Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosis
Current approaches to the treatment of non-affective psychosis include elements of mentalization-based treatment and the potential in enhancing mentalizing capacity in this patient group has been widely emphasized. This article presents the “psychotic identity dilemma”, a concept by Stavros Mentzos,...
| Published in: | Frontiers in Psychiatry |
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| Main Authors: | , , , |
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-07-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1229113/full |
| _version_ | 1851838188128043008 |
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| author | Anna-Lena Bröcker Dorothea von Haebler Dorothea von Haebler Günter Lempa Christiane Montag |
| author_facet | Anna-Lena Bröcker Dorothea von Haebler Dorothea von Haebler Günter Lempa Christiane Montag |
| author_sort | Anna-Lena Bröcker |
| collection | DOAJ |
| container_title | Frontiers in Psychiatry |
| description | Current approaches to the treatment of non-affective psychosis include elements of mentalization-based treatment and the potential in enhancing mentalizing capacity in this patient group has been widely emphasized. This article presents the “psychotic identity dilemma”, a concept by Stavros Mentzos, and a therapeutic approach considering this concept as a valuable complementary addition to these treatments. The idea of a dilemma between closeness and distance, which in itself cannot be represented mentally at first, helps to respond to specific needs of patients with psychotic disorders by placing the treatment focus on fundamental interpersonal processes. Following this train of thought, this article attempts to shed light on the importance of the “real relationship” between therapist and patient as well as the exploration of the “here and now”, especially at the beginning of psychotherapeutic treatment. Two treatment modes are suggested, one characterized by the experience of interpersonality within the therapeutic relationship and a second one characterized by the reflection of interpersonal phenomena. These modes are framed by Stavros Mentzos’ concept of an identity dilemma. We describe how mentalizing first needs to be addressed implicitly in a tolerable, exemplary relationship in which closeness and distance are regulated based on the therapist’s countertransference, then explicitly. A series of interventions are described, which allow for moments of shared attention, promote intentionality and contingency and, later in the course of therapy, help to integrate experiences into narratives. |
| format | Article |
| id | doaj-art-decf31c7a68b4b67b4ce0853c3028fa1 |
| institution | Directory of Open Access Journals |
| issn | 1664-0640 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| spelling | doaj-art-decf31c7a68b4b67b4ce0853c3028fa12025-08-19T22:29:32ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-07-011410.3389/fpsyt.2023.12291131229113Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosisAnna-Lena Bröcker0Dorothea von Haebler1Dorothea von Haebler2Günter Lempa3Christiane Montag4Department of Psychiatry and Neurosciences, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, GermanyDepartment of Psychiatry and Neurosciences, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, GermanyInternational Psychoanalytic University Berlin, Berlin, GermanyPsychotherapy Practice, Munich, GermanyDepartment of Psychiatry and Neurosciences, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, GermanyCurrent approaches to the treatment of non-affective psychosis include elements of mentalization-based treatment and the potential in enhancing mentalizing capacity in this patient group has been widely emphasized. This article presents the “psychotic identity dilemma”, a concept by Stavros Mentzos, and a therapeutic approach considering this concept as a valuable complementary addition to these treatments. The idea of a dilemma between closeness and distance, which in itself cannot be represented mentally at first, helps to respond to specific needs of patients with psychotic disorders by placing the treatment focus on fundamental interpersonal processes. Following this train of thought, this article attempts to shed light on the importance of the “real relationship” between therapist and patient as well as the exploration of the “here and now”, especially at the beginning of psychotherapeutic treatment. Two treatment modes are suggested, one characterized by the experience of interpersonality within the therapeutic relationship and a second one characterized by the reflection of interpersonal phenomena. These modes are framed by Stavros Mentzos’ concept of an identity dilemma. We describe how mentalizing first needs to be addressed implicitly in a tolerable, exemplary relationship in which closeness and distance are regulated based on the therapist’s countertransference, then explicitly. A series of interventions are described, which allow for moments of shared attention, promote intentionality and contingency and, later in the course of therapy, help to integrate experiences into narratives.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1229113/fullmentalizingmetacognitionpsychosisschizophreniadilemmaimplicit |
| spellingShingle | Anna-Lena Bröcker Dorothea von Haebler Dorothea von Haebler Günter Lempa Christiane Montag Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosis mentalizing metacognition psychosis schizophrenia dilemma implicit |
| title | Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosis |
| title_full | Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosis |
| title_fullStr | Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosis |
| title_full_unstemmed | Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosis |
| title_short | Mentalizing in the context of Mentzos’ dilemma–on the use of implicit work in the treatment of non-affective psychosis |
| title_sort | mentalizing in the context of mentzos dilemma on the use of implicit work in the treatment of non affective psychosis |
| topic | mentalizing metacognition psychosis schizophrenia dilemma implicit |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1229113/full |
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