate on inner feelings and fantasies.<ref name="TaylorTaylor"/> |
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| + | # Can reflect on (i.e. observe and experience at the same time) a full range of own and others' feelings or experiences (including subtle variations in feelings). Can reflect both in the present and with reference to a longer-term view of self, values, and goals. Can reflect on multiple relationships between feelings and experiences, across the full range of age-expected experiences in the context of new challenges. |
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| + | # Can reflect on feelings or experiences of self and others both in the present and with reference to a longer-term view of a sense of self, values, and goals for ''some'' age-expected experiences, but not others. Cannot be reflective in this way when feelings are strong. |
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| + | # Can reflect on moment-to-moment experiences, but not with reference to a longer-term sense of self and experiences, values, and goals. |
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| + | # Unable to reflect genuinely on feelings or experiences, even in the present. Self-awareness consists often of polarized feeling states or simple basic feelings without an appreciation of subtle variations in feelings. Self-awareness is lacking, and there may be a tendency toward fragmentation. <ref>PDM Task Force. (2006). Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations. p.82</ref> |
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| + | == Personality correlates == |
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| + | Psychological mindedness (PM) is expected to be related to psychological strength and negatively related to weakness. One study found a [[correlation]] between PM and two of the [[Big Five personality traits]] ([[Extraversion and introversion|extraversion]] and [[openness to experience]]) and a negative correlation with [[neuroticism]].<ref name = Beitel2003>{{cite journal | last = Beitel | first = M | coauthors = Cecero JJ | year = 2003 | title = Predicting psychological mindedness from personality style and attachment security | journal = Journal of Clinical Psychology | doi = 10.1002/jclp.10125 | volume = 59 | issue = 1 | pages = 163–72 }}</ref> Other studies have linked it to the tolerance of ambiguity,<ref name = Beitel2004>{{cite journal | last = Beitel | first = M | coauthors = Cecero JJ & Ferrer E | year = 2004 | title = Psychological mindedness and cognitive style | journal = Journal of Clinical Psychology | doi = 10.1002/jclp.10258 | volume = 60 | issue = 6 | pages = 567–82 }}</ref> [[mindfulness]], [[empathy]]<ref name = Beitel2005>{{cite journal | last = Beitel | first = M | coauthors = Cecero JJ & Ferrer E | year = 2005 | title = Psychological mindedness and awareness of self and others | journal = Journal of Clinical Psychology | doi = 10.1002/jclp.20095 | volume = 61 | issue = 6 | pages = 739–50 }}</ref> and positive adjustment to college.<ref name = Beitel2008>{{cite journal | last = Beitel | first = M | coauthors = Cecero JJ & Prout T | year = 2008 | title = Exploring the relationships among early maladaptive schemas, psychological mindedness and self-reported college adjustment | journal = Psychology and psychotherapy | volume = 81 | issue = 1 | pages = 105–18 | url = http://www.biomedexperts.com/Abstract.bme/17588307/Exploring_the_relationships_among_early_maladaptive_schemas_psychological_mindedness_and_self-reported_college_adjustme | doi = 10.1348/147608307X216177 }}</ref> PM has also been associated negatively with problem-oriented psychological constructs such as the personality factor of [[neuroticism]],<ref name = Beitel2003/> the cognitive constructs of [[magical thinking]] and [[external locus of control]],<ref name = Beitel2004/> and early maladaptive [[schema]]s.<ref name = Beitel2008/> Low PM has also been linked to [[alexithymia]], suggesting that certain [[clinical psychology|clinical]] patients do not respond to counseling due to a lack of PM.<ref name=Taylor1997>{{cite book |author=Piper, WB; McCallum, M | chapterauthor = Taylor, GJ & Taylor, HL | chaptertitle = Alexithymia |title=Psychological mindedness: a contemporary understanding |publisher=[[Taylor and Francis|Lawrence Erlbaum Associates]] |location=Hillsdale, N.J |year=1997 |pages=[http://books.google.com/books?id=ZdxNQdpPhRIC&pg=PA77 77–104] |isbn=0-8058-1722-0 |oclc= |doi= |accessdate=}}</ref> |
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| + | == Psychological Mindedness in Groups, Environments and Society == |
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| + | In the UK a lot of work has been done to extend the concept of psychological mindedness beyond the individual. This work recognises that the health and success of families, schools, hospitals, businesses, communities and indeed society as a whole depends in a large part on the psychological mindedness of the system or environment created by that institution. This is more than the sum of the individual parts. For example, an individual nurse on a psychiatric ward may be psychologically minded and motivated to connect with a service user who may also have some psychological mindedness. However, the chances of two such individuals having a psychologically minded encounter can easily be sabotaged by a "psychologically blind" or "alexithymic" care system that allows the nurse no time, no headspace, no structure and no back up to function in this way. It is well known that nurses on chaotic psychiatric wards have to shut off emotionally just to survive personally in the face of the overwhelming demands placed upon them. Once this happens the experience for the service user will obviously become one of "not being listened to". This real emotional neglect coupled with transference factors is what leads to so many incidents on our psychiatric wards. Service users who feel rejected are bound to escalate their behaviour in order to be heard and in order to "hit back" at those who are in effect just repeating the failures of past caregivers. |
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| + | Martin Seager <ref>Seager, M. The Concept of "Psychologcal Safety" - A psychoanalytically informed contributon towards "safe, sound and supportive" mental health services, ''Psychoanalytic Psychotherapy'', Volume 20, Issue 4, December 2006, pp 266-280</ref> (2006) developed the concept of "psychological safety" to explain and address these kinds of problems in health care systems. Out of this work, Martin was invited by the then secretary of state for health, [[Patricia Hewitt]], to form in 2007 a "national advisory group" on the universal psychological principles and standards underpinning good mental health care. Martin was able to convene a group of distinguished thinkers from the full range of psychological approaches to produce a guiding document. Group members included [[Susie Orbach]], [[Andrew Samuels]], Lucy Johnstone and [[Valerie Sinason]]. The core recommendations of this group took account of all psychological theory and spiritual factors in the human condition. "Psychological mindedness" was the concept and the phrase that seemed to bind everything together. This work has led to the formation of a further national working group (2008) on the back of the [[Improving Access to Psychological Therapies]] (IAPT) initiative in the UK. This new working group is looking at "10 high impact changes" for mental health policy in the UK that will increase psychological mindedness. The group aims to stimulate a proactive public health psychological policy that will address the relational and environmental causes of mental health problems and shift the emphasis away from an exclusive focus on reactive psychological treatments. |
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==See also== |
==See also== |
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Psychological mindedness (PM) is a concept which refers to an individual's capacity for self-examination, self-observation, introspection and personal insight.[How to reference and link to summary or text] It also includes an ability to recognize and see the links between current problems within self and with others, and the ability to insight one's past particularly for its impact on present attitudes and functioning. Psychologically minded people have average and above-average intelligence and generally have some insight into their problems even before they enter therapy. Psychological mindedness is distinct from intellectualizations and obsessional rumination about one's inner problems. The latter is of no help in psychotherapy, rather it is a sign of resistance.
Psychological mindedness bespeaks a capacity to tolerate psychological conflict and stress intrapsychically rather than by regressive means of conflict management or resolution such as somatization. Its role, like that of alexithymia, in the genesis of psychosomatic illness is becoming evident.[1]
Conceptual definitions of PM have included variant, but related descriptions. Some definitions relate solely to the self, “a person’s ability to see relationships among thoughts, feelings, and actions with the goal of learning the meanings and causes of his experiences and behaviors”.[2] Conte (1996) extended the concept beyond self-focus, as involving “... both self-understanding and an interest in the motivation and behavior of others”.[3] Finally, Hall’s (1992) definition introduces the multidimensional nature of PM. She defined it as “reflectivity about psychological processes, relationships and meanings [that] is displayed by ... both interest in and ability for such reflectivity across affective and intellectual dimensions”[4]
PDM description
The Psychodynamic Diagnostic Manual (PDM) describes psychological mindedness as an individual's ability to observe his or her own internal life. The PDM details a four point sliding scale between high to low psychological mindedness, or 'healthy-to-impaired functioning'.
- Can reflect on (i.e. observe and experience at the same time) a full range of own and others' feelings or experiences (including subtle variations in feelings). Can reflect both in the present and with reference to a longer-term view of self, values, and goals. Can reflect on multiple relationships between feelings and experiences, across the full range of age-expected experiences in the context of new challenges.
- Can reflect on feelings or experiences of self and others both in the present and with reference to a longer-term view of a sense of self, values, and goals for some age-expected experiences, but not others. Cannot be reflective in this way when feelings are strong.
- Can reflect on moment-to-moment experiences, but not with reference to a longer-term sense of self and experiences, values, and goals.
- Unable to reflect genuinely on feelings or experiences, even in the present. Self-awareness consists often of polarized feeling states or simple basic feelings without an appreciation of subtle variations in feelings. Self-awareness is lacking, and there may be a tendency toward fragmentation. [5]
Personality correlates
Psychological mindedness (PM) is expected to be related to psychological strength and negatively related to weakness. One study found a correlation between PM and two of the Big Five personality traits (extraversion and openness to experience) and a negative correlation with neuroticism.[6] Other studies have linked it to the tolerance of ambiguity,[7] mindfulness, empathy[8] and positive adjustment to college.[9] PM has also been associated negatively with problem-oriented psychological constructs such as the personality factor of neuroticism,[6] the cognitive constructs of magical thinking and external locus of control,[7] and early maladaptive schemas.[9] Low PM has also been linked to alexithymia, suggesting that certain clinical patients do not respond to counseling due to a lack of PM.[10]
Psychological Mindedness in Groups, Environments and Society
In the UK a lot of work has been done to extend the concept of psychological mindedness beyond the individual. This work recognises that the health and success of families, schools, hospitals, businesses, communities and indeed society as a whole depends in a large part on the psychological mindedness of the system or environment created by that institution. This is more than the sum of the individual parts. For example, an individual nurse on a psychiatric ward may be psychologically minded and motivated to connect with a service user who may also have some psychological mindedness. However, the chances of two such individuals having a psychologically minded encounter can easily be sabotaged by a "psychologically blind" or "alexithymic" care system that allows the nurse no time, no headspace, no structure and no back up to function in this way. It is well known that nurses on chaotic psychiatric wards have to shut off emotionally just to survive personally in the face of the overwhelming demands placed upon them. Once this happens the experience for the service user will obviously become one of "not being listened to". This real emotional neglect coupled with transference factors is what leads to so many incidents on our psychiatric wards. Service users who feel rejected are bound to escalate their behaviour in order to be heard and in order to "hit back" at those who are in effect just repeating the failures of past caregivers.
Martin Seager [11] (2006) developed the concept of "psychological safety" to explain and address these kinds of problems in health care systems. Out of this work, Martin was invited by the then secretary of state for health, Patricia Hewitt, to form in 2007 a "national advisory group" on the universal psychological principles and standards underpinning good mental health care. Martin was able to convene a group of distinguished thinkers from the full range of psychological approaches to produce a guiding document. Group members included Susie Orbach, Andrew Samuels, Lucy Johnstone and Valerie Sinason. The core recommendations of this group took account of all psychological theory and spiritual factors in the human condition. "Psychological mindedness" was the concept and the phrase that seemed to bind everything together. This work has led to the formation of a further national working group (2008) on the back of the Improving Access to Psychological Therapies (IAPT) initiative in the UK. This new working group is looking at "10 high impact changes" for mental health policy in the UK that will increase psychological mindedness. The group aims to stimulate a proactive public health psychological policy that will address the relational and environmental causes of mental health problems and shift the emphasis away from an exclusive focus on reactive psychological treatments.
See also
References
- ↑ Shill MA, Lumley MA (2002). The Psychological Mindedness Scale: factor structure, convergent validity and gender in a non-psychiatric sample. Psychology and psychotherapy 75 (Pt 2): 131–50.
- ↑ Appelbaum SA (1973). Psychological-mindedness: word, concept and essence. The International journal of psycho-analysis 54 (1): 35–46.
- ↑ Conte HR, Ratto R, Karusa TB (1996). The Psychological Mindedness Scale: Factor structure and relationship to outcome of psychotherapy. Journal of Psychotherapy Practice and Research, 5(3), 250–259.
- ↑ Hall JA (1992). Psychological-mindedness: a conceptual model. American journal of psychotherapy 46 (1): 131–40.
- ↑ PDM Task Force. (2006). Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations. p.82
- ↑ 6.0 6.1 Beitel, M, Cecero JJ (2003). Predicting psychological mindedness from personality style and attachment security. Journal of Clinical Psychology 59 (1): 163–72.
- ↑ 7.0 7.1 Beitel, M, Cecero JJ & Ferrer E (2004). Psychological mindedness and cognitive style. Journal of Clinical Psychology 60 (6): 567–82.
- ↑ Beitel, M, Cecero JJ & Ferrer E (2005). Psychological mindedness and awareness of self and others. Journal of Clinical Psychology 61 (6): 739–50.
- ↑ 9.0 9.1 Beitel, M, Cecero JJ & Prout T (2008). Exploring the relationships among early maladaptive schemas, psychological mindedness and self-reported college adjustment. Psychology and psychotherapy 81 (1): 105–18.
- ↑ Piper, WB; McCallum, M (1997). Psychological mindedness: a contemporary understanding, 77–104, Hillsdale, N.J: Lawrence Erlbaum Associates.
- ↑ Seager, M. The Concept of "Psychologcal Safety" - A psychoanalytically informed contributon towards "safe, sound and supportive" mental health services, Psychoanalytic Psychotherapy, Volume 20, Issue 4, December 2006, pp 266-280
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