Skip to main content

The Theory of Modes: Applications to Schizophrenia and Other Psychological Conditions

A Correction to this article was published on 25 April 2020

This article has been updated

Abstract

A novel, person centered approach to the understanding and treatment of severe mental illness—Recovery Oriented Cognitive Therapy (CT-R)—has recently been implemented in many settings in the mental health care system. The theory and therapy, originally based on clinical observations, are grounded on the assumption that the personality is composed of a number of “modes” which are composed of specific components such as cognition, affect, motivation and behavior. The activation of a particular mode and its status as relatively adaptive or maladaptive depends on the “fit” between an individual’s internal impulses and cravings and external situational factors. In addition, persistent cognitive distortions within the modes may be responsible for poor adaptation observed in psychiatric disorders. We outline here the difference between the reflexive, automatic activation of modes and a separate superordinate function that provides oversight for the modes. We focus on the theory of modes as it applies to schizophrenia, as individuals given this diagnosis are “stuck” in maladaptive modes. Additionally, we outline some core therapeutic elements of CT-R, which aim to activate the adaptive modes of personality, deactivate the maladaptive modes, and promote movement towards recovery. Finally, we project our understanding of modes onto other psychopathological and non-clinical populations and propose suggestions for the application of this theory in future research and practice.

This is a preview of subscription content, access via your institution.

Change history

References

  • Adler, A. (1924). The practice and theory of individual psychology. Brace: Harcourt.

    Google Scholar 

  • Adler, A. (1954). Understanding human nature (WB Wolfe, Trans.). New York: Fawcett Premier. (Original work published 1927).

  • Andreasen, N. C. (1982). Negative symptoms in schizophrenia: Definition and reliability. Archives of General Psychiatry, 39(7), 784–788.

    CAS  Article  Google Scholar 

  • Andreasen, N. C. (1984). Scale for the assessment of positive symptoms. Iowa City: University of Iowa Department of Psychiatry.

    Google Scholar 

  • Andreasen, N. C., & Olsen, S. A. (1982). Negative v positive schizophrenia: Definition and validation. Archives of General Psychiatry, 39(7), 789–794. https://doi.org/10.1001/archpsyc.1982.04290070025006.

    CAS  Article  PubMed  Google Scholar 

  • Beck, A. T. (1967). Depression: Causes and treatment. University of Pennsylvania Press.

  • Beck, A. T. (1971). Cognition, affect, and psychopathology. Archives of General Psychiatry, 24(6), 495–500.

    CAS  Article  Google Scholar 

  • Beck, A.T. (1996). Beyond belief: A theory of modes, personality, and psychopathology. In Salkovskis, P.M. (Ed) Frontiers of Cognitive Therapy. Guilford Press

  • Beck, A. T., & Alford, B. A. (2009). Depression: Causes and treatment (2nd ed.). University of Pennsylvania Press.

  • Beck, A. T., Baruch, E., Balter, J. M., Steer, R. A., & Warman, D. M. (2004). A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophrenia Research, 68(2–3), 319–329.

    Article  Google Scholar 

  • Beck, A.T., Grant, P.M., Inverso, E., Brinen, A., & Perivoliotis, (in press). Recovery oriented cognitive therapy for serious mental health conditions. New York, NY: The Guilford Press.

  • Beck, A. T., & Haigh, E. A. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1–24.

    Article  Google Scholar 

  • Beck, A. T., Himelstein, R., Bredemeier, K., Silverstein, S. M., & Grant, P. (2018). What accounts for poor functioning in people with schizophrenia: a re-evaluation of the contributions of neurocognitive v. attitudinal and motivational factors. Psychological Medicine., 48, 1–10. https://doi.org/10.1017/S0033291718000442.

    Article  Google Scholar 

  • Beck, A. T., Rector, N. A., Stolar, N., & Grant, P. M. (2009). Schizophrenia: cognitive theory, research, and therapy. New York, NY: Guilford Press.

    Google Scholar 

  • Beck, J. S. (2011). Cognitive behavior therapy (2nd ed.). New York, NY: The Guilford Press.

    Google Scholar 

  • Beck, J.S. (in press). Cognitive Behavior Therapy (3rd ed.). New York, NY: The Guilford Press.

  • Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. The Cochrane Library, 12, CD003388.

    Google Scholar 

  • Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review, 26(1), 17–31.

    Article  Google Scholar 

  • Campellone, T. R., Sanchez, A. H., & Kring, A. M. (2016). Defeatist performance beliefs, negative symptoms, and functional outcome in schizophrenia: A meta-analytic review. Schizophrenia Bulletin, 42(6), 1343–1352. https://doi.org/10.1093/schbul/sbw026.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carlisle, C. (2006). Becoming and Un-becoming: The theory and practice of Anatta. Contemporary Buddhism, 7(1), 75–89. https://doi.org/10.1080/14639940600878034.

    Article  Google Scholar 

  • Carter, R. (2008). Multiplicity. New York: Little Brown.

    Google Scholar 

  • Clark, D. A., & Beck, A. T. (1999). Scientific foundations of cognitive theory and therapy of depression. John Wiley & Sons.

  • Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M., & Andersson, G. (2014). Psychological treatment of generalized anxiety disorder: A meta-analysis. Clinical Psychology Review, 34, 130–140.

    Article  Google Scholar 

  • Cutting, J. (2003). Descriptive psychopathology. Schizophrenia, 42, 15–24.

    Google Scholar 

  • Dozois, D. J., & Beck, A. T. (2008). Cognitive schemas, beliefs and assumptions. In Risk factors in depression (pp. 119–143). Elsevier.

  • Dunlosky, J., & Metcalfe, J. (2008). Metacognition. Sage Publications.

  • Fulton, P. R. (2008). Anatta: Self, non-self, and the therapist. In S. F. Hick & T. Bien (Eds.), Mindfulness and the therapeutic relationship (pp. 55–71). New York: Guilford Press.

    Google Scholar 

  • Freud, S. (1923). The ego and the id. SE, 19, 1–66.

  • Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94(3), 319–340. https://doi.org/10.1037/0033-295X.94.3.319.

    CAS  Article  PubMed  Google Scholar 

  • Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. The Journal of Clinical Psychiatry, 69(4), 621.

    Article  Google Scholar 

  • Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

    Article  Google Scholar 

  • Horney, K. (1991). Neurosis and human growth: The struggle toward self-realization. WW Norton & Company.

  • Hume, D. (1969). A treatise of human nature. London: Penguin. (Original work published 1739–1740)

  • Kirkpatrick, B., Fenton, W. S., Carpenter, W. T., & Marder, S. R. (2006). The NIMH-MATRICS consensus statement on negative symptoms. Schizophrenia Bulletin, 32(2), 214–219.

    Article  Google Scholar 

  • Lester, D. (2010). A multiple self theory of personality. Hauppauge, NY: Nova Science.

    Google Scholar 

  • Lester, D. (2012). A multiple self theory of the mind. Comprehensive Psychology, 1, 02–09.

    Google Scholar 

  • Lester, D. (Ed.). (2017). On multiple selves. Routledge.

  • Lifton, R. J. (1993). The Protean self. New York: Basic Books.

    Google Scholar 

  • Markus, H. (1977). Self-schemata and processing information about the self. Journal of Personality and Social Psychology, 35(2), 63.

    Article  Google Scholar 

  • Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98(2), 224–253. https://doi.org/10.1037/0033-295X.98.2.224.

    Article  Google Scholar 

  • Mendlovic, S. (2008). L'ordine sociale dei sè multipli [The social order of the multiple self-s]. Rome: Alpes Italia.

    Google Scholar 

  • Metcalfe, J., & Shimamura, A. P. (Eds.). (1994). Metacognition: Knowing about knowing. MIT press.

  • Moritz, S., & Woodward, T. S. (2007). Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Current Opinion in Psychiatry, 20(6), 619–625.

    Article  Google Scholar 

  • Öst, L. G., Havnen, A., Hansen, B., & Kvale, G. (2015). Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical Psychology Review, 40, 156–169.

    Article  Google Scholar 

  • Philip, N., & Smith, H. (2004). Buddhism: A concise introduction. Harper San Francisco.

  • Pitson, T. (2005). Hume’s philosophy of the self. Routledge.

  • Rafaeli, E., Bernstein, D. P., & Young, J. (2010). Schema therapy: Distinctive features. Routledge.

  • Riggs, S. E., Grant, P. M., Perivoliotis, D., & Beck, A. T. (2010). Assessment of cognitive insight: A qualitative review. Schizophrenia Bulletin, 38(2), 338–350.

    Article  Google Scholar 

  • Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. The American Psychologist, 55, 5–14.

    CAS  Article  Google Scholar 

  • Vaden, M. B. (2016). The false self and true self: A christian perspective.

  • Wood, A. M., & Tarrier, N. (2010). Positive clinical psychology: A new vision and strategy for integrated research and practice. Clinical Psychology Review, 30(7), 819–829.

    Article  Google Scholar 

  • Young, J. E., Klosko, J. S., & Weishaar, M. E. (2006). Schema therapy: A practitioner's guide. Guilford Press.

Download references

Author information

Authors and Affiliations

Authors

Contributions

Credit for original conceptualization of the manuscript given to A.T.B with significant contributions in idea formulation, writing, editing and design of manuscript given to M.R.F. Literature review conducted by M.R.F. The first draft of the manuscript was written by A.T.B and M.R.F. Supervision, critical commentary and significant revisions provided by J.S.B. All authors edited and commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Aaron T. Beck.

Ethics declarations

Conflict of Interest

Aaron T. Beck, Molly R. Finkel and Judith S. Beck declare that they have no conflict of interest.

Ethical Approval

No procedures were used in this study, no humans or animals participated in this study. The writing of this manuscript was in accordance with the national and international ethical standards.

Informed Consent

No informed consent had to be obtained from any subjects.

Animal Rights

No animal studies were carried out by the authors for this paper.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original version of this article was revised: The corresponding author “Aaron T. Beck” first name and email address has been corrected.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Beck, A.T., Finkel, M.R. & Beck, J.S. The Theory of Modes: Applications to Schizophrenia and Other Psychological Conditions. Cogn Ther Res 45, 391–400 (2021). https://doi.org/10.1007/s10608-020-10098-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10608-020-10098-0