Rethinking Mental Health Through Emerging Relational Frameworks : A Review of Multi-Person Approaches

Abstract

Mental health research, psychiatric practice and neuroscience have long oscillated between individual-centred and sociallyembedded paradigms. After the rise of social psychiatry in the mid-20th century, the field largely turned toward individualized,biological approaches. However, growing calls across neuroscience, psychiatry and psychotherapy now signal a renewedfocus on relational processes. Recent theoretical and empirical developments suggest that psychiatric disorders may be betterunderstood as disorders of social interaction rather than isolated deficits. Concepts such as interpersonal misattunement, interaction-based phenotyping, and second-person neuropsychiatry offer promising alternatives to traditional observer-basedmodels. Alongside these ideas, the emerging field of relational neuroscience, using methods such as hyperscanning, providestools to explore the dynamics of reciprocal human interaction. Multi-person approaches also offer potential for advancingour understanding of psychotherapy and other relational settings by moving beyond isolated individuals to the dynamics ofshared experience. By capturing meaningful interpersonal moments as they unfold, these approaches may offer insights into theneurobiology of relational change. We propose that a more comprehensive understanding of moments of genuine connectionholds promise for advancing mental health research and supports new forms of relationally attuned mental health systems.