Giancarlo Dimaggio, Tiziana Passarella
Is it possible to face the challenges presented by patients with a combination of severe symptoms, problematic behaviors and interpersonal dysfunctions being aware they suffer from personality disorders and yet adopt a constructivist stance? Is this attention to severe patients necessary to overcome the dissemination problem that clinical constructivism has faced in the last decades? Here we describe how Metacognitive Interpersonal Therapy (MIT) faced the issue, as a model from constructivist roots, lying in personal construct theory first and then on narrative and dialogical developments. We show how MIT tries to both remaining uniquely focused to the unique individuals construction and at the same time adopting formal procedures. We highlight how before changing meaning-making systems patients need to be aware of being guided by them and only after self-knowledge is sufficient patients can be guided to change. We also note how changing is more that adopting different ideas, and is much more of an embodied and experiential process, one that requires very often to retrieve and relieve some central – self-defining – memories, to let arousal grow and then rewrite them so that different narrative and dialogical patterns can be created and will guide the person toward health and adaptation. We conclude suggesting that a shift toward more embodied practices and an attitude toward formal methods of empirical testing is necessary so clinical constructivism can emerge and thrive again.