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The present qualitative study aims at investigating the role of socio-relational variables in the construction of threats to self-esteem, grandiosity, and relaxation in a non-clinical sample of 35 young university students. The work provides fresh experimental evidence of the structural analogy observed in clinical settings between constructions of threat to self-esteem and grandiose fantasies. We hypothesize that the relational dimension would be more strongly present than either biological or psychological dimensions.The results show that descriptions of relaxation differ significantly from their characterizations of the other two domains. Specifically we found greater continuity and narrative connection between the aspects of threat and grandiosity, while the domain of relaxation showed a more “isolated” pattern.
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38 The Open Psychology Journal, 2015, 8, 38-43
1874-3501/15 2015 Bentham Open
Open Access
Narcissism and Defending Self-Esteem. An Exploratory Study based on
Guido Veronese1,*, Rossella Procaccia2, Giovanni M. Ruggiero3, Sandra Sassaroli3 and
Marco Castiglioni1
1Department of Human Sciences, University of Milano-Bicocca, Italy
2University e-Campus, Novedrate (LC), Italy
3Studi Cognitivi, Psychotherapy School, Milano, Italy
Abstract: The present qualitative study aims at investigating the role of socio-relational variables in the construction of
threats to self-esteem, grandiosity, and relaxation in a non-clinical sample of 35 young university students. The work
provides fresh experimental evidence of the structural analogy observed in clinical settings between constructions of
threat to self-esteem and grandiose fantasies. We hypothesize that the relational dimension would be more strongly
present than either biological or psychological dimensions.The results show that descriptions of relaxation differ
significantly from their characterizations of the other two domains. Specifically we found greater continuity and narrative
connection between the aspects of threat and grandiosity, while the domain of relaxation showed a more “isolated”
Keywords: Grandiose fantasies, threat to self-esteem, non-pathological narcissism, self-characterzation, qualitative methods.
As defined by DSM IV-TR [1], the distinctive traits of
patients with Narcissistic Personality Disorder (NPD)
include grandiose fantasies of power, success and/or
superiority; a feeling of entitlement; and an inability to
appreciate the successes and good qualities of others [2].
Horowitz [3] suggested that grandiose states are actually a
defensive manoeuvre with the function of mitigating feelings
of low self-esteem and masking a deep-lying sense of
inferiority and shame. Through their grandiose fantasies,
narcissists attempt to protect themselves from criticism and
humiliation, both of which they experience as intolerable [4-
13]. All narcissistic subjects perceive themselves at some
level to be excluded, despised and ostracized [2, 14, 15].
Veronese and colleaugues [16] reported empirical
evidence of an interconnection between grandiose fantasies
and fantasies of threats to self-esteem in a study with a non-
clinical sample; in contrast, evoking relaxing scenarios has
been found to distract subjects from narcissistic contents
The current study was underpinned by a systemic-
constructionist perspective, which attributes a primary role to
intersubjectivity and social (particularly familial) relations in
the origin, development and maintenance of the self and
*Address correspondence to this author at the Department of Human
Siences, Univesity of Milano-Bicocca, Piazza dell‟Ateneo Nuovo 1, 20126,
Milano, Italy; Tel: +39 2 64484800; Fax: +39(0)264484863;
identity, whether typical or atypical. In this approach, the
relational context is viewed as “complex”, including in
addition to “traditional” dyadic relationships, interactions
among three or more participants [18-23].
The aim of the study was to conduct a qualitative
exploration of how narcissistic defensive structures may
contribute to increased risk of loss of self-esteem in non-
pathological individuals. Specifically, we examined the
construct system of a sample of university students, with a
view to advancing understanding of non-pathological
narcissistic mechanisms and informing theoretical reflection
on analogous traits of pathological narcissism [6, 24].
One of the peculiar traits of narcissism, whether in the
context of a healthy and balanced personal identity [25] or of
a pathological personality type [2, 6] is a marked difficulty in
building and maintaining significant “warm” relationships
with others. Narcissistic individuals‟ preoccupation with
rank and their continuous monitoring of relationships
perceived as threatening prevents them from committing to
warm relationships or forming strong relational bonds. This
also explains why one of the key challenges in
psychotherapy with persons affected by NPD is building a
satisfactory therapeutic alliance between patient and
therapist. The primary outcome of this difficulty in
establishing relationships is the tendency to exploit
relationships to achieve the narcissist‟s own ends in cases of
non-pathological narcissism, and a self-perpetuating cycle of
rupture and repair of the psychotherapist-patient therapeutic
alliance in the case of pathological narcissism [26]. Both in
Narcissism and Defending Self-Esteem The Open Psychology Journal, 2015, Volume 8 39
the case of NPD and in that of non-pathological narcissistic
traits, a fear of relationships perceived as threatening appears
to have a crucial influence on the construct systems of
individuals. Nonetheless, few studies reported in the
literature have explored the narcissistic personality from a
relational perspective or attempted to explain the relational
characteristics of the narcissistic personality [24, 27, 28]. It
would almost appear that the relational domain is treated as a
superordinate category mediated by individual variables of
the psychological, emotional and behavioural kinds [7-9].
Given the theoretical background just outlined, our
research aim was to investigate the role of socio-relational
variables in the construction of threats to self-esteem,
grandiosity, and relaxation. Specifically, we hypothesized
that the relational dimension would be more strongly present
than either biological or psychological dimensions.
A further aim was to provide fresh experimental
evidence, in a non-clinical sample of young university
students, of the structural analogy observed in clinical
settings between constructions of threat to self-esteem and
grandiose fantasies; we also hypothesized that participants‟
descriptions of relaxation would differ significantly from
their characterizations of the other two domains. Specifically
we expected that there would be greater continuity and
narrative connection between the aspects of threat and
grandiosity, and that the domain of relaxation would present
a more “isolated” pattern.
Thus, we set out to use qualitative analysis of self-
characterizations [29], to verify whether, and to what extent,
relational aspects prevail over psychological and biological
aspects in the defence strategies that individuals normally
activate to protect themselves from threats to their self-
esteem. In our view, threats themselves are also more
relational in nature than psychological and biological. Thus,
structural similarities between the threatening and
“protective grandiose” contents of the self in individuals‟
self-characterizations would suggest the hypothesis that a
coping strategy of using grandiose fantasies to protect the
self from threats to self-esteem is ineffective and
counterproductive. We therefore also set out to explore via
the self-characterization task whether, as suggested in the
literature, relaxation strategies may not represent a valid
alternative to the use of the grandiose self in coping with
threats to self-esteem.
Instrument and administration procedure
A purposive convenience sample of 35 university
students (average age 22.5; sd 3.2) was asked to write a self-
characterization [30]. In order to protect participants‟
anonymity and privacy, they were asked to identify
themselves with a nickname that did not reveal their true
identity. They were given as much time as necessary, in
practice between 25 and 45 minutes, to compose their self-
The specific instructions provided were as follows:
“First of all, please choose a nickname for yourself (for
example your initials followed by your date of birth).
Write your nickname on each of the sheets that you are
given. Try to choose an “original” nickname to prevent
you from being confused with another respondent.
Now, please write a character sketch of yourself, just as if
you were the main character in a play. Write it as it might
be written by a friend who knew you very intimately,
perhaps better than anybody else. Be careful to use the
third person. For example, begin by saying X
(= nickname) is …”.
The task was administered to all participants at one
Data analysis
The self-characterization texts were subjected to content
analysis. We used the software for textual analysis Atlas-Ti
to define the relationships between semantic nodes
ascribable to our three preordained families (or clusters) of
threat, grandiosity and relaxation and to a further three
families of codes predefined on the basis of the bio-psycho-
social model [31]. Thus nine families of codes were created
in all: the families of biological, psychological and relational
codes (dimensions), distributed across three macro-families
or domains: threat, grandiosity and relaxation.
Atlas-Ti is a software for the coding and analysis of texts.
The analytical procedure involves importing the text, reading
it closely, and then selecting words, phrases or paragraphs
(quotations) to link to a series of conceptual categories
(codes). The data may subsequently be exported to statistical
packages such as Spss for the purposes of quantitative
investigation. One of the advantages of Atlas-Ti is that
aggregate codes, individual codes or citations may be easily
retrieved in real time. This function is useful both during the
analysis phase and for the purposes of calling up fragments
of text for inclusion in the research report. As well as
allowing analysis to be conducted rapidly and flexibly, the
programme is suited to the treatment and manipulation of
large quantities of data. In the present study, after a first
“free” coding stage carried out by a researcher whose brief
was to stay as closely as possible to the text, the initial codes
were classified and relabelled (e.g., “strong self-esteem”;
etc..) via inter-judge discussion, and then grouped into three
clusters: the first cluster contained all the fragments of text
ascribable to a semantic universe of threat to self-esteem,
namely descriptions, adjectives or nouns that could be
perceived as undermining a positive self-image (e.g., “feels
inadequate”, etc.); the second cluster was related to the
semantic universe of “grandiosity”, that is to say, all
descriptions that could be read as attempts to defend the self
from threat by defining it positively, in terms of self-
efficacy, relational success, etc.; the third cluster was made
up of nouns, adjectives and descriptive phrases that reflected
an attempt on the part of the respondent to relax without
invoking either positive or negative definitions of self (e.g.,
“winds down while painting”). The coders then subdivided
each of the three clusters of threat, grandiosity and relaxation
into three dimensions: the first grouped together descriptions
focusing on the body and physiological states (biological
dimension), the second contained references to inner and
psycho-emotional experience (psychological dimension),
while the third contained fragments of text describing
40 The Open Psychology Journal, 2015, Volume 8 Tani et al.
respondents‟ social and relational lives (relational
dimension). Finally the coders defined a series of logical-
semantic connections (such as code A is related to B, A is
part of B, A causes B, A is a property of B, etc.) among the
codes from the three bio-psycho-social dimensions and the
three domains of self-description (self under threat,
grandiose self and “relaxing” to distance the self from
The self-characterizations reflected a tendency for
individuals to describe themselves predominantly in
psychological and relational terms (see Table 1). The
tendency to describe the self in terms of the bodily
dimension was far more limited (see Fig. 1). The relational
dimension was slightly more prominent than the
psychological dimension in terms of number of occurrences
(quotations) and frequency of codes. References to the
biological dimension were far less numerous and frequent.
The frequency of psychological and relational codes in the
threatening and grandiose domains was almost equal,
whereas these domains contained drastically fewer
references to the biological dimension.
The domains of threat and grandiosity were characterized
by highly similar semantic structures. In both cases, the
semantic network of the psychological dimension revolved
around the “node” of “self-esteem” (see Figs. 2 & 3), and
that of the socio-relational dimension around nodes
concerning significant relationships and themes of social
belonging and loneliness.
In contrast, the domain of relaxation was characterized
by a completely different semantic structure and self-
descriptive modes to the other two domains: the prevalent
meanings were those related to the sphere of religion and
self-liberating practices, which allowed respondents to
detach” from the issues of belonging and self-esteem. Thus
this dimension appeared to be totally independent of those of
threat and grandiosity. The attempts to relax described in the
self-characterizations were never relational in nature (see
Fig. 3) [32].
Thus, in general, the threatening and grandiose
descriptions formed similar semantic networks, as though
personal identity were in constant and unstable equilibrium
between a threatened self and a grandiose form of
narcissistic defence. It appears that the more individuals try
to defend themselves from threats to their identity by raising
the shield of narcissistic grandiosity, the more the self feels
threatened by the failure of this strategy of “positive self-
description”. Subjects become trapped in a vicious cycle that
does not allow them to distance themselves from the
continuous battle between their need to define themselves
positively and humiliating attacks on their self-esteem [7-9].
Table 1. Frequency of biological, psychological and relational codes in the domains of grandiosity, relaxation and threat.
Fig. (1). Graphic representation of grandiose traits, threat and relaxation in the biological dimension.
Narcissism and Defending Self-Esteem The Open Psychology Journal, 2015, Volume 8 41
Fig. (2). Graphic representation of grandiose traits, threat and relaxation in the psychological dimension.
42 The Open Psychology Journal, 2015, Volume 8 Tani et al.
Fig. (3). Graphic representation of grandiose traits, threat and relaxation in the relational dimension.
The results appear to confirm our hypothesis regarding
the key importance of the socio-relational dimension in
relation to threat and grandiosity. This dimension also plays
a key role in the domain of relaxation, although in this
context bodily and physiological contents are equally present
and salient.
At the clinical-interpretative level it would appear that
the “public” (whether made up of one or more other persons)
is of vital importance, both in situations of threats to self-
esteem and in grandiosity [33, 14, 15]. In contrast, when
subjects wish to relax they focus on fantasies that involve the
physical-bodily and psychological dimensions rather than the
relational one.
With regard to triadic/polyadic interactions, our results
confirm that triadic contexts do not feature in people‟s
“common sense” schemas [34]: subjects tend to think of
interactions predominantly in dyadic terms. However it is
interesting to note that the highest frequency of
triadic/polyadic interactions occurs in relation to threats to
In sum, our findings provide further evidence for the
structural similarities between the domains of grandiosity
and threats to self-esteem hypothesized in the literature [3,
35, 36]. In contrast, relaxation appears to follow a pattern of
its own. This suggests that narcissists‟ attempts to protect
their self-esteem via grandiose manoeuvres only reinforce
the very sense of threat and feelings of inadequacy from
which they are desperately trying to protect themselves. A
more effective distancing strategy could be to progressively
train themselves to focus on whatever they find relaxing. It is
most likely that narcissists seek “refuge” in grandiose
fantasizing because they have difficulty protecting
themselves from threats to their self-esteem by drawing on
strategies that help them to relax [32].
Naturally some limitations of the present work should be
noted. Firstly, while our findings provide useful guidance for
weight issues
insecure about physical
has strong self-esteem
prepared to be self-critical
likes to do their best
adjusts to situations
Narcissism and Defending Self-Esteem The Open Psychology Journal, 2015, Volume 8 43
the formulation of hypotheses to be extended to patient
populations, they may not be reliably generalized in that the
data was drawn from a non-clinical sample. The
low numerosity of the sample, and the uneven gender
distribution and young age of the participants, also prevents
us from viewing the results as definitive. Nevertheless, it
must be noted that in the qualitative research samples must
be large enough to provide a set of data to explain the
phenomenon we want to study, but at the same time if the
sample is too large data becomes redundant and superfluous.
Summing up in this study the authors followed the principle
of saturation [37]; that is when new data are not able to add
any further explanation on the research‟s questions under
The authors confirm that this article content has no
conflicts of interest.
Declared none.
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Received: October 25, 2014 Revised: January 30, 2015 Accepted: February 02, 2014
© Veronese et al.; Licensee Bentham Open.
This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (
ses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
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... An alternative perspective is that of quantitative analysis, which has attracted increasing interest over the last 50 years and is based on the idea that given characteristics of language or word use may be counted and statistically analyzed [39][40][41][42][43][44]. Much research informed by this perspective has investigated linguistic style, or how people tend to express themselves using specific types of words, independently of the context and semantic content of their utterances (see [30]). ...
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COVID-19 broke out in China in December 2019 and rapidly became a worldwide pandemic that demanded an extraordinary response from healthcare workers (HCWs). Studies conducted during the pandemic observed severe depression and PTSD in HCWs. Identifying early predictors of mental health disorders in this population is key to informing effective treatment and prevention. The aim of this study was to investigate the power of language-based variables to predict PTSD and depression symptoms in HCWs. One hundred thirty-five HCWs (mean age = 46.34; SD = 10.96) were randomly assigned to one of two writing conditions: expressive writing (EW n = 73) or neutral writing (NW n = 62) and completed three writing sessions. PTSD and depression symptoms were assessed both pre- and post-writing. LIWC was used to analyze linguistic markers of four trauma-related variables (cognitive elaboration, emotional elaboration, perceived threat to life, and self-immersed processing). Changes in PTSD and depression were regressed onto the linguistic markers in hierarchical multiple regression models. The EW group displayed greater changes on the psychological measures and in terms of narrative categories deployed than the NW group. Changes in PTSD symptoms were predicted by cognitive elaboration, emotional elaboration, and perceived threat to life; changes in depression symptoms were predicted by self-immersed processing and cognitive elaboration. Linguistic markers can facilitate the early identification of vulnerability to mental disorders in HCWs involved in public health emergencies. We discuss the clinical implications of these findings.
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Aim. Little research has focused on hypersensitive narcissism in Slavic countries. One of the reasons for that is the absence of suitable inventories. The present study aims to make the Ukrainian adapted translation of the Hypersensitive Nar-cissism Scale (HSNS) and to check for its psychometric properties in a non-clinical sample. Methods. To prepare materials, we first conducted a double-blind translation procedure with further linguistic analysis. The following two empirical studies to collect data for statistical analysis were then made. Results. The data shows adequate internal consistency and scale validity, as well as a three-factor structure (obtained with the principal components analysis [PCA]), in line with the theoretical background. However, the confirmatory factor analysis (CFA) and Cronbach's alphas analysis yield the unidimensional scale to be the best fit for the Ukrainian version. The data also support evidence for maladap-tive social relationship patterns of people with high HSNS scores. Conclusion. We proved vulnerable and grandiose narcissism are qualitatively different phenomena and showed how a cultural context of nar-cissism manifestation may be reflected through social interactions and self-attitude. HSNS in Ukrainian is a reliable and valid tool for complex psychological personality research among non-clinical adult samples. Practical application. The proposed translation of the HSNS is adapted to be used for research in Ukrainian culture, with Ukrainian-speaking respondents and psychologists' and psychotherapists' clients.
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The purpose of this study was to determine the relationship between self-esteem and risk taking with adolescent narcissistic behavior using social media. This study uses self-esteem variables (X1) and risk taking behavior (X2), as well as narcissism as the dependent variable (Y). This study uses Google Forms in data collection and uses a quota sampling technique, meaning that the number of samples used has been determined. In this study, a sample of 150 teenagers aged 12-24 years old and active users of social media for 2 years was used. Based on regression analysis, it shows that self-esteem and risk-taking behavior simultaneously have a relationship with the narcissistic behavior of adolescent social media users with a p value = 0.000 and an effectiveness contribution of 14.1%. Partially, self-esteem has a significant relationship with the narcissistic behavior of adolescent social media users with p value = 0.001 in a negative direction, in contrast to risk taking behavior which has no partial relationship with the narcissistic behavior of adolescent social media users.
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The study explored the qualitative features of: a) memories of threat to self-esteem, b) grandiose fantasies and c) relaxing scenarios, experimentally induced in a non-clinical participant sample. A group of 103 young university students produced and transcribed personal memories of threat to self-esteem, grandiose fantasies and relaxing scenes. A five point scale was designed ad hoc to enable three independent raters to assess the biological, psychological and relational contents of each of the texts. Inter-rater agreement was satisfactory. Memories of threat to self-esteem and grandiose fantasies were mainly socio-relational, while relaxing scenarios were characterised by both relational and biological elements. With reference to the biological dimension, there was also significant correlation between memories of threat to self-esteem and grandiose fantasies.
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Narcissism is a complex phenomenon, involving a level of defensive self-enhancement. Narcissists have avoidant attachment styles, maintain distance in relationships and claim not to need others. However, they are especially sensitive to others’ evaluations, needing positive reflected appraisals to maintain their inflated self-views, and showing extreme responses (e.g. aggression) when rejected. The current study tested the hypothesis that narcissists also show hypersensitivity in brain systems associated with distress during exclusion. We measured individual differences in narcissism (Narcissistic Personality Inventory) and monitored neural responses to social exclusion (Cyberball). Narcissism was significantly associated with activity in an a priori anatomically defined social pain network (anterior insula, dorsal anterior cingulate cortex and subgenual anterior cingulate cortex) during social exclusion. Results suggest hypersensitivity to exclusion in narcissists may be a function of hypersensitivity in brain systems associated with distress, and suggests a potential pathway that connects narcissism to negative consequences for longer-term physical and mental health—findings not apparent with self-report alone.
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Narcissism has been conceptualized as involving attempts to defend against negative self-schemata (implicit negative beliefs about one's own self-worth). This idea has been termed the 'mask model of narcissism'. This study explores the mask model, examining the association between extreme narcissistic personality traits and performance on a task purported to assess the influence of negative self-schemata. Participants (n = 232) from the UK and the UAE completed the Narcissistic Personality Inventory and also performed an incidental learning task involving the surprise recall of self-referential adjectives (traits). A greater recall of negative adjectives was viewed as indicative of negative self-schemata. Looking at the sample as a whole, there were no associations between narcissistic traits and negative adjective recall. However, amongst those scoring in the upper quartile of the Narcissistic Personality Inventory, narcissism scores were positively correlated with the recall of negative adjectives even after controlling for age and memory. Narcissism may reflect self-enhancement strategies rooted in negative self-beliefs. Copyright © 2012 John Wiley & Sons, Ltd.
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A narcissistic personality can be seen as arising from a number of separate dimensions of mental life: (a) a characteristic set of states of mind; (b) alterations in metacognitive skills—in particular a difficulty in accessing one's own inner states, desires, and emotions—and a difficulty in under-standing another's mind from a decentrated perspective; (c) the sensation that experiences are not being shared with a relevant other and that one does not belong to real-life groups; (d) characteristic methods of regulating one's self-image and self-esteem through cognitive biases; (e) the use, in most cases, of values, rather than emotional experience and interpersonal regula-tion, for regulating behavior; and (f) characteristic dysfunctional interper-sonal cycles. In this work the authors propose an integrated model that describes how the disorder perpetuates itself and suggest some hierarchies of importance between the elements portrayed above. Over the past 30 years, starting with the work done by Kohut (1966) and Kernberg (1967), many researchers have described the various aspects that make up a narcissistic personality. In this article we first try to identify its fundamental elements. After that we propose a psychopathological model describing the hierarchies of importance between the various
This is a comprehensive, up-to-date introduction to the origins, development, and practice of cognitive-analytic therapy (CAT). Written by the founder of the method and an experienced psychiatric practitioner and lecturer, it offers a guide to the potential application and experience of CAT with a wide range of difficult clients and disorders and in a variety of hospital, community care and private practice settings. Introducing Cognitive Analytic Therapy includes a wide range of features to aid scholars and trainees: Illustrative case histories and numerous case vignettes Chapters summaries, further reading and glossary of key terms Resources for use in clinical settings Essential reading for practitioners and graduate trainees in psychotherapy, clinical psychology, psychiatry and nursing.
The gap between psychotherapeutic practice and clinical theory is ever widening. Therapists still don't know what role interpersonal relations play in the development of the most common psychopathologies. Valeria Ugazio bridges this gap by examining phobias, obsessive-compulsions, eating disorders, and depression in the context of the family, using an intersubjective approach to personality. Her concept of “semantic polarities” gives a groundbreaking perspective to the construction of meaning in the family and other interpersonal contexts. At no point is theory left in the wasteland of abstraction. The concreteness of the many case studies recounted, and examples taken from well-known novels, will allow readers to immediately connect the topics discussed with their own experience.
The term “voice therapy”, which is commonly called “onsei-chiryou” in Japanese, includes vocal rest, vocal hygiene, and vocal modification training. In this paper the focus of the discussion was on vocal modification training, which is called “onsei-kunren” in Japanese. In most cases, speech therapists should be responsible for vocal modification training. The purposes, conditions for application, and 6 categories of the training were proposed. Among the categories, the rationale and training procedures for the modification of loudness, pitch, and voice quality were explained concisely. In order to demonstrate some clinical results of the efficiencies of vocal modification training, previously presented results for cases of functional voice disorders, vocal nodules of children, and spasmodic voice disorders were reported. Finally, 5 essential issues when conducting voice therapy were pointed out. They were ; (1) establishing the criteria for the application of therapy, (2) developing the technical skills with the theoretical bases, (3) the effort to assess therapy outcomes objectively, (4) an efficient team approach with medical doctors and speech therapists, and (5) to provide the patients with warm and helpful advice to reduce their psychological and social problems with voice disorders.
Systemic therapists assume, but have not yet proved that ordinary people: (i) normally do not use triadic thinking and (ii) are able, thanks to therapists' interviewing techniques, to construct triadic explanations. To test these assumptions this study analyses the explanations provided by 400 undergraduates of an unexpected piece of behaviour framed in four stimulus situations where the breadth of the observation field was manipulated. The results show that triadic explanations are unusual and increase with the widening of the field of observation from the monad to the triad. It is the ‘enigmatic’ triadic situation – adding a puzzling discrepancy between the actors' forms of behaviour – that elicits more triadic explanations. This suggests that therapists should explore with clients the contradictions disclosed by the widening of the field of observation and support reframings actively co-constructed with them instead of ‘pre-packaged’ ones.