[2] Jung considered that psychotic episodes in particular could be understood as an existential crisis which might be an attempt at self-reparation: in such instances metanoia could represent a shift in the balance of the personality away from the persona towards the shadow and the self.
[4] Laing's colleague, David Cooper, considered that "metanoia means change from the depths of oneself upwards into the superficies of one's social appearance" – a process that in the second of its three stages "generates the 'signs' of depression and mourning".
Ideally, it aimed to support people whilst they broke down and went through spontaneous healing, rather than thwarting such efforts at self-repair by strengthening a person's existing character defences and thereby maintaining the underlying conflict.
The Dutch psychiatrist Jan Foudraine wrote extensively about it, tracing its history through the work of Jung and Laing, and eventually considering it “a permanent change in gestalt.” He cites an example where one sees a black vase, then one blinks, and instead one sees two white faces in profile opposite each other (the Rubin vase).
[6] In transactional analysis, metanoia is used to describe the experience of abandoning an old scripted self or false self for a more open one: a process which may be marked by a mixture of intensity, despair, self-surrender, and an encounter with the inner void.