Three-Dimensional Neuropsychodynamic Model of Mental Disorders and Their Defence Mechanisms

Abstract

On the basis of a three-dimensional model encompassing the psychodynamic dimensions defence mechanisms, conflict, and structure (Mentzos, Lehrbuch der Psychodynamik. Die Funktion der Dysfunktionalität psychischer Störungen. Vandenhoeck und Ruprecht, 2009), an analogous model was developed on the neuronal level. It is shown how this original, three-dimensional model of psychic illness can be translated into a neuropsychodynamic context.

The first dimension of defence and compensation describes certain modes of intrinsically predisposed mechanisms for processing extrinsic life events. From a neuronal perspective, the different modes of defence and compensation of conflicts and/or traumata are analogous to the resting state spatiotemporal structures’ ability to modulate and adapt as well as to the resting state’s self-specific organisation.

The second dimension (conflict) in a neuropsychodynamic perspective may be characterised as an interaction between the intrinsic resting state activity and the extrinsic event or stimuli, which has been operationalised as rest-stimulus interaction.

The third dimension (structure) focusses on the organisation of the personality and the psychic structure of the subject including her/his relationship to the object and to the self. The intrinsic activity and its spatiotemporal structure would appear to fulfil the criteria for self- and object-specificity analogous to the structure in the psychodynamic context. This spatiotemporal structure is most probably constituted by the interaction between different networks and regions and the interaction between different fluctuations in different frequencies.

Thereby, self- and object-specificity may be understood as two extreme poles of an underlying commonly shared continuum which runs along the relationship between the brain and world, i.e. their respective spatiotemporal structures.

The three-dimensional neuropsychodynamic model of psychic disorders—as a core element of neuropsychodynamic psychiatry—may contribute to the development of future diagnostic classification systems focussing on functional mechanisms in psychopathology and their subject-related application. Furthermore, it is a diagnostic instrument for the planning, application, and evaluation of psychotherapy.