Assessment of self‐contempt in psychotherapy: A neurobehavioural perspective

Objective The aim of this methodological paper was to present self‐contempt, and its assessment, in a broad transdiagnostic framework of psychopathology and related to change in psychotherapy. Self‐contempt may be a central phenomenon in many psychological disorders. We outline methodological recomm...

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Bibliographic Details
Published inCounselling and psychotherapy research Vol. 20; no. 2; pp. 209 - 213
Main Authors Kramer, Ueli, Renevey, Julien, Pascual‐Leone, Antonio
Format Journal Article
LanguageEnglish
Published Abingdon Blackwell Publishing Ltd 01.06.2020
Subjects
assessment
Borderline personality disorder
contempt
emotion
fMRI
neuro‐behavioural
Psychopathology
Psychotherapy
transdiagnostic
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Summary:Objective The aim of this methodological paper was to present self‐contempt, and its assessment, in a broad transdiagnostic framework of psychopathology and related to change in psychotherapy. Self‐contempt may be a central phenomenon in many psychological disorders. We outline methodological recommendations for the study of complex transdiagnostic phenomena which involve multilevel biobehavioural responses. Method We illustrate the assessment of self‐contempt as a complex transdiagnostic phenomenon with a study in which emotion‐eliciting two‐chair dialogues focused on the elaboration of self‐criticism, and an observer‐rated system was applied to assess each client's expressed self‐contempt at the moment of enacted self‐criticism. The client's own self‐contemptuous words were extracted from this self‐critical dialogue and then later presented as part of a functional magnetic resonance imaging paradigm. Results This assessment paradigm was applied to a brief treatment for clients with borderline personality disorder, and the results of pre–post change over time in markers of self‐contempt are presented. Conclusions The importance of the assessment of self‐contempt in an ecologically valid manner, by using individualised stimuli and taking into account multilevel activations, is discussed in the context of a transdiagnostic conception of psychopathology and in the context of change in psychotherapy.
Bibliography:Funding information
Part of this research was supported by the Swiss National Science Foundation, Grant 100014_179457/1 (Dr. Kramer).
Self‐contempt may be assessed both from an observational behaviour perspective and from a neuroimaging perspective.
Practitioner points
Self‐contempt may a central transdiagnostic process that clinicians should take into account.
Assessment of self‐contempt should take into account the emotional engagement, or arousal, of the client with the therapeutic process.
Self‐contempt should be differentiated from other emotional states, such as anger, and emotional variables, such as emotion transformation, in the assessment of a client's problems and resources.
ISSN:1473-3145
1746-1405
DOI:10.1002/capr.12307