ABSTRACT
The important aspects of personality disorder (PD) therapy includes learning to question, distancing from pathogenic schemas and constructing new self-images and narratives to guide one towards adaptation and self-achievement. In metacognitive oriented social skills training (MOSST), patients first relate a narrative episode and then in a group they are assisted in putting together a picture as metacognitively sophisticated as possible of what they themselves and others think and feel. A similar approach can be used with PD patients with histories of profound inhibition and social isolation, with prevailingly avoidant, dependent, obsessive-compulsive and paranoid features and schizoid traits. In metacognitive interpersonal therapy (MIT) oriented groups, patients exercise their communication skills during relational exchanges and, as well as increasing their knowledge of self and of others' minds, train at new exchanges in which they exercise reciprocity, turn-taking, mutual caregiving and social play. In MIT the therapeutic contract does not get formulated or reformulated at defined moment but gets re-discussed at turning point.
