As I have described previously, a mode is a state of the individual that is activated by and normally adapted to the specific situation. Thus, a passive-focused mode is activated while watching a movie in a theater whereas an active focused mode is activated when participating in a sport such as soccer or basketball. When a specific mode is activated, the entire personality, including motivation, cognition, affect, and behavior is involved. The mode may be understood in terms of the significant behavior (passive or active) or emotion (sad, angry, happy, etc.) that is involved. In some individuals the modes are sharply delineated, and in the dissociated personality disorder each of the modes may be labeled and take on a life of its own (Tom, Harry, Mary, etc.). In our work, however, we tend to focus our attention on several modes. For example, the withdrawn mode, the psychotic mode, the active mode, adaptive mode, angry or anxious mode, etc. As described previously, two of the modes (the withdrawn mode and active mode) tend to be complimentary to each other. Each of the characteristics of the withdrawn mode has its counterpart in the active mode. For example, inactive is paired with active, lack of pleasure with experience of pleasure, apathetic with happy, andunresponsive with responsive. The trick in therapy is to activate the positive, active mode which at the same time deactivates the negative, passive mode. The initial step is to penetrate the mode of withdrawal that comes from the place of avoidance in the individuals that are under our care. We can initially achieve this through the interpersonal traction such as encouraging the individual to go for a walk together. Over time, the successive activations of the positive modes help to unfreeze the dominanceof the negative mode. Ultimately, the individual is able to adapt the activation of a particular mode to fit the specific situation. The adaptive mode is an all-purpose mode that activates the appropriate mode when the situation is changing.
Frequently at the beginning of treatment, some individuals are in the psychotic mode (actively hallucinating, highly delusional, disorganized, combative, etc.). We use a variety of techniques, for example, deep breathing, refocusing exercises, engagement in pleasurable activities to diffuse the psychotic mode and gradually activate the adaptive mode. When the individual is in the adaptive mode, some of the other procedures may be considered: finding the individuals’ “sweet spot,” setting up the aspirations, setting up a treatment plan, etc. It is remarkable how most individuals can “flip” from the withdrawal or psychotic mode into the adaptive mode. Since the activation of the adaptive mode is often only temporary, the staff and the individual need to reactivate it numerous times until the individual meets his or her aspirations.