“It’s like looking in a mirror!”: How the iModes mirror emotional states
A young woman, Dana, came to my office for her first visit. “I’m just not sure what I want to do with my life,” she said. “When I try something new, it is exciting at first, but after a while, I get bored with it. I have changed my major at college a bunch of times. I turn in assignments late. It has gotten so bad that they are threatening to kick me out of school!”
I keep a set of iModes cards on my desk. The iModes have pictures in cartoon-form that show common emotional states, known as “modes”. I asked her to look through the cards and choose the ones that she recognized in herself. She flipped through the cards, looking at the images on the front, and then turning them over to read the name and brief description of the modes on the back. Finally, she picked up the card for the Undisciplined Child mode, and said, “This one!” The picture shows a young woman, probably a teenager, lying on a couch, looking bored. I asked her to explain what she saw of herself in the image. “When it comes right down to it, I want to do what I want to do, and don’t want to do what I don’t want to do.”
After that, we used the cards to tell her story, and the rest of the pieces quickly fell into place. She was the “baby” of the family. Her parents took care of everything for her. She felt special, but also lazy and incompetent. Whenever things got too hard, she gave up. She felt guilty for “always taking the easy way out.” I explained that her parents, with the best of intentions, had given her “too much of a good thing.” In doing so, they deprived her of the opportunity to make mistakes and learn from them, to fall down and see that she could pick herself up again.
She surveyed the pictures we had chosen, spread out on the desk. The cards “are like looking in a mirror,” she said. “You see yourself in them!”
Our research confirms this mirror-like property of the iModes. For example, in a study with Child Protective Services in the Netherlands, my colleagues and I used the iModes to resolve conflicts between youth with serious behavior problems and their parents. In separate sessions, we asked them to describe each other, using the cards. The youth selected the cards that described their parents’ modes, and vice versa. We then presented them with the cards that they had chosen to describe each other.
Remarkably, the children and parents were able to recognize themselves in each other’s descriptions. One mother, for example, was touched that her son had recognized how lonely she was. When asked to describe her, he had chosen the Lonely Child card, a poignant image of a child sitting by herself in a corner. Her son, in turn, realized how worried his mother was about his drug use. His mother had chosen the card for the Detached Self-Soother mode, a card showing drug paraphernalia. The iModes had enabled the youth and parents to see themselves “through each other’s eyes,” developing more empathy for each other.
As I discussed in my previous blog-post, the iModes work according to the evidence-based principle of “amplification through simplification”. By simplifying the cartoon-images to their essential elements, the cards produce a powerful, immediate experience of recognition. This principle explains the mirror-like property of the cards. As in the case of Dana, our clinical experience shows that many patients can recognize their modes using the cards, often in a single session. The official iModes guide provides guidance about how to use the cards in clinical practice for purposes of assessment, psychoeducation, and therapy.
The iModes also play an essential role in SafePath-Solutions, a program that I developed to train treatment teams that work with psychiatric and forensic patients. Through exercises and playful “serious games” using the cards, we teach staff to respond therapeutically when confronted with patients’ extreme modes – for example, modes involving anger, impulsivity, aggression, deception, and manipulation. Within a few hours of working with the cards, staff are not only able to recognize modes in their patients, but get in touch with their own emotional reactions to patients – a crucial step towards intervening more effectively. The iModes also facilitate resolving conflict situations with patients. For example, after incidents on the ward, staff can sit with patients to examine them. They lay the cards in a sequence on a table, so that the escalating pattern of modes becomes clear, including the contributions of patients and staff to dysfunctional interactions. Working together, they make agreements about how to prevent future escalations. The mirror-like property of the iModes make these interventions possible, by facilitating recognition of emotional states in both staff and patients.
SafePath has been adopted by all five high-security forensic youth hospitals in the Netherlands, as well as a variety of other settings (e.g., addiction, residential youth care, adult forensic). Our recently published research shows that SafePath teams function better than regular treatment teams; produce a better ward climate (i.e., supportive, rather than punitive; and are less reliant on physical interventions (e.g., restraint) with patients.
Check out our SafePath Solutions website to learn more about our program.