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Bringing the "self" into focus: conceptualising the role of self-experience for understanding and working with distressing voices

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posted on 2023-06-09, 02:15 authored by Sarah F Fielding-Smith, Mark HaywardMark Hayward, Clara StraussClara Strauss, David FowlerDavid Fowler, Georgie Paulik, Neil Thomas
A primary goal of cognitive behavior therapy for psychosis (CBTp) is to reduce distress and disability, not to change the positive symptoms of psychosis, such as hearing voices. Despite demonstrated associations between beliefs about voices and distress, the effects of CBTp on reducing voice distress are disappointing. Research has begun to explore the role that the psychological construct of “self” (which includes numerous facets such as self-reflection, self-schema and self-concept) might play in causing and maintaining distress and disability in voice hearers. However, attempts to clarify and integrate these different perspectives within the voice hearing literature, or to explore their clinical implications, are still in their infancy. This paper outlines how the self has been conceptualised in the psychosis and CBT literatures, followed by a review of the evidence regarding the proposed role of this construct in the etiology of and adaptation to voice hearing experiences. We go on to discuss some of the specific intervention methods that aim to target these aspects of self-experience and end by identifying key research questions in this area. Notably, we suggest that interventions specifically targeting aspects of self-experience, including self-affection, self-reflection, self-schema and self-concept, may be sufficient to reduce distress and disruption in the context of hearing voices, a suggestion that now requires further empirical investigation.

History

Publication status

  • Published

File Version

  • Published version

Journal

Frontiers in Psychology

ISSN

1664-1078

Publisher

Frontiers Media

Volume

6

Department affiliated with

  • Psychology Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2016-07-26

First Open Access (FOA) Date

2016-07-26

First Compliant Deposit (FCD) Date

2016-07-26

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