Psychological mindedness

Overview
Psychological Mindedness (PM) is a useful though not exactly defined umbrella concept which refers to an individual's capacity for self-examination, self-observation, introspection and ultimately insight. 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. It is necessary to distinguish psychological mindedness from intellectualizations and obsessional rumination about one's inner problems. The latter is of no help in psychotherapy, but 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.

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”. Conte (1996) extended the concept beyond self-focus, as involving “. . . both self-understanding and an interest in the motivation and behavior of others”. 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”

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'.

Illustrative descriptions of the range and adequacy of 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.

Low psychological mindedness
According to Mary Beth Boylan the absence of psychological mindedness may be subsumed under the construct of alexithymia. This 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. As noted by Taylor and Taylor, 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.