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Self-reflection in illness and health: literal and metaphorical?

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number17091
JournalPalgrave Communications
Issue number1
Published10 Oct 2017

King's Authors


Self-reflection describes a series of processes whereby a person appraises, evaluates or judges themselves. This appraisal can be in terms of physical, psychological or moral attributes. A number of self-reflection tasks have been designed and applied in experimental psychology and clinical settings. What is not known is whether self-reflection is a valid construct for study and whether it has any clinical implications for psychiatric patients deemed to have impaired self-reflection or “insight”. One design is to contrast the appraisal of another person with that of the self. Although it would be useful to measure this appraisal against a gold standard, that is not always possible. Similarly there may be doubt about what the person really thinks as opposed to what they may say. Nevertheless, the simple act of self-reflection can be studied using cognitive neuroscience methods. It appears that a certain brain network, the central midline system (CMS), is engaged in this task. People with mental disorders, especially those at the psychotic end of the spectrum, often see themselves differently from how others see them and the term lack of insight may be used to describe this situation. Recent neuroimaging research has shown that those whose self-appraisal accords most with others, especially their doctors’, show greater activation in the CMS and may have a better clinical outcome. One potential therapeutic approach with such patients to encourage self-reflection has been to make use of literal self-reflection through photographs and video.

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