Psychological-Mindedness as a Defense

Abstract

Many patients seen today use sophisticated capacities for psychological reflection and premature synthesis to ward off knowledge of more primitive conflict and islands of unintegration. They show a precocious talent for free association, a talent they perversely misuse. Similarly, they enjoy access to a rich fantasy life, even as they subtly impoverish it. Effective therapeutic work requires that they suffer "traumatization"--experiences of dedifferentiation that undermine their considerable capacity to know what they feel and think. Structural and process variables interact with content variables in complex and ambiguous ways. As a consequence, estimates of the authenticity and "fit" of personal and interpersonal experiences and behaviors of both partners in the therapeutic encounter become necessarily involved. Such factors may increase the possibility of misunderstandings, but also of more authentic and firmly grounded understandings. Similar issues are eventually revealed in these patients' early lives, where psychological and other formulaic understandings were prematurely applied to offset overwhelmedness and other unarticulable experiences; the patient's talents for ambiguity, irony, self-soothing, or responsiveness to others were, in effect, exploited at the expense of full psychological growth. Versions of this clinical presentation may be increasingly common in a new generation of analyzable patients. Clinical work with them is facilitated by a synthesis of contemporary developmental, structural, and object relations theory.

Psychological mindedness and cognitive style

“…The TSCS total score and the PPI subscales did correlate in the predicted ways-assertiveness (r (38) ϭ 0.49, p Ͻ .001), sociability (r (38) ϭ 0.45, p Ͻ .01), and passivity (r (38) ϭ Ϫ0.59, p Ͻ .001)-a correlation that suggests a degree of construct validity. Fogel (1993) suggested that "psychologically-minded patients are masters of ambiguity . .…”

The Psychological Mindedness Scale: Factor structure, convergent validity and gender in a non‐psychiatric sample

“…Other measures of PM include the Psychological Mindedness Assessment Procedure (PMAP), which is a structured, scored interview procedure (McCallum & Piper, 1997b), and the Psychological Mindedness Scale (PMS), which is a rapid self-report measure (Conte & Ratto, 1997). Although the PMAP has shown promise as an empirical measure of PM, it does not assess self-awareness or insight (McCallum & Piper, 1997b), which is widely acknowledged to be an essential component of PM (Appelbaum, 1973;Fogel, 1995;Hatcher & Hatcher, 1997). The same limitation applies to the PY scale of the CPI (Gough, 1975), which also exhibits low validity and reliability (Conte & Ratto, 1997).…”

The analyst's theory: A third source of countertransference

“…Another instance of a theory's promoting a positive countertransference response to a resistance can be observed with patients who use psychologicalmindedness as a defense (Fogel, 1995). In this circumstance, it is easy for the analyst whose theory attaches value to this ability to feel positive about its display-that is, the analysis' 'going well'-and to be distracted from developing a more meaningful countertransference, one more appropriate to and informative about the patient's resistance.…”