Peter Kinderman

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Peter Kinderman University of
Liverpool Simon Duff University of Liverpool
Using ICS to inform clinical work with complex
cases
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Overview personality disorder based on
the Interacting Cognitive Subsystems model
non-discriminative processing and interlock
these two processes, together with abnormal
schema content, can explain the rigidity and
maladaptive nature of cognitive schemata that are
believed to lead to the clinical features of
personality disorder. the implications for
psychological therapies with people experiencing
such difficulties will be discussed
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Personality disorder An enduring pattern of
inner experience that deviates markedly from the
expectations of the individuals culture in two
or more of, cognition, affect (e.g., range,
intensity, lability, appropriateness),
interpersonal functioning, and impulse control.
(DSM-IV APA, 1994) It is considered to be
pervasive across a wide range of personal and
social situations, is characterised by
inflexibility (Millon Davis, 2000), and results
in clinically significant stress or impairment
for the individual. In spite of a long history
of brilliant cogitations, psychopathologic
nosology still resembles Ptolemys astronomy of
over 2,000 years ago Our diagnostic categories
describe, but they do not really explain.
(Millon et al., 2001).
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e.g. Psychoanalytic Theory (e.g., Kernberg,
1996) - poor development of the superego, which
may come about through abuse. Attachment Theory
(e.g., Bartholomew, 1997) - less than optimal
development alters the individuals ability to
deal with stress in a flexible manner.
Cognitive Theory (e.g., Beck et al., 1990) -
particular schemata come to be used
preferentially to others, leading to inflexible
responses, itself based upon an evolutionary view
of schema development. Evolutionary Theory
(e.g., Millon, 1990) suggests that personality
disorders emerge from the acting out of extreme
forms of evolutionary imperatives.
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An integrative model should be based on the idea
that personality disorder is, and personality
disorders are Individual expressions of a
shared, underlying mechanism And that
personality disorder lies at an extreme end of a
continuum, diagnosable when there is a severe
disturbance in the characterological condition
and behavioural tendencies of the
individual. By implication, personality
disorder is An extreme expression of normal
psychology (an idea that Bentall (2003) has
promoted for Axis-I disorders.)
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Kinderman, P. (2005) A psychological model of
mental disorder. Harvard Review of Psychiatry.
13 206217.
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Social cognition appears dysfunctional, but not
deficient, in personality disorder. We need an
overarching conceptual framework for
understanding social cognition, within which such
abnormalities might fit. One good candidate for
this is Barnards distributed architecture for
human cognition, Interacting Cognitive Subsystems
(ICS)
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Interacting cognitive subsystems ICS describes
an integrated, distributed network of subsystems
working in principled ways which are responsible
for processing specific kinds of information. It
has grown out of neuropsychological literature
and has been used for describing working memory
phenomena, modelling rumination recollection
deficits in dysphoric mood and understanding mood
dependent cognition.
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Interacting cognitive subsystems ICS consists of
9 major subsystems which share the same structure
and functions, The transformational engine A
memory record differing only in the mental codes
with which they work. This simplicity of
structure supports the richness and complexity of
cognition because it is the integration and flow
of mental codes which determine the form and
content of any particular mental representation.
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Interacting cognitive subsystems A central
feature of ICS is the ability of the system to
learn. This learning involves the modification of
stored representations through the transformation
of information, the transmission of information
from one subsystem to another and the combination
of such information. If these stored
representational schemata are not modified,
behaviour will appear rigid and maladaptive.
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Non-discriminative processing Non-discriminative
processing occurs when novel material is
recognised as discrepant with existing
expectations, but does not lead to a modification
of existing representational schemata. In ICS,
a subsystem will develop automatic,
proceduralised processing if it has developed a
learned regularity of (for instance) A ? X. If
the subsystem then encounters AB, the presence
of B should act as a discrepant stimulus. Such a
discrepant stimulus should trigger buffered,
non-proceduralised processing and should lead to
a new response ? Z. However, if the subsystem
finds that B is non-discriminative if it gives
no information about possible alternative
responses the discrepant information will not
lead to an altered output.
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Non-discriminative processing Non-discriminative
processing is a normal and healthy part of the
normal cognitive architecture. If deployed
inappropriately when objectively discriminative
stimuli are present the responses may seem
dysfunctional. Non-discriminative processing
will occur if the person has LEARNED that the
material is non-discriminative.
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If you do that again, I wont love you anymore.
Criticism (A) ? withdrawal of
affection (X) If repeated a sufficient number of
times, in particular situations, this will become
a proceduralised response, and concurrent
discrepant stimuli will become non-discriminative.

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Criticism (A) ? withdrawal of
affection (X) Presence of (B) Im not your
mother, is non- discriminative
Are you leaving that dirty plate on the side?

You dont love me and you will leave me.
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Interlock Interlock refers to a situation where
the unchanged output of subsystem processing is
used as the input for another subsystem in a
feedback loop. When interlock occurs in the
IMPLIC subsystem, this reciprocal feedback
fails to provide new information, but mirrors the
original IMPLIC representation because of the
individuals learning history. This leads to
cycles of IMPLIC ? PROP PROP ? IMPLIC
which reinforce a current representation. The
tendency of the central engine to be prone to
interlock could be considered a risk factor for
PD and as these loops are considered
self-preserving, could explain the maintenance of
maladaptive behaviour in the absence of any
triggers.
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Are you leaving that dirty plate on the side?
fears of desertion ? ? sadness anger ? ? fears
of desertion ?
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Implications Personality disorders arise because
the cognitive architecture, coupled with learning
history, does not allow new, objectively
discriminative material to be made available to
the representational schemata. Thus we do not
need to change the schemata, we do need to give
them access to information represented in other
subsystems to break the functional isolation
and locked processing cycles. How to do
this? ICS contrasts with the Beckian approach
consciously available material as underlying
maladaptive behaviour. In ICS this provides a
partial explanation, at the PROP level, whereas
we suggest it is the IMPLIC level which is
important.
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Implications In line with Teasdales approach
(Teasdale, Segal, Williams, 1995) for
preventing depressive relapse, provide
individuals with competing tasks (to reduce
resources to interlock processes) concentrating
on here and now information (providing PROP
etc input). Enhanced Thinking Skills programmes
including inter-personal problem solving skills,
social perspective taking, critical reasoning
skills etc. have proved effective in reducing
recidivism (Friendship et al., 2002) in offenders
with personality disorder. Mindfulness -
designed to increase awareness of mental
processes and perceptual systems normally not
attended to is characterised by direct
experience of current reality in the moment
rather than elaborative, ruminative, thinking
about ones situation.
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A clinical example Ms D is a 53-year old woman
with a long history of dysphoria, depression
and enduring problems with interpersonal across
a range of personal and social situations,
characterised by inflexibility and resulting in
significant distress and difficulties. Ms D
believed that other people felt her to be
insignificant or trivial. Her self-concept was
limited and pooryet she also believed this
perceived response by other people to be
unfair. Ms D worked as a middle manager in
industry. Her office nick-name was the
Rottweiler, as a consequence of her robust
interpersonal style. A fellow-worshipper at her
church described Ms D as her friend, a
situation Ms D dismissed as yeah, Lynn has
adopted me as her counselling project
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Peter Kinderman Professor of Clinical
Psychology, University of Liverpool