ABSTRACT
This is the second chapter of the guidebook to Metacognitive Reflection and Insight Therapy (MERIT). It describes how MERIT views disruptions in the meaning-making process, or the ability to form complex and integrated ideas about the self and others, which we use to guide our lives, as a parsimonious explanation for the collapse in a life often seen in serious mental illness (SMI). Simply put, as persons with SMI struggle to fit information into an integrative sense of themselves and others, it becomes more and more difficult to understand and respond to psychosocial and psychiatric challenges. This view is linked to early models of SMI including those of Bleuler as well as contemporary neuroscientific research. It is argued that the field has lost interest in this phenomenon because of difficulties finding a way to systematically and quantitatively measure metacognition, or a person’s capacity to form integrated ideas about themselves and others. This task is much more demanding and nuanced than simply determining whether a specific response is correct or not. It is discussed how integration needs to be understood in terms of its complexity and adaptiveness for each unique individual.
