Between a rock and a hard place: Associations between Mentzos' “dilemma”, self‐reported interpersonal problems, and psychosocial functioning in individuals with non‐affective psychoses

Primary aim of this study was to determine the extent and type of self-reported interpersonal problems in patients with non-affective psychoses and their impact on psychosocial functioning. Furthermore, we aimed to explore potential links with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma", which describes an insufferable inner tension caused by an individual's struggle of being torn between "self-oriented" and "object-oriented" tendencies. In a cross-sectional study among 129 patients with non-affective psychoses, measures of cognition, symptom load and social functioning as well as a tentative, psychodynamic assessment of Mentzos' "dilemma" were obtained during a clinical research visit. Self-report data on interpersonal problems were gathered using the Inventory of Interpersonal Problems (IIP-64D) and compared with a German representative standard sample. Second, IIP-64D scores were compared between groups with or without Mentzos' "dilemma". Hierarchical regression analyses were performed to test for the impact of interpersonal problems on psychosocial functioning, while controlling for cognitive deficits and psychopathology. Results showed that IIP-64D scores differed significantly from healthy controls, except for "self-centred" and "intrusive" interpersonal styles. Participants with a potential "psychotic dilemma" scored significantly higher on the subscales: "domineering", "self-centred", "cold", and "socially avoidant" than the group without a "psychotic dilemma". The total amount of interpersonal problems, and particularly high scores on the IIP-64D "socially avoidant" subscale, predicted psychosocial dysfunction, whereas a "cold" interpersonal style had an opposite effect. In conclusion, specific interpersonal problems may predict psychotherapeutic outcome measures like psychosocial functioning and are partly compatible with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma"

Psychoanalytic sociology and the traumas of history: Alexander Mitscherlich between the disciplines

This article examines the way aspects of recent history were excluded in key studies emerging from psychoanalytic social psychology of the mid-twentieth century. It draws on work by Erikson, Marcuse and Fromm, but focuses in particular on Alexander Mitscherlich. Mitscherlich, a social psychologist associated with the later Frankfurt school, was also the most important psychoanalytic figure in postwar Germany. This makes his work significant for tracing ways in which historical experience of the war and Nazism was filtered out of psychosocial narratives in this period, in favour of more structural analyses of the dynamics of social authority. Mitscherlich?s 1967 work The Inability to Mourn, co-authored with Margarete Mitscherlich, is often cited as the point at which the ?missing? historical experience flooded back into psychoanalytic accounts of society. I argue that this landmark publication doesn?t hail the shift towards the psychoanalysis of historical experience with which it is often associated. These more sociological writers of the mid-century were writing before the impact of several trends occurring in the 1980s-90s which decisively shifted psychoanalytic attention away from the investigation of social authority and towards a focus on historical trauma. Ultimately this is also a narrative about the transformations which occur when psychoanalysis moves across disciplines