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

  • Heinz BoekerEmail author
  • Georg Northoff


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.


Defence mechanisms Conflict Structure Neuropsychodynamic model Spatiotemporal structure 


  1. Böker H. Sekundary amenorrhoea and psychosomatic phenomenon: Empirical studies of the personality structure and the object relations of patients with amenorrhoea. Medical Dissertation, Faculty of Medicine, Justus-Liebig-University, Giessen/Germany; 1979.Google Scholar
  2. Böker H, Hell D, Budischewski K, Eppel A, Härtling F, Rinnert H, von Schmeling C, Will H, Schoeneich F, Northoff G. Personality and object relations in patients with affective disorders: idiographic research by means of the repertory grid-technique. J Affect Disord. 2000;60:53–60.CrossRefGoogle Scholar
  3. Duncan NW, Hayes DJ, Wiebking C, Tiret B, Pietruska K, Chen DQ, Rainville P, Marjańska M, Ayad O, Doyon J, Hodaie M, Northoff G. Negative childhood experiences alter a prefrontal-insular-motor cortical network in healthy adults: a preliminary multimodal rsfMRI-fMRI-MRS-dMRI study. Hum Brain Mapp. 2015;36(11):4622–37.CrossRefGoogle Scholar
  4. Freud S. Inhibition, symptom and anxiety. Standard Edition, Volume XX, 1926. pp. 75–176.Google Scholar
  5. Gabbard GO. Psychodynamic psychiatry in clinical practice. Washington, DC: American Psychiatric Publishing Inc; 2005/2014.Google Scholar
  6. Grande T, Burkmayer-Lose M, Cierpka M, Galwender RW, Davis-Osterkram S, Vriesert G, Jurasky PO, Brach C, Schauenburg H, Strak N, Strauss W. Die Beziehungsachse der Operationalisierten Psychodynamischen Diagnostik (OPD) – Konzept und klinische Anwendungen. Z Psychosom Med Psychoanal. 1997;43:280–96.Google Scholar
  7. Green A. The imago of the “dead mother“. Psyche Z Psychoanal. 2002.Google Scholar
  8. Janssen PL, Dalbender RW, Freiberger HJ, Holst G, Mans EJ, Rudolg G, Schneider W, Seitler GH. Leitfaden zur Psychodynamisch-diagnostischen Untersuchung. Psychotherapeut. 1996;41:297–304.CrossRefGoogle Scholar
  9. Kernberg OF. Borderline conditions and pathological Narcissism. New York: Jason Aronson; 1975.Google Scholar
  10. Kernberg OF. Object relations theory and clinical psychoanalysis. New York: Jason Aronson; 1976.Google Scholar
  11. Kernberg O. Structural interviewing. Psychiat Clin N Am. 1981;4:169–95.CrossRefGoogle Scholar
  12. Kohut H. The analysis of the self: a systematic approach to the psychoanalytic treatment of narcissistic personality disorders. New York: International Universities Press; 1971.Google Scholar
  13. Kohut H. The restoration of the self. New York: International Universities Press; 1977.Google Scholar
  14. Laplanche J, Pontalis J. Das Vokabular der Psychoanalyse. Frankfurt: Suhrkamp-Taschenbuch; 1989.Google Scholar
  15. Marty P, de M’Uzan M. La pensée operatoire. Rev franc psychosomat 27:345 ff; 1963.Google Scholar
  16. Mentzos S. Neurotische Konfliktverarbeitung. Einführung in die psychoanalytische Neurosenlehre unter Berücksichtigung neuer Perspektiven. München: Kindler Verlag; 1982.Google Scholar
  17. Mentzos S. Interpersonale und institutionalisierte Abwehr. Frankfurt: Suhrkamp; 1988.Google Scholar
  18. Mentzos S. Lehrbuch der Psychodynamik. Die Funktion der Dysfunktionalität psychischer Störungen. Göttingen: Vandenhoeck und Ruprecht; 2009.Google Scholar
  19. Nakao T, Bai Y, Nashiwa H, Northoff G. Resting-state EEG power predicts conflict-related brain activity in internally guided but not in externally guided decision-making. NeuroImage. 2013;66:9–21.CrossRefGoogle Scholar
  20. Northoff G. How is our self altered in psychiatric disorders? A neurophenomenal approach to psychopathological symptoms. Psychopathology. 2014a;47(6):365–76.CrossRefGoogle Scholar
  21. Northoff G. Unlocking the brain, Coding, vol. 1. Oxford: Oxford University Press; 2014b.Google Scholar
  22. Northoff G. How do resting state changes in depression translate into psychopathological symptoms? From ‘spatiotemporal correspondence’ to ‘spatiotemporal psychopathology’. Curr Opin Psychiatry. 2016;29:18–24.CrossRefGoogle Scholar
  23. Northoff G. The brain’s spontaneous activity and its psychopathological symptoms–spatiotemporal binding and integration. Prog Neuro-Psychopharmacol Biol Psychiatry. 2017;80(Pt B):81–90. Scholar
  24. OPD. Operationalisierte Psychodynamische Diagnostik. Bern: Grundlagen und Manual; 1996.Google Scholar
  25. OPD (1998) Operationalisierte Psychodynamische Diagnostik. Grundlagen und Manual. 2. Korrigierte Auflage. Hans Huber, Bern.Google Scholar
  26. OPD Task Force. Operationalized psychodynamic diagnostics OPD-2 – manual of diagnosis and treatment planning. Göttingen: Hogrefe Publishing GmbH; 2009.Google Scholar
  27. Richter HE. Eltern, Kind und Neurose. Rheinbeck: Rowohlt; 1967.Google Scholar
  28. Rudolf G. Strukturbezogene Psychotherapie. Leitfaden zur psychodynamischen Therapie struktureller Störungen. Stuttgart: Schattauer; 2006.Google Scholar
  29. Schüssler G, Holst G, Hoffmann SO, Mans E, Mentzos S. Operationalisierte Psychodynamische Diagnostik (OPD): Konfliktdiagnostik. In: Buchheim P, Cierpka M, Seifert D, editors. Lindauer Texte. Wien: Springer; 1996.Google Scholar
  30. Willi J. Die zweier Beziehung. Spannungsursachen, Störungsmuster, Klärungsprozesse, Lösungsmodelle. Rowohlt, Rheinbeck; 1975.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Psychiatry, Psychotherapy, and PsychosomaticsPsychiatric University Hospital Zurich, University of ZurichZurichSwitzerland
  2. 2.Mind, Brain Imaging, and Neuroethics, Institute of Mental Health ResearchUniversity of OttawaOttawaCanada

Personalised recommendations