The construction of 'self' in individuals with congenital facial palsy; A grounded theory exploration

Davies, Laura

Abstract

Background: Developmental and psychoanalytic research findings suggest that early face to face interactions with caregivers play a significant role in the construction of an individual’s sense of self and that disruptions to these interactions can have negative consequences for social and emotional development. However, there is currently a significant gap in the research literature regarding how the sense of self is constructed in individuals who have limited or no facial expression due to conditions such as congenital facial palsy. Consequently, little is known about how the sense of self develops in these individuals. The aims of this study were twofold: to explore the construction of ‘self’ in individuals living with this condition and to construct a grounded theory of this process. It is hoped that these findings will add to the limited literature in this area and be used to develop specialist psychotherapeutic interventions for those living with this condition.

Method: A constructivist Grounded Theory methodology was adopted, and a purposive sampling strategy used to recruit the initial sample. Semi structured interviews were conducted with fourteen adults (8 male and 6 female) with a diagnosis of congenital facial palsy; eight interviews were conducted face to face with participants in the USA and six via Skype with participants in the UK. In the final stages of the analysis theoretical sampling was used to recruit two parents of children with congenital facial palsy. Participants were asked about their experiences across the lifespan of living with congenital facial palsy and their constructions of self were explored.

Findings: Participants’ retrospective accounts suggest that living with congenital facial palsy negatively influences communications with caregivers and others across the lifespan. Participants’ accounts suggest that two separate self-states were constructed through their interactions with others; a ‘“defective me”’ and a “validated me”. Participants described how the ‘“defective me”’ self-state was constructed through the following relational processes; ‘struggling to make connections’, ‘experiencing invalidation,’ and ‘struggling with affect regulation’. Conversely, several participants described how the construction of a “validated me’’ self-state occurred through; ‘making validating connections’. Those participants who described the ability to move more fluidly between self-states described better psychosocial outcomes as they recovered more quickly from negative interactions with others.

Conclusion: The findings of this study highlight the central role that the face occupies in the construction of the ‘self’ and the unique challenges those with congenital facial palsy are likely to experience in constructing a validated self-state. It is suggested that psychotherapies which focus on healing the non-verbal sense of self may be one effective approach to working clinically with this population.

Citation

Davies, L. The construction of 'self' in individuals with congenital facial palsy; A grounded theory exploration. (Thesis). University of the West of England. Retrieved from https://uwe-repository.worktribe.com/output/1490905

• Thesis Type: Thesis
• Publicly Available Date: Jul 29, 2019
• Keywords: counselling psychology, self, relational psychoanalytic
• Public URL: https://uwe-repository.worktribe.com/output/1490905
• Award Date: Jul 29, 2019