Abstract
With weak social and economic security caused by the current pandemics, emotional wellbeing and cognitive resilience are challenged.
Methods: A longitudinal, quasi-experimental case-control study provided mentalizing training (MBT) in health care professionals in stressful circumstances of an inpatient psychiatry ward.
Results: Participants took the opportunity to engage in a voluntary MBT with significantly better mentalizing abilities.
Conclusion: Having a growth-mindset vs. a fixed-mindset determines how we perceive and react to the world.
Letter to the Editor
In the face of the COVID-19 pandemic, the masks we wear, quite paradoxically, are an expression of our shared experience of isolation, as much as they are a signal of our caring for each other. We have not only been fighting this emergency but are struggling with consequences. These days Vienna is additionally shaken by a presumably terrorist shooting in the last hours before lockdown.
While people were swallowing disinfectant and had been treated with potentially harmful hydroxychloroquine [1], the importance of access to up-to-date quality news was obvious. The PubMed search for 'COVID19' reveals 66.151 results (04.11.2020), but knowledge is just crystallizing.
"The positivist paradigm is based on the assumption that a single tangible reality exists" [2], claiming trust in human's innate ability to learn and to reflect on findings.
However, considering the impossibility of experiencing someone else's experience, we might all inhabit different realities [3].
'Our world,' and/or the perception of it, has changed within weeks to such an extent that we were snapped out of our sociocultural context.
Mentalizing, "the capacity to understand others and oneself in terms of internal mental states," is the precondition for adapting to our social world and for shared intentionality [4].
For patients with schizophrenia or depression, due to their felt sense of isolation, the perception of the world as a welcoming place and of the others as nonhazardous for oneself has not even been existing [5].
Therapists need to react with a kind attitude, providing containment, thus staying a sustainable vis-à-vis, metabolizing affects, reflecting and caring about them, maybe inducing a change in their view.
We provided the opportunity for a voluntary 'Mentalizing training '(MBT) for professionals in a Viennese psychiatric inpatient clinic in a longitudinal quasi-experimental case-control study. The opportunity was taken by 21 out of the 61 health-care workers who were initially contacted. Already before engaging in MBT training, the MBT-training group showed significantly higher mentalizing abilities (operationalized with reflective functioning) when confronting this group with therapists who refused to undergo the training (p= 0.0385); this might reflect a more benevolent, ambitious mindset [6]. Further research must be conducted to increase reproducibility and representativeness of findings, to avoid small sample size bias.
The ability to trust relies on reflecting on mental states with an inquisitive mind, with an unprejudiced stance towards the world. Endowed with imagination, humans train this attitude already in the context of early interpersonal experiences. That said, let us aim for an open-minded and kind attitude, despite the pandemics and similar challenges for our physic and equally for our mental health.
Acknowledgments
We refer to a manuscript submitted for publication [6], for this study: we would like to thank the participants and the external rater Felix Richter who have helped in carrying out the research.
Ethical Approval
We refer to a manuscript submitted for publication [6], for this study: an approval from Ethics committee of the City of Vienna and of the Medical University of Vienna were not necessary, as no patients were involved in the study. The data protection committee approved the study on 17.01.2020, with written informed consent by all participants and it study was done in accordance with the terms set forth in the Declaration of Helsinki.
Previous Presentations
Reference to a Manuscript submitted for publication: Steinmair D, Horn R, Richter F, Wong G, Löffler-Stastka H. Mind Reading Improvements in Mentalization-Based Therapy Training. Manuscript submitted for publication. 2020.
Data sharing: “available on request, for information please contact the corresponding author.”
Author Contributions
“Conceptualization & methodology, H.L.-S.; validation, H.L-S. ; formal analysis, D.S. ; investigation, R.H., F.R. ; resources, H.L.-S.; data curation, H.L.-S.; writing—original draft preparation, DS.; writing—review and editing, HLS.; supervision, H.L.-S.; project administration, H.L.-S.; All authors have read and agreed to the published version of the manuscript.”
References
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3. Ratcliffe M. Empathy and psychiatric illness. Edt. Malbourn, Taylor and Francis, The Routledge Handbook of Philosophy of Empathy, London: Routledge. 2017.
4. Luyten P, Campbell C, Allison E, Fonagy P. The mentalizing approach to psychopathology: State of the art and future directions. Annual Review of Clinical Psychology. 2020 May 7;16:297-325.
5. Dziobek I, Fleck S, Kalbe E, Rogers K, Hassenstab J, Brand M, et al. Introducing MASC: a movie for the assessment of social cognition. Journal of autism and developmental disorders. 2006 Jul 1;36(5):623-36.
6. Richter F, Steinmair D, Löffler-Stastka H. Mentalisierung bei Störungen aus dem schizophrenen Formenkreis. psychopraxis. neuropraxis. 2020;23: 175–179.
7. Steinmair D, Horn R, Richter F, Wong G, Löffler-Stastka H. Mind Reading Improvements in Mentalization-Based Therapy Training. The Bulletin of the Menninger Clinic 2021: (Manuscript submitted for publication).