Harman, R.; (2005) The role of shame and self-critical thinking in the development and maintenance of current threat in post traumatic stress disorder. Doctoral thesis , University of London.

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Abstract

Fear, helplessness and horror are the emotions traditionally linked with posttraumatic stress disorder (PTSD) and are central to the current diagnostic criteria. However recent research suggests that a range of other emotions may also play a role in PTSD, and researchers have specifically identified a subgroup of people whose severity of PTSD was linked to the severity of shame they experienced. Recently researchers have been interested in the role individuals' inner dialogues have on the development and maintenance of shame. Specifically it has been suggested that shame is linked to self-critical inner dialogues and an inability to be caring and compassionate towards the self. In this paper these ideas are explored in relation to PTSD. It is suggested that self- criticism and a lack of a caring and compassionate part of the self can lead individuals who have suffered a trauma to experience high levels of shame and as a consequence feel as if their psychological integrity is under threat. Continued self-critical attacks maintain a sense of ongoing current threat, which as specified in Ehlers and Clark's (2000) cognitive model of PTSD is central to the creation and maintenance of PTSD. It is suggested that treatment interventions that focus on the development of a caring and compassionate part of the self are likely to prove a beneficial adjunct to traditional exposure based treatments for individuals who have PTSD associated with high levels of shame.

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