Bringing the "self" into focus: conceptualising the role of self-experience for understanding and working with distressing voices.
Sarah F. Fielding-Smith, Mark Hayward, Clara Strauss, David Fowler, Geòrgie Paulik, Neil Thomas
Frontiers in Psychology 2015 DOI: 10.3389/fpsyg.2015.01129 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Philosophy of mind |
| Keywords | Auditory verbal hallucinations Psychological intervention Psychosis Schizophrenia Self-experience Voice hearing |
| Key findings | Argues that the psychological construct of "self" may play a role in causing and maintaining distress and disability in people who hear voices, and proposes that interventions specifically targeting aspects of self-experience, such as self-affection, self-reflection, self-schema, and self-concept, may be sufficient to reduce distress and disruption, though this suggestion requires further empirical investigation. |
Abstract
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.
Comparable studies
Other narrative reviews on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Body Consciousness: A Philosophy of Mindfulness and Somaesthetics | 2008 | Review article | |
| Phenomenology, Structure, and Dynamic of Psychedelic States | 2016 | Review | |
| Classic Hallucinogens and Mystical Experiences: Phenomenology and Neural Correlates. | 2018 | Review | |
| The lived experience of psychosis: a bottom-up review co-written by experts by experience and academics. Individuals with lived experience of psychosis, family members, and carers | 2022 | Co-written bottom-up review | |
| From autopoiesis to neurophenomenology: Francisco Varela's exploration of the biophysics of being. | 2003 | Review |
Citations in the library
Cited by 2
- Hearing voices and the quest for autonomy: An interpretative phenomenological analysis. Psychology and Psychotherapy Theory Research and Practice December 7, 2025
- Immersion in altered experience: An investigation of the relationship between absorption and psychopathology. Consciousness and Cognition March 2017
Cites 12
- Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry 2003
- Self-disturbance and schizophrenia: structure, specificity, pathogenesis (Current issues, New directions). Schizophrenia Research 2014
- How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review April 1, 2015
- What are the neurocognitive correlates of basic self-disturbance in schizophrenia?: Integrating phenomenology and neurocognition. Part 1 (Source monitoring deficits). Schizophrenia Research January 2014
- What are the neurocognitive correlates of basic self-disturbance in schizophrenia? Integrating phenomenology and neurocognition: Part 2 (aberrant salience). Schizophrenia Research January 2014
and 7 more in the library