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

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.