Elena T. Sokolova

The article analyzes certain socio-cultural and personal predispositions, which determine the modern diversity of subjective uncertainty and ambiguity manifestations. It stresses that for the creation of ‘realistic’ clinical psychology (in terms of A.R. Luria) one needs to retrace the relations between the resourceful and the psychopathological aspects of the ambiguity phenomenon and the cultural environment with its destructive ideals and mythologems, manipulative media-technologies and all-pervading idea of ‘deconstruction’. Methods for modeling the experiences of ambiguity in experimental settings, in pathopsychological examination and in projective psychological diagnostics are put in comparison. The arguments are adduced for the interpretation of deficient manifestations of subjective uncertainty as a criterion for diagnostics of the severity of personality disorder.

The article describes the development of an integrative bio-psycho-social model of personality disorders. This model is based on the interconnection of intellect, self-regulation, self-identity, and social relationships. The prognostic value of the category of “affective-cognitive style” is estimated on the grounds of a meta-analysis of various empirical studies and theoretical models. The article discusses the results of clinical and experimental studies that specify the functions of cognitive differentiation and integrity and of symbolic mediation and reflection in the regulation of the content, emotional valence, temporal stability, and spatial organization of intrapsychic representations of self and interpersonal relationships, as well as the systemic organization of defense and coping operations.

The author discusses the controversial issues of formation and functioning of psychological defense mechanisms in ontogenesis and in personality disorders as they are represented in classical and contemporary psychoanalysis, in cognitivism and communication theory. The paper emphasizes the role of cognitive organization (style), sign-symbolic mediation, representative system of object relations and attachments in individual typological variability of the level organization of defense mechanisms, in efficiency of personal and social adaptation, in maturity and mental health of personality.

Basing on the theoretical analysis and personal longstanding research, the author offers general characteristics of narcissism, delineates the relations between the disturbances of identity structure, regulatory mechanisms, cognitive styles and modes of interpersonal cognition, which allows predicting a wide range of psychic and behavioral disorders. It is shown that the phenomenon of narcissism has a bio-psycho-social causation, and that the contemporary technological glut as well as the expansion of consumerist values give new stimuli for the development of narcissistic and perfectionist personality trends.

Basing on Vygotsky’s cultural-historical methodology, Bakhtin’s conception of inner dialogue, and some ideas of object relations theory, the authors propose an integrative approach to self-awareness in psychotherapy. Serious attention is paid to the predictors of borderline personality disorders and comorbid illnesses: pathogenic family conditions of personality development and, in consequence of them, splitting and structural distortions of self-awareness. The descriptive-analytic, semiotic and dialogical procedures of analysis of verbal communications between patient and psychotherapist were elaborated and approbated.