The Theory of modes

The theory of modes presented as a way of accounting for several questions, such as: how does the person adapt to the shifting situations? How does an individual flip from being withdrawn and hallucinating to being engaged and productive? A specific mode reflects the entire personal experience at a given time including the cognitive, affective, and motivational components. According to the theory, modes constitute basic structures of personality that have specific characteristics, such as content, charge, and durability, respond to external or internal stimuli, and draw on the various resources of personality, such as the basic functions of attention, memory, flexibility, cognitive processing, etc.

The characteristics of the modes are as follows:

-Content: This may vary from psychotic to normal. The content is also relevant to the meaning of the mode, particularly in terms of the individual’s concept of the self, the social environment, and the future.

-Durability: This has to do with the density of the modes, which is related to how often the mode has been used

-Charge: Refers to the degree of activation. The modes, in general, draw on the same mental resources, so that an individual may be just as attentive watching a ball game or listening to a friend’s interesting experience as they are in their delusion that they are being followed or watched. The context in which a mode is activated depends on the interaction of internal and external stimuli. For example, a withdrawn individual who is exposed to music may flip into the adaptive mode and sing and dance and is engage in completely realistic communication.

The regressive mode in schizophrenia may appear superficially similar to the regressive mode that occurs in some infectious diseases such as pneumonia. In actuality, the mode in schizophrenia is maladaptive whereas in pneumonia it is adaptive. In pneumonia, the regressive mode operates in order to conserve energy for more important purposes, namely, fighting the infection. In schizophrenia, the regressive mode is also involved in conserving energy or resources, but is maladaptive: it is based on a cluster of dysfunctional beliefs around the escapist or defeatist theme. When those with schizophrenia are exposed to a set of circumstances that engage their interest, they generally have more access to their resources. Thus, we have seen an individual who is totally regressed, sitting in the corner with a blanket over his head who when stimulated by his favorite music, may get up and dance. Even though this adaptive behavior occurs suddenly, it does not persist after the context changes.

The important lesson from this is that no matter how regressed individuals may be, they are still subject to activation of their adaptive mode, provided the clinician can come upon their “sweet spot”. The fundamental problem is how to facilitate the patient’s becoming involved in real life situations. We have found for example, that at first, with the individual’s interest and then their engagement activated, it is possible to fill out the individual’s aspirations and thus help the individual to go through the various steps and challenges leading to their aspirations. As part of the activation of the adaptive mode, it is important to search for the meanings in the identified activities. The adaptive mode is flexible enough to generate a variety of mini-modes such as giving a lecture or attending a concert. Also, there are a number of maladaptive modes corresponding to various disorders such as depression, anxiety disorders, obsessive-compulsive disorder (OCD)and personality disorders. In addition, a number of maladaptive mini-modes may develop such as test anxiety, germ phobia, and self-harm.

-ATB