O'Brien-Venus Bethany, Jenkins Tom, Chadwick Paul
Department of Psychology, University of Bath, Bath, United Kingdom.
Front Psychiatry. 2023 Oct 3;14:1173380. doi: 10.3389/fpsyt.2023.1173380. eCollection 2023.
Meta-dehumanisation and self-dehumanisation have been identified as potentially relevant phenomena for developing a deeper understanding of distress related to voice-hearing, particularly those experiencing voices as part of psychosis. Chadwick has previously argued that those with psychosis, including those who hear distressing voices, typically feel "dehumanised and set apart by their experiences of psychosis and trauma." The present study explores the subjective experience of self-dehumanisation in people who experience distressing voices, which was selected as a useful starting point to inform future research focused on understanding dehumanisation in people with psychosis.
Qualitative data was obtained through twenty semi-structured interviews with self-identifying voice hearers and analysed using reflexive thematic analysis. This followed the recursive six phase procedure of Braun and Clarke, and this was conducted from a critical realist, contextualist position.
Reflexive thematic analysis of participant's experiences produced a core theme, Dehumanisation as the End of Experiential Continua, and six subthemes: Extent of Distressing Sensory Fragmentation; Sense of Belonging with Other Humans; Integrity of Self as a Private, Coherent Entity; Sense of Worth as a Human Being; Strength of Personal Agency; and Trust in Own Credibility and Reliability. Two further themes, The Push and Pull of Dehumanising Forces and Reclaiming Life through Humanising Forces, were identified. Findings were presented to a panel of five experts by experience, all with lived experience of psychosis and service-use; all five strongly endorsed the themes as fitting with and expressing their own experiences of self-dehumanisation.
Reflexive thematic analysis of voice hearers' accounts identified self-dehumanisation as the endpoint where six experiential continua coalesce. Experiential movement along these continua was affected by a range of interpersonal, intrapersonal, and societal forces over time, including dehumanising attitudes of others and voice malevolence and omnipotence. Future research might examine if and how psychological therapies aimed at those experiencing distressing voices, such as people experiencing psychosis may address feelings of self-dehumanisation.
元去人性化和自我去人性化已被确定为可能与更深入理解与幻听相关的痛苦有关的现象，尤其是那些将幻听作为精神病一部分体验的人。查德威克此前曾指出，患有精神病的人，包括那些听到令人痛苦声音的人，通常会感到“因他们的精神病和创伤经历而被去人性化并与他人区分开来”。本研究探讨了经历令人痛苦声音的人的自我去人性化主观体验，将其作为一个有用的起点，为未来专注于理解精神病患者去人性化的研究提供信息。
通过对自我认定的幻听者进行20次半结构化访谈获得定性数据，并使用反思性主题分析进行分析。这遵循了布劳恩和克拉克的递归六个阶段程序，并从批判现实主义、情境主义立场进行。
对参与者经历的反思性主题分析产生了一个核心主题，即“去人性化作为体验连续体的终点”，以及六个子主题：痛苦的感觉碎片化程度；与他人的归属感；自我作为一个私密、连贯实体的完整性；作为人的价值感；个人能动性的强度；以及对自身可信度和可靠性的信任。还确定了另外两个主题，即“去人性化力量的推拉”和“通过人性化力量重塑生活”。研究结果提交给了一个由五名有经验的专家组成的小组，他们都有精神病和使用服务的亲身经历；所有五人都强烈认可这些主题符合并表达了他们自己的自我去人性化经历。
对幻听者叙述的反思性主题分析确定自我去人性化是六个体验连续体汇聚的终点。随着时间的推移，沿着这些连续体的体验运动受到一系列人际、个人和社会力量的影响，包括他人的去人性化态度以及声音的恶意和全能性。未来的研究可能会考察针对经历令人痛苦声音的人，如患有精神病的人，心理治疗是否以及如何能够解决自我去人性化的感受。
