Shame is a major component of many mental health problems and affects symptoms, coping styles, remission, and therapeutic ruptures. There are few qualitative studies aimed at understanding shame and its role for patients diagnosed with depression. In this research, we explored the origins of shame, and the coping strategies that patients diagnosed with depression employ to cope with shame. This qualitative research aimed at an in-depth analysis of shame experiences of adult women who had been diagnosed with depression and treated with cognitive behavioral psychotherapy in a Women Health Center in Turkey. Purposive sampling yielded nine high shame prone adult women who were married and had children. Four semi-structured interviews were conducted with each of the nine participants, and 36 semi-structured interviews were analyzed by Interpretative Phenomenological Analysis. According to the results of the analysis, four themes emerged. These were "substitution of rage for the feeling of shame and unworthiness," "perfection struggle to overcompensate the belief of being inadequate," "feeling shame for their own body and sexual acts," and "need for individuation." The results were interpreted by considering the social context and culture of Turkey, and the clinical implications were discussed.

Bu makale psikoterapi araştırmalarında söylem, anlatı ve konuşma analizinin kullanımı ile psikoterapide değişen anlamın incelenmesine odaklanmıştır. Psikoterapi sürecinin incelendiği araştırmalar terapötik varsayımların kabul edildiği ve sorgulandığı farklı epistemolojik duruşlar esas alınarak aktarılmıştır. Bu bağlamda, vakaya odaklanan ve danışanın problemini, içsel duygu durumunu, bilişsel sürecini yansıtan araştırmalar, terapi ilişki ve terapi etkileşimine odaklanan araştırmalar ve kültürel bağlam, güç ilişkisi, ideoloji gibi makro seviyede psikoterapi sürecini ele alan araştırmalar incelenmiştir. Son olarak psikoterapi araştırmalarında etik ikilemler ve araştırmanın niteliği konuları tartışılmıştır.

ÖzNitel araştırma yöntemlerinin kullanıldığı psikoterapi araştırmaları ile terapi ilişkisi, duygular terapide değişim süreci ve terapist danışan etkileşimi gibi konularda psikoterapide süreç araştırmaları yapılabilmektedir (McLeod, 2001). Konuşma analizi, dilin etkileşimsel dinamiğine odaklandığı için terapi ilişkisinin araştırılmasında tercih edilmektedir (Perakyla, 2004). Bu çalışmanın amacı, bir psikoterapi süreç araştırması olarak, kaçınmanın terapist ve danışan etkileşim sürecinde nasıl ortaya çıktığının ve terapi ilişkisinin bundan nasıl etkilendiğinin anlaşılmasıdır. Şema terapi yaklaşımı ile gerçekleştirilmiş ve terapist-danışan arasındaki kaçınma örüntüsünün ortaya çıktığı üç seans, konuşma analizi ile incelenmiştir. Araştırmanın odağı, terapi diyaloğundaki zayıf anlaşma ve anlaşmazlık bildiren ifadeler, söz kesme, çakışmaları içeren sıra alış organizyonu olmuştur. Analiz sonuçlarına göre şema terapi seanslarında, terapistin, danışanın terapi seansı ile ilgili negatif duygularını derinlemesine analiz etmekten kaçındığı, konuyu değiştirdiği; danışanın ise geri çekildiği ve terapistin terapi diyaloğundaki anlaşmazlığı onaramadığı gözlenmiştir. Terapist ve danışan arasındaki kaçınma örüntüsünün analiz edilmesi terapötik ittifakta kırılma ile ilgili bilgi vermesi açısından önemlidir. Terapist ve danışanın kaçınma davranışlarının etkileşimi, terapötik ittifakta kırılma ve şema terapi mod modeli bağlamında tartışılmıştır AbstractPsychotherapy process research can be conducted to analyze therapeutic relationship, emotions, change process in therapy and therapist-client interaction by using qualitative research methods (McLeod, 2001). Conversational analysis is preferred with its main focus on interaction within dialogue, to investigate therapeutic relationship (Perakyla, 2004). This study as a psychotherapy process research aimed at analyzing the avoidance within therapist-client interaction and its effect on therapeutic relationship. Conversational analysis of three schema therapy oriented sessions which represented the avoidance pattern of therapist and client were explored. The focus was on weak agreement and disagreement in the dialogue, interruption and overlap within turn taking organization. Over the course of schema therapy sessions, it was observed that therapist avoided deeply analyzing client's negative emotions related to therapy and changed the topic. Besides, client was withdrawn, and therapist could not repair the disagreement in the therapeutic dialogue. Investigating avoidance patterns of psychotherapist and client was important to uncover therapeutic rupture. Interaction of avoidance behaviors of client and therapist was discussed in terms of therapeutic alliance rupture and schema therapy model.

Intrusive thoughts and repetitive behaviors are very diverse and occur in numerous forms but people with such different forms of symptoms are diagnosed under the category of obsessive-compulsive disorder (OCD) in the symptom-based system. The social constructivist approach, which is having an increasingly and substantial impact on psychotherapy research, emphasizes the subjectivity of individuals since the therapeutic field focuses on one-on-one work. Although studies on psychotherapy and language use are expanding, specifically the subjectivity of people labeled with the obsessive-compulsive disorder has not yet been studied by using a combination of qualitative, discursive, critical, and language-based perspectives. The main purpose of this study is to critically evaluate the symptom-based diagnosis in the therapeutic process especially OCD symptoms, with a particular emphasis on the subjectivity of people and their discursive practices. For this aim, interviews were conducted with six participants, who diagnosed with OCD and selected via purposive sampling method. As for the qualitative analysis, critical and Lacanian Discourse Analysis perspectives were utilized. The analysis revealed that the participants’ basic signifiers, positioning, and relationships with the Other were quite distinct, although they were all diagnosed under the same category of OCD. Additionally, differentiated discourses of the patients and gender differences emerged crucial issues, that were discussed considering literature. These findings suggested that individuals should be carefully listened to within their subjectivity and psychological structures rather than being broadly categorized based on their symptom similarity. Based on the findings, the current study presents a diagnostic debate and key clinical implications.

Aims Our study focused on a self‐soothing system and analysed how women feeling shame experienced compassion‐focused group intervention with schema therapy techniques. Group schema therapy, which is process‐oriented and person‐oriented (Farrell & Shaw, 2012), inspired us to combine schema therapy techniques with Compassionate Mind Training in the interventions for this study. Methods Data were collected through the programme that comprised 2‐hr sessions over a period of 10 weeks and self‐compassion and self‐criticism diaries of women. Analysis Data analysis was conducted according to the phases of thematic analysis (Braun & Clarke, 2006). Twenty hours of group sessions (2 hr per session) and follow‐up sessions were audio recorded and transcribed. Thematic analysis was conducted to analyse 26 hr of group intervention and follow‐up sessions and also women's self‐compassion and self‐criticism diaries, to understand how shame‐prone women experienced change process. Findings Thematic analysis of the group sessions yielded two superordinate themes: overcoming the threat of compassion and the process of change. Overcoming the threat of compassion was divided into three subthemes; fear of self‐compassion, the difficulty of accessing the vulnerable child side, and feeling anger at others and self. The process of change involved two subthemes; the feeling of acceptance, and recognising self‐compassion and its sources in the self. When the women could access their self‐soothing system, they could better understand the needs of their vulnerable child side and address these needs by transferring the emotions of compassion to their vulnerable child side.