Clinical, scientific and stakeholders’ caring about identity perturbations

Abstract

In this editorial we comment on the article by Zhang et al published in the recent issue of the World Journal of Psychiatry. We focus on identity diffusion, identity perturbations, their origin and developmental pathways. This is an upcoming problem in the society as not only school children are affected. Adolescents and young people suffer from uncertainty in gender identity, in self-image, migration effects due to chronic crises caused by war, pandemic disruptions or climate change. We show how such chronic uncertainty can be cared for, treated, and contained. The key is affective holding, reflection and to provide adequate affective mentalizing in a close concomitant way. These key features also depend on ambient conditions, such as psychotherapeutic care. In a qualitative interview study carried out in a cyclical research design with a comparative analysis on the basis of thematic coding using Grounded Theory Methodology we found institutionalized defenses in health policies. Professionals request better training and adequat academic knowledge as well as research into unresolved areas for improvement of the ambient conditions for adequat development of the self. Practice points for further clinical and scientific development are given and discussed.

Keywords: Identity diffusion; Trauma; Dissociation; Ambient conditions; Environment; containment; Mentalized affectivity

Core Tip: Research on development of the self and identity disturbance has progressed over the past decade studying memory changes and brain plasticity. However, there are still many unanswered questions related to clinical and ambient, environmental applications. As external stimuli have personal valence and meaning, we investigated efficacy of psychotherapeutic care. Stakeholders provide insight into institutional resistances and solutions for better care- and containment-competence development and training. The goal therefore is to target containment processes in both, in individuals who suffer from mental disorders, and their ambient conditions with real-world consequences.