Centre for Psychotherapy Knockbracken Healthcare Park 16 October 2006

(c) P. Weinreich 2006(c) P. Weinreich 2006 11

Analysing identity processes in Analysing identity processes in psychiatric contexts using psychiatric contexts using

Identity Structure Analysis – Identity Structure Analysis – diagnostic and etiological diagnostic and etiological

features.features.

Centre for PsychotherapyCentre for PsychotherapyKnockbracken Healthcare ParkKnockbracken Healthcare Park16 October 200616 October 2006

Prof Peter Weinreich, University of UlsterProf Peter Weinreich, University of Ulster


A basic premise for psychiatry: A basic premise for psychiatry: one’s sense of identityone’s sense of identity

Whatever the origins of people’s Whatever the origins of people’s psychiatric distress – whether these psychiatric distress – whether these derive primarily from genetic derive primarily from genetic predispositions or dysfunctional predispositions or dysfunctional biographical experiences – people biographical experiences – people generate a sense of identity that generate a sense of identity that incorporates their interpretations of incorporates their interpretations of themselves living in the social world themselves living in the social world


Identity Structure Analysis Identity Structure Analysis provides the means for provides the means for assessing fundamentals of assessing fundamentals of people’s sense of identity…people’s sense of identity…

Based upon the processes of Based upon the processes of appraisal and identificationappraisal and identification

Adaptable approachAdaptable approach A meta-theoretical frameworkA meta-theoretical framework


A Metatheoretical Framework…A Metatheoretical Framework… Psychodynamic approachPsychodynamic approach……identity over identity over

the lifespan through identificationsthe lifespan through identifications Symbolic InteractionismSymbolic Interactionism……identity through identity through

communicationcommunication Social constructionismSocial constructionism……identity through identity through

societysociety Reference Group TheoryReference Group Theory……identity through identity through

comparison and aspirationcomparison and aspiration Personal Construct approachPersonal Construct approach……identity identity

through experience and meaningthrough experience and meaning Cognitive-affective consistency theoryCognitive-affective consistency theory……

identity subject to emotional and cognitive identity subject to emotional and cognitive pressurespressures


Integration of qualitative Integration of qualitative aspects and quantitative aspects and quantitative parameters of identityparameters of identity Qualitative (emic): Qualitative (emic):

(1) Discourses in the vernacular;(1) Discourses in the vernacular; (2) Biographical experiences;(2) Biographical experiences; (3) Case-study.(3) Case-study.

Quantitative (etic):Quantitative (etic): Quantification and standardisation of Quantification and standardisation of

identification parameters.identification parameters.


Identity is defined as…Identity is defined as…

“… “… the totality of one's self-the totality of one's self-construal, in which how one construal, in which how one construes oneself in the construes oneself in the presentpresent expresses theexpresses the continuitycontinuity between between how one construes oneself as one how one construes oneself as one was in the was in the pastpast and how one and how one construes oneself as one aspires construes oneself as one aspires to be in the to be in the futurefuture”.”.


The process of appraisal…The process of appraisal…

People People appraiseappraise the the circumstances in which they are circumstances in which they are involved in order to involved in order to bring bring meaningmeaning to the circumstance … to the circumstance …against the greater background of against the greater background of how they appraise how they appraise selfself in relation in relation to their to their social world.social world.


The process of appraisal…The process of appraisal…

During appraisals of the social world During appraisals of the social world people use constructs to people use constructs to construeconstrue and and evaluate evaluate other agents and events during other agents and events during which they interact. They form which they interact. They form cognitionscognitions about these agents and experience about these agents and experience emotional tonesemotional tones with respect to them. with respect to them.

Such cognitions and affects may be Such cognitions and affects may be compatiblecompatible or or incompatibleincompatible, as when a , as when a good friend joyfully supports a valued good friend joyfully supports a valued objective, or an admired person engages objective, or an admired person engages in a despicable event, respectively.in a despicable event, respectively.


The process of appraisal…The process of appraisal… Compatibilities between cognitions and affects Compatibilities between cognitions and affects

secure and stabilise self’s evaluative secure and stabilise self’s evaluative connotations of one’s constructs, whereas connotations of one’s constructs, whereas incompatibilities undermine and destabilise incompatibilities undermine and destabilise them.them.

Core evaluative dimensions of identityCore evaluative dimensions of identity are ones are ones whereby constructs are used with high whereby constructs are used with high cognitive-affective compatibility.cognitive-affective compatibility.

Dimensions under stressDimensions under stress are designated by are designated by constructs associated with much cognitive-constructs associated with much cognitive-affective incompatibility.affective incompatibility.


The processes of The processes of identification…identification…

People People identify withidentify with elements of elements of significant others who have significant others who have influence over their personal well-influence over their personal well-being, either for good or ill. being, either for good or ill.


The processes of The processes of identification…identification… They form They form aspirationalaspirational identifications identifications

with others when they wish to with others when they wish to emulate their prized featuresemulate their prized features

or or dissociate from their unpalatable dissociate from their unpalatable

aspects.aspects.


Aspirational identification in Aspirational identification in two aspects…two aspects…

They form They form idealistic-idealistic-identifications identifications with others when they wish to with others when they wish to emulate their prized features.emulate their prized features.

They form They form contra-contra-identifications with identifications with others when they wish to others when they wish to dissociate dissociate from their unpalatable aspects.from their unpalatable aspects.


The processes of The processes of identification…identification… a different mode in the here and a different mode in the here and

now …now … People People empathetically identifyempathetically identify with with

others when they others when they recogniserecognise in the in the others features of themselves, whether others features of themselves, whether good or bad.good or bad.

… … a person’s empathetic a person’s empathetic identification with another identification with another modulates according to situations, modulates according to situations, contexts and mood statescontexts and mood states


Conflicted identifications…Conflicted identifications… When self When self empathetically identifiesempathetically identifies with with

another person while simultaneously another person while simultaneously contra-contra-identifingidentifing with that person, self’s with that person, self’s identification with the other is identification with the other is conflictedconflicted. .

I.e., Self is as the other in several respects, I.e., Self is as the other in several respects, while wishing to dissociate from some of the while wishing to dissociate from some of the characteristics of the other - characteristics of the other - “to be as the “to be as the other, while not wishing to be”other, while not wishing to be”

… … Since people’s empathetic identification with Since people’s empathetic identification with others modulate according to situations, contexts and others modulate according to situations, contexts and mood states, so will their conflicted identifications mood states, so will their conflicted identifications alter accordinglyalter accordingly


Identity diffusion …Identity diffusion … People’s conflicted identifications with People’s conflicted identifications with

others may be dispersed across several others may be dispersed across several persons. persons.

A state of high A state of high identity diffusionidentity diffusion is is manifest when self’s manifest when self’s conflicted conflicted identificationsidentifications with others are both with others are both substantialsubstantial and and dispersed across manydispersed across many others. others.

… … extent of identity diffusion may also extent of identity diffusion may also modulate according to situations, modulate according to situations, contexts and mood states. contexts and mood states.


Identity Structure Analysis is Identity Structure Analysis is operationalised through…operationalised through…

……the Identity Exploration the Identity Exploration computer software…computer software… IDEX-IDIOIDEX-IDIO – – for individual analysesfor individual analyses IDEX-PHASEIDEX-PHASE – – for longitudinal analysesfor longitudinal analyses IDEX-NOMOIDEX-NOMO – – for group analysesfor group analyses IDEX-NOMO-PHASEIDEX-NOMO-PHASE – – for group longitudinal for group longitudinal

analysesanalyses


How does it work?How does it work?

Psychological definitionsPsychological definitions

AlgorithmsAlgorithms

Computer softwareComputer software

Analysis and interpretationAnalysis and interpretation


Customised identity instrumentCustomised identity instrument 2 lists:2 lists:

– EntitiesEntities – people, groups, – people, groups, emblems, images, events, emblems, images, events, abstractions, material objects, etcabstractions, material objects, etc

– ConstructsConstructs – discourses about – discourses about experiences and expectations, experiences and expectations, beliefs and values, attributes, etcbeliefs and values, attributes, etc


Customised identity instrumentCustomised identity instrument E.g.,E.g.,

EntitiesEntities – – my best friend; my Member of my best friend; my Member of ParliamentParliament

ConstructConstruct – – discourse about ‘trust’ discourse about ‘trust’

9 point scale:9 point scale: ……can be trusted …can’t be trustedcan be trusted …can’t be trusted

4 3 2 1 0 1 2 3 44 3 2 1 0 1 2 3 4 Would you place your best friend at the same Would you place your best friend at the same

place on the scale as your Member of Parliament?place on the scale as your Member of Parliament?


Identity, Depression & Anxiety (Alison McKenna)

Joiner, Coyne, & Blalock, 1999:3Joiner, Coyne, & Blalock, 1999:3By ignoring By ignoring “the intricacies of “the intricacies of depressed persons’ involvement depressed persons’ involvement with other people”with other people” one may one may “attribute to depressed persons “attribute to depressed persons characteristics they do not possess”characteristics they do not possess” and and “leave significant aspects of “leave significant aspects of their experience unexplained.”their experience unexplained.”


Depression & Anxiety

Prolonged, unresolved periods of anxiety Prolonged, unresolved periods of anxiety often precede depressive episodes (Wolpe, often precede depressive episodes (Wolpe, 1971; Bittner et al, 2004).1971; Bittner et al, 2004).

Sloman, Farvolden, Gilbert, & Price, Sloman, Farvolden, Gilbert, & Price, 2006:982006:98

“…“…[they] have complex and important [they] have complex and important co-regulating influences on each other that co-regulating influences on each other that may explain [their] high comorbidity…”may explain [their] high comorbidity…”


Postulates Examined

Participants’ biographical experiences within their social milieu are likely to be reflected by ISA through their modulation of identity indices with significant others.

The psychological processes underlying comorbidity of depression and anxiety will be elucidated through examination of participants’ identifications with others across depressed and anxious selves.


Case study “Philip”: diagnostic Case study “Philip”: diagnostic resultsresults Anxiety was associated with his high Anxiety was associated with his high

identity diffusion that accompanied his identity diffusion that accompanied his engagement with the social world that engagement with the social world that entailed problematic conflicted entailed problematic conflicted identifications with others. identifications with others.

Depression accompanied his social Depression accompanied his social withdrawal, that is, diminution of his withdrawal, that is, diminution of his empathetic identification with others, empathetic identification with others, which diminished his identity diffusion which diminished his identity diffusion through resolution of his conflicted through resolution of his conflicted identifications with others.identifications with others.


““Philip”: diagnostics of anxiety-Philip”: diagnostics of anxiety-depression co-morbiditydepression co-morbidity

Being depressed is to realise that self in unable to Being depressed is to realise that self in unable to effectively pursue one’s aspirations that require effectively pursue one’s aspirations that require engagement with the social world.engagement with the social world.

However, re-engagement with the social world is to However, re-engagement with the social world is to reinstate problematic conflicted identifications, that is, reinstate problematic conflicted identifications, that is, high identity diffusion accompanied by greater anxiety.high identity diffusion accompanied by greater anxiety.

A vicious cycleA vicious cycle ensues whereby social withdrawal that relieves anxiety results in depression, and efforts to come out of depression require social re-engagement that generates anxiety: … depression is traded off against anxiety, and vice versa …


““Philip”: further diagnostics Philip”: further diagnostics and etiological factorsand etiological factors

He had endured numerous prejudicial attacks.He had endured numerous prejudicial attacks.

Nevertheless, he held strong aspirations Nevertheless, he held strong aspirations towards positive social relationships towards positive social relationships (SP=99.69).(SP=99.69).

Depression likened to loss – related to loss of Depression likened to loss – related to loss of relationships due to prejudicial encounters.relationships due to prejudicial encounters.

Idealized his “well” self states, thus inducing Idealized his “well” self states, thus inducing the retaliations of others and amplifying their the retaliations of others and amplifying their prejudicial appraisals of him.prejudicial appraisals of him.


A case of aggressive impulsivity in A case of aggressive impulsivity in paranoid schizophrenia paranoid schizophrenia (Cherie Part)(Cherie Part)

EntitiesEntities Past selves:Past selves: ‘‘Me when I hurt someone…’Me when I hurt someone…’ ‘‘Me when I calmed down after hurting someone…’Me when I calmed down after hurting someone…’

‘‘Socially deviant’ others:Socially deviant’ others: ‘‘A violent prisoner…’A violent prisoner…’ ‘‘A teenager who opens fire with a gun in his A teenager who opens fire with a gun in his

school…’school…’

Victim domain:Victim domain: ‘‘Someone I have physically hurt…’Someone I have physically hurt…’ ‘‘An abused child…’An abused child…’


A case of aggressive impulsivity in A case of aggressive impulsivity in paranoid schizophrenia paranoid schizophrenia (Cherie Part)(Cherie Part) Bipolar ConstructsBipolar Constructs Impulsivity:Impulsivity: BIS-11 (Patton et al., 1995)BIS-11 (Patton et al., 1995) ……act/s quickly without act/s quickly without …think/s carefully before…think/s carefully before

thinkingthinking doing anythingdoing anything

Aggressive Impulsivity:Aggressive Impulsivity: ……lose/s itlose/s it …stay/s calm…stay/s calm ……suddenly gets violently suddenly gets violently …think/s or talks things…think/s or talks things angryangry through calmlythrough calmly

Perceived Threat:Perceived Threat: (Link et al., 1998; 1999)(Link et al., 1998; 1999) ……believe/s there are people believe/s there are people …doesn’t think there’s …doesn’t think there’s who want to do them harm anyone out to hurt themwho want to do them harm anyone out to hurt them


Paranoid schizophrenia - Paranoid schizophrenia - diagnostic and etiological features: diagnostic and etiological features: “Peter”“Peter”From case history notesFrom case history notes 49-year-old Peter was first diagnosed with 49-year-old Peter was first diagnosed with

paranoid schizophrenia in his late teens. paranoid schizophrenia in his late teens. He had a history of verbal and physical He had a history of verbal and physical aggression towards his wife. During one aggression towards his wife. During one episode of an activeepisode of an active psychotic state, he psychotic state, he had attacked his wife with an axe. had attacked his wife with an axe. The The couple had been separated for several couple had been separated for several years prior to this investigation.years prior to this investigation.


Paranoid schizophrenia - Paranoid schizophrenia - diagnostic and etiological features: diagnostic and etiological features: “Peter”“Peter”PostulatePostulate• The experience of a process of The experience of a process of

intimate defensive identification with intimate defensive identification with his wife, his perception of her threat his wife, his perception of her threat to his well-being, alongside a desire to to his well-being, alongside a desire to defend self and escape the aversive defend self and escape the aversive ‘threatening’ relationship gave rise to ‘threatening’ relationship gave rise to Peter’s aggressive impulses.Peter’s aggressive impulses.


A Process of Intimate Defensive A Process of Intimate Defensive Identification is defined by …Identification is defined by … Exertion of malevolent power over Exertion of malevolent power over

selfself Perceived threat to self’s well beingPerceived threat to self’s well being Inability to escape the aversive Inability to escape the aversive

situationsituation Identification with the coercive Identification with the coercive

other while wishing to dissociate other while wishing to dissociate from that otherfrom that other


Evidence: “Peter”Evidence: “Peter”

Peter contra-identified with ‘my ex-partner’ to Peter contra-identified with ‘my ex-partner’ to a profound extent (0.81), indicating a process a profound extent (0.81), indicating a process of defensive identification with her.of defensive identification with her.

He referenced ‘me when I hurt someone’ as He referenced ‘me when I hurt someone’ as being self when he had attacked his wife with being self when he had attacked his wife with the axe. the axe.

His profoundly high empathetic identification His profoundly high empathetic identification with her as based in this ‘past’ self-image with her as based in this ‘past’ self-image (0.81) revealed that he felt closest to his wife (0.81) revealed that he felt closest to his wife when he was hurting her.when he was hurting her.


Evidence: “Peter”Evidence: “Peter” Peter’s simultaneous close Peter’s simultaneous close

empathetic and high contra- empathetic and high contra- identification with his ex-wife accords identification with his ex-wife accords with his attack on her.with his attack on her.

This extremely strong conflicted This extremely strong conflicted identification with her when cued into identification with her when cued into his ‘impulsive aggressive’ state (0.82) his ‘impulsive aggressive’ state (0.82) highlighted a pathological identity highlighted a pathological identity problem for Peter.problem for Peter.


Peter appraised his ex-wife as ‘impulsive’ and Peter appraised his ex-wife as ‘impulsive’ and ‘aggressively impulsive’. Through a process of defensive ‘aggressively impulsive’. Through a process of defensive identification, he appeared to have integrated his wife’s identification, he appeared to have integrated his wife’s perceived ‘aggressive impulsive’ stance into his own self-perceived ‘aggressive impulsive’ stance into his own self-concept and had acted accordingly when cued by a concept and had acted accordingly when cued by a particular social context, exhibiting the same ‘abhorrent’ particular social context, exhibiting the same ‘abhorrent’ characteristics appraised in the coercive other (his wife). characteristics appraised in the coercive other (his wife).

He was intensely ego-involved with his ex-wife (4.15) He was intensely ego-involved with his ex-wife (4.15) where her power over him was experienced as malign where her power over him was experienced as malign and perceived to have had a detrimental impact upon his and perceived to have had a detrimental impact upon his sense of well-being. sense of well-being.

Peter indicated that he ‘believed that there were people Peter indicated that he ‘believed that there were people who wanted to do him harm’ when he expressed his who wanted to do him harm’ when he expressed his aggressive impulses. Thus, he had felt ‘threatened’ when aggressive impulses. Thus, he had felt ‘threatened’ when he ‘lashed out’ and may have been acting in defence.he ‘lashed out’ and may have been acting in defence.


Sharp decline in empathetic identification with wife following the attack illustrated an attempt to:

Reverse the exertion of her malevolent ‘power’

Escape the coercive experience

Resolve his conflicted identification with her

Undo internalisation of wife’s ‘aggressive impulsive’ stance into own self-concept


Conclusions: ISA is ableConclusions: ISA is able …… To provide diagnostic evidence of To provide diagnostic evidence of

the nature of a client’s the nature of a client’s psychological distresspsychological distress

To elucidate ongoing psychological To elucidate ongoing psychological processesprocesses

To assist in comprehending To assist in comprehending etiological aspects of psychological etiological aspects of psychological distress based in biographical distress based in biographical experiencesexperiences


www.analysingidentity.orwww.analysingidentity.orgg

Website for ISA powered by Sycadex Website for ISA powered by Sycadex Ltd. provides Ltd. provides information about ISA and resources such information about ISA and resources such

as research papersas research papers a discussion forum and network for ISA a discussion forum and network for ISA

practitioners with postings about the ISA practitioners with postings about the ISA Study GroupStudy Group

access to the dedicated computer access to the dedicated computer softwaresoftware

Centre for Psychotherapy Knockbracken Healthcare Park 16 October 2006

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