What are you thinking right now? On the topic of metacognition.

Your heart is racing, you can feel a blush on your cheeks, you’re breathing faster, and your palms are sweaty. Why? There could be numerous explanations, ranging from nervousness for a presentation you are about to give, to having just scaled some steep stairs, to having sex. How is it possible that we can monitor ourselves so well that we can often figure out right in the moment why we’re feeling what we’re feeling? And not only that – how is it possible that we can somehow tell what other people are feeling, just by looking at them?

“How is it possible that we can monitor ourselves so well that we can often figure out right in the moment why we’re feeling what we’re feeling?”

It turns out that figuring out what exactly we are thinking and feeling, and -perhaps even more importantly- why, is no small feat. Traditionally, metacognition has been defined as “thinking about thinking” (meta = about, cognition = thinking), but in recent years researchers have been adding “feelings” into the mix.

Let’s turn to a few examples to see how complicated metacognitions truly are. We’re all perfectly capable of realizing that our own opinions may not always be true. But have you ever noticed how, during an argument, it becomes more and more difficult to stay aware of this? If somebody firmly disagrees with something you believe quite strongly, you may soon stop questioning your own belief, opting instead to only come up with reasons for why you are right and the other person is wrong. This qualifies as a temporary ‘dip’ in metacognition.

Another example: reading this article, it may seem easy to think that others have their own separate lives, and that these lives are unrelated to yours. If, however, you hear the sad news that someone you loved dearly passed away, it may seem very odd to you that other people go about their lives as usual.

Metacognitions about yourself are a series of steps that you have to perform in order to be able to make sense of yourself, the environment, and how you respond to the environment. Let’s start with the simplest two steps. First, you have to be able to say “I am having thoughts” and conclude “These are my thoughts”. Second, you have to be able to notice “I am having emotions” and “These emotions are mine”. Most persons can do this quite well, but in some severe mental illness even these basic operations can prove difficult.

“Metacognitions about yourself are a series of steps that you have to perform in order to be able to make sense of yourself, the environment, and how you respond to the environment.”

But the third step becomes trickier: how do you differentiate “angry” from “upset”, “love” from “friendship”, and “hoping” from “wishing”? You may find it difficult to put this to words, yet somehow you know there is a difference. And, most importantly, you can probably tell two related thoughts or feelings apart. It´s not easy, thought, and when you look at it like this, it´s perhaps not too strange to imagine that we all have the occasional metacognitive difficulties. Have you ever just felt bad all day, without knowing exactly why, or perhaps even what you were feeling, aside from ‘bad’?.

Persons with severe psychological problems struggle with these same difficulties, yet at times at a more profound level. Think about how difficult it can be to determine how people feel about you by looking at their faces. Now think about how difficult that might be if you have a voice whispering in your ear, stating that you’re worthless, in a way that a person diagnosed with schizophrenia might hear voices. You can imagine that this person might be inclined to see someone else in a more negative light, and be afraid and confused.

“Metacognitive dysfunctions are a feature of many psychological disorders.”

It turns out that difficulties with metacognition – metacognitive dysfunctions – are a feature of many psychological disorders. Persons diagnosed with Post-Traumatic-Stress-Disorder (PTSD) may have difficulties with thoughts like: “If I stay aware of all possible threats in the environment I may stay safe” or “What if I’m going crazy?”. Similarly, persons who are depressed may struggle with intrusive beliefs about themselves such as: “I can’t even get out of bed, I’m absolutely worthless”.

But there may also be difficulties on a deeper level. Persons diagnosed with autism may have difficulties understanding that others do not know what they themselves know. (Perhaps you can relate – think of a skill you have, and how incompetent your friends may be at it; it may be difficult not to get impatient with them and do things for them.) Persons diagnosed with schizophrenia, who have problems correctly recognizing other people’s expressions, tend to jump to conclusions and have difficulties reflecting on their own thoughts and emotions. This can vary from mild symptoms to rather large delusions (“My thoughts are implanted by a witch”).

As such, therapies are constantly being investigated and refined that are aimed at just those processes: from helping persons with psychological problems question their own dysfunctional beliefs (“I am worthless and unlovable”) to programs aimed at delusions for persons with schizophrenia, or even just training programs to help adolescents with ADHD figure out the best way for them to study.

Image with permission from Ashley de Jong-Doucette: http://dejongdoucette.com.

Steven is a PhD candidate in Clinical Psychology. He received a Bachelor’s Degree in Psychology and a Bachelor’s Degree in Social and Political Thought from York University, Canada, and a Master’s Degree in Psychology from the University of Groningen. His research is currently focused on the metacognitive capacities of persons diagnosed with a psychotic disorder.

Select publications

de Jong, S., Renard, S.B., van Donkersgoed, R., van der Gaag, M., Wunderink, L., Pijnenborg, G.H.M., Lysaker, P.H. (2014) The influence of adjunctive treatment and metacognitive deficits in schizophrenia on the experience of work. Schizophrenia Research, in press.

Lysaker, P. H., Vohs, J., Hamm, J. A., Kukla, M., Minor, K. S., de Jong, S., Dimaggio, G. (2014). Deficits in metacognitive capacity distinguish patients with schizophrenia from those with prolonged medical adversity. Journal of Psychiatric Research, in press.

Lysaker, P. H., Leonhardt, B. L., Pijnenborg, G.H.M., van Donkersgoed, R., de Jong, S., & Dimaggio, G. (2014). Metacognition in Schizophrenia Spectrum Disorders : Methods of Assessment and Associations with Neurocognition , Symptoms , Cognitive Style and Function. Israel Journal of Psychiatry and Related Sciences, 51(1): 54-62.

van Donkersgoed, R. J., de Jong, S., Van der Gaag, M., Aleman, A., Lysaker, P. H., Wunderink, L., & Pijnenborg, G.H.M. (2014). A manual-based individual therapy to improve metacognition in schizophrenia: protocol of a multi-center RCT. BMC Psychiatry, 14(1), 27. doi:10.1186/1471-244X-14-27.

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