Masters Dissertations
Masters dissertations which achieved a mark of over 60% pre September 2016, and 70% post September 2016.
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Recent Submissions
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Attunement in Art PsychotherapyBackground: British art psychotherapy in 2020 is influenced by an integrative psychodynamic and ‘affective neuroscience’ approach, which measures emotions or feelings (‘affects’) embodied in brain processes – such as the firing of ‘mirror neurons’ – and relates them to intersubjective inner processes of the unconscious such as ‘attunement’. Attunement is frequently confused with related concepts such as empathy; these concepts have been correlated with successful therapeutic outcomes, so it is important to break them down into essential, operational components in order to apply them to theory, research and practice. In art psychotherapy these interpersonal processes take place within the multidimensional ‘triangular’ relationship between client, therapist and image. Research Question: What are the essential components of the concept of ‘attunement’, and how has this been operationalised in the art psychotherapy literature? Method: From a subjective/constructivist/‘metaphorist’ paradigm and using a qualitative approach, Walker and Avant’s eight-step concept analysis method is applied to 25 primary literature sources with ‘attunement’ in their titles. Additionally, 16 snowballing reference sources and 43+ articles published in BAAT’s Inscape/International Journal of Art Therapy (IJAT) are examined for their uses and operationalisation of attunement. Findings: Attunement is a mutual, automatic/unconscious, ongoing process which ‘recasts’ the outward expression of the same shared affect into a different form or modality matching in ‘activation contour’ (intensity, shape, rhythm, etc.), e.g. a sound into a movement, or the creation of an image into words. This ‘recasting’ is what distinguishes attunement from emotional ‘contagion’ and mirroring; empathy is more conscious/intentional. There are differing levels of attunement, and ‘moderate’, with ruptures and repairs, appears to be the most developmentally and therapeutically effective. Key conclusions/recommendations: Articles in IJAT refer to attunement with increasing frequency and scholarly citation/definition over time, although there appears to be ongoing misunderstanding of the concept. Several authors describe attunement with the image, and it has been suggested that this can generalise over time to attunement with the therapist, the self, and others. Future research could use video analysis and physiological measures to investigate ‘moderate’ attunement with the image and therapist, and how the rupture/repair cycle applies to art psychotherapy.
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Pre-registration student nurses’ perceptions of their learning experiences during the Covid 19 pandemic – an Interpretive Phenomenological AnalysisBackground The Covid 19 (C19) pandemic led to social distancing and academic institutes moved to online delivery with changes made to practice placements. Student Nurses (SNs) faced unique challenges due to these changes and the full impact is still unknown. Sample and Setting Five SNs from one North West England university. Data Collection and Analysis Semi structured interviews were transcribed and analysed using the IPA approach. Findings Four Group Experiential Themes were created. The SNs perceived that they had experienced an Impoverished programme, isolation, fear, and financial hardship. Conclusion Although the full impact of the C19 pandemic is not yet known, the results of this study demonstrate gaps in practice, in both the practical and theoretical components. Although further research is necessary, the SNs did offer solutions to the issues they experienced. Recommendations Training in pandemic preparedness for academics, students and practice partners; mandatory digital training for students and academics; experience of online blended learning; a buddy system and small study groups to be created; extra curricula fun activities, specifically for SNs; mandatory mental health and motivational interviewing training for academics and students, with an exploration of how this can be delivered to practice partners; raising awareness of funding and lobbying for funding for exceptional circumstances.
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Hope as an indicator of successAbstract available in hard copy
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Head and tails: corporeal boundaries in the early Anglo-Saxon mortuary areaAbstract available in hard copy
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The development of elementary education in Chester, 1800-1902Abstract available in hard copy
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Frequency domain methods for continuous and discrete volterra equationsAbstract available in hard copy
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Behavioural and hormonal responses of callitrichid monkeys to relocationAbstract available in hard copy
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The Other F Word: A Qualitative Exploration of the Impact of Fatness in the Counselling RoomIt is widely acknowledged that rates of ‘obesity’ worldwide are rising, alongside an increasing prevalence of anti-fat attitudes within Western society. It is also widely acknowledged that anti-fat bias can have an adverse impact on the mental and physical health of an individual, therefore, there is potential for more fat clients to access counselling in general, or to access it specifically to address their own body image or effects of anti-fat bias. This study aimed to explore the lived experiences of individuals who identify as fat or plus size and have received some form of therapeutic counselling, to shed light on whether their fatness had any impact on their counselling experience. This study also aimed to increase counsellors’ awareness of any biases and stigma around fatness that clients may face. Data was collected through semi-structured interviews and Interpretative Phenomenological Analysis was then used to analyse the data. Four Group Experiential Themes emerged which encapsulated the differing meanings and connotations associated with the term fat, the many ways participants felt their daily lives are impacted by their fatness, the impact participants felt their fatness had on their experience of counselling, and how participants felt there is a lack of training and awareness around fatness within the counselling profession. The findings support established literature around the prevalence of anti-fat bias in all aspects of life and its impact on mental health, and also supports emerging literature around the presence of anti-fat bias within the counselling profession. This study provides important insights and indicates that client fatness does impact on their experience of counselling, in numerous ways, and therefore warrants further study. This study suggests counsellors should be aware of how their counselling space and their interactions with fat clients can impact on how they experience counselling and their therapeutic journey.
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Food Literacy: Insights from UK Nutrition and Health Professionals on an Emerging ConceptReview paper abstract: Today’s foodscape is characterized by an abundance of unhealthy food and food practices, and evidence suggests that this has negatively impacted on people’s health and wellbeing, leading to the modern malnutrition of obesity and chronic diseases. Food literacy concept has emerged as a promising tool to help people navigate the food system in a health-enhancing manner and so, take control over their dietary practices and behaviours. Food literacy has built momentum by being employed either implicitly or explicitly in dietary interventions, and this led to an increased interest of researchers to establish a shared meaning of the term. This study aimed to explore the current understanding of the food literacy concept and, possibly identify any gaps in the existing literature that may help reach a consensus on its definition and conceptual framework. For this purpose, it provided an overview of the food literacy definitions, components and competencies as well as its association with other health-related concepts, such as nutrition and health literacy. It followed a systematic review approach and discussed 19 paper articles which were selected based on their contribution to the conceptual framework of the term and the understanding of its relationship with other health-related concepts. Although a relatively novel concept, many variations of the definitions, components and competencies of food literacy could be identified in the current literature. This suggests that food literacy concept is subject to the environmental dynamics and, therefore, it calls for understanding and conceptualization in the light of one’s personal and environmental experiences. A gap in the existing literature concerned with food literacy education has been identified through the absence of any research on this topic conducted in the UK context. Research paper abstract: Globally, food systems continue to grow in complexity and, consequently, it becomes more difficult for people to engage in healthy food practices. This ‘food confusion’ may lead to unhealthy eating patterns and, consequently to diet-related diseases. This concern urged health practitioners and public health policy-makers to find optimal solutions to re-connect people with their food in a health-enhancing manner. The ‘food literacy’ concept emerged as a promising tool to foster positive food relationships and so, help people maintain and improve their health. It has been argued that the components and competencies of food literacy are not static but influenced by one’s personal and environmental experiences. There are many variations of the food literacy definition and competencies, however, this concept has not been explored and defined in the UK context. This study aimed to explore the food literacy concept, its defining components and key determinants in the UK context. The objectives were to capture the views of UK health and nutrition professionals on this emerging concept and construct a conceptual framework of the term. The World Café research technique was employed to explore participants’ understanding of the concept of food literacy and the thematic analysis method was used to analyze their views on this topic. The findings revealed a wide range of competencies clustered into two main domains: Applied Food Education and Empowerment and Food Ethics. Key determinants impacting on food literacy were identified at two levels: Agency (personal capabilities) and Structure (System capabilities). The conceptual framework of food literacy as understood in the UK context as well as identifying the influencing factors may help UK health practitioners and public health policy-makers to use food literacy explicitly in health-promoting dietary interventions and food education programmes.
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An exploration of the tensions experienced by bisexual men in long-term, monogamous, mixed-orientation relationships, whose bisexuality is known to their partners: Implications for counsellingThis research explores the tensions encountered by bisexual men who are in a long-term monogamous relationship with someone who does not identify as bisexual, in the circumstance of their bisexuality being known to their partner. It was anticipated that tensions and partner anxieties would arise from preconceptions of bisexual men, as described in the literature. Semi-structured interviews were conducted with six bisexual men. The interview transcripts were analysed using Interpretative Phenomenological Analysis. The analysis uncovered three main themes: formative experiences; fear and longing; and the relationship. Within these themes, the participants revealed how formative experiences have left them aware that a part of them which they experience as fundamental may be met with rejection, stigma, denial, incomprehension, and misconceptions. The second theme revealed how the tension between the desire to be known and live authentically on the one hand, and the desire to be safe from rejection and stigma on the other, creates situations of living with partial disclosure, vigilance and caution, and inauthenticity. In the third theme, romantic relationships were shown to bring opportunities for being known and accepted; the possibility of rejection; further restrictions to living authentically; and the onus of answering to partner anxieties. Additionally, an incongruence was observed between participants’ averred feelings about their relationships and implicit feelings about the terms of their acceptance. The implications of the findings for counselling are considered from a person-centred perspective.
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The Counsellor’s Experience of Aloneness And Its Impact on The Therapeutic Relationship: A Heuristic StudyAims and Method: This small scale study explored counsellors’ experiences of aloneness and how this influenced the therapeutic relationship. The research was conducted within a qualitative paradigm and used a heuristic methodology. Semi-structured interviews were undertaken with four therapists who had expressed an interest in exploring their perceptions of this phenomenon. Thematic analysis was used to analyse the data from these dialogues. Findings: Two overarching themes emerged from the data (Braun & Clarke, 2013): Personal experience of aloneness and Awareness of aloneness and the therapeutic space (the therapist’s perspective). Seven themes were highlighted under these two main headings: aloneness provides space, aloneness affects attachments, aloneness as a choice, the uniqueness of aloneness experience, aloneness is not always understood by others, how aloneness affects the therapeutic relationships, and the final theme is aloneness and self-care as a therapist. Conclusion: Our experiences of aloneness are unique and complex and how these encounters are defined, and the skills needed to be alone, are still little understood. This investigation explored individual experience of aloneness and has provided insight into how the phenomenon affects relationships with clients in the therapeutic space. It adds to a general conversation on loneliness, aloneness and solitude, and shines a light on the little researched association of our alone experiences impacting on the counselling relationship. Key Words: Aloneness, Therapeutic Relationship, Counsellor
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The death of a mother in adolescence. A qualitative study of the perceived impact on a woman’s adult life and the parent she becomes.Aim: The purpose of this research was to explore the lived experience and meaning of the unique stories of women who had been bereaved of their mothers during their adolescence. The objective: to develop and enhance an understanding of the perceived impact on their adult life and subsequent approach to motherhood. Method: This qualitative study was conducted by using semi-structured interviews with four participants, all of whom were mothers and over forty years of age to allow for retrospect. Data was analysed using Interpretive Phenomenological Analysis. Findings: The study revealed five main themes, all with striking similarity amongst participants. The findings indicated that the effect of mother death in adolescence was influenced by contextual factors such as suppression of grief through silence and behaviour of surviving parent. All participants reported an enduring psychological effect from their experience; an enduring sense of hurt; feelings of low self-esteem; anger; insecurity; anxiety; neediness and chronic sorrow for both themselves and their mothers. Sadness stemmed from continuous mourning felt through the loss of an adult relationship with their mothers and an awareness of having lost an aspect of themselves. The study identified a ‘ripple effect’ to future generations and established an effect on parenting, with mothers identifying themselves as anxious, uncertain, protective and over compensatory. The study also highlighted facets of posttraumatic growth. Aspects of their healing process were described by participants, including a felt sense of continuing connection with their mothers. All participants believed that they had developed positive character traits as a result of their loss, such as strength and empathy. Furthermore, with age and motherhood, participants experienced an enhanced awareness and self-understanding which afforded them some comfort. Conclusion: This work contributes to growing research suggesting ‘particular effect’ of mother death in adolescence and the subsequent impact on motherhood. Through participants’ words this research details how this experience shaped their lives and reiterates the enormity of loss and its ripple effect. Through the distinct similarities of participant responses, it affirms this phenomenon which has significance not only for women bereaved of their mothers in adolescence but for counsellors’ understanding of this phenomenon.
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An exploration of women’s experiences of emotional ambivalence during their first trimester of pregnancy and their perceptions of psychosocial support during that timeThe first trimester is a vital stage of pregnancy. Many important developmental changes take place for both mother and baby during this time. These changes are vast and fast paced and encompass changes to a woman’s body, their emotional and also their social wellbeing. This qualitative study aimed to gain insight into women’s experiences of emotional ambivalence and their perception of psychosocial support during the stage of the first trimester of pregnancy. Through Interpretative Phenomenological Analysis (IPA), super-ordinate themes and sub-ordinate themes were identified. Hearing first-hand accounts of four women’s lived experiences highlighted the prevalence of emotional ambivalence during the first trimester. It also exposed the reality and impact of perceived support that was deemed beneficial including support from significant relationships and support that was considered lacking including emotional holding and individually-led support. This study has added to the conversation that there is scope for further research with the view to addressing women’s mental and emotional wellbeing and the standard of perceived support they receive during the first trimester of pregnancy.
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Finding My Voice: A Qualitative Exploration into the Perceived Impact of Person-Centred Counsellor Training upon Counsellors who were Adopted as a BabyThis small-scale qualitative study explores how qualified Person-Centred counsellors who were adopted as a baby perceived the impact of their Person-Centred counselling training. The study focused on the adoptees’ experiences of adoption and how these influenced their experience of Person-Centred counselling training. Data was collected using semi-structured interviews from three qualified Person-Centred counsellors who were adopted as babies. The data was analysed using Interpretative Phenomenological Analysis to gain insight into how the participants made sense of their lived experience. The findings supported the difficulties associated with adoption which are present in existing literature and research but also placed an emphasis on the particular vulnerabilities associated with being adopted as a baby. The findings further highlighted the positive impact Person-Centred Counselling training had on the participants’ personal development including: increased self-awareness, self-acceptance, identity development and having a voice. The findings confer implications for clinical practice in understanding the experience of adoptees who were adopted as a baby as well as the significant aspects of Person-Centred counselling training which facilitated the participants’ positive self-development. The links made between adoption and Person-Centred training are an original area of research and are worthy of further exploration. They elucidate the healing aspects of the approach and offer hope in overcoming human adversity.
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Cyclic fatigue resistance of nickel titanium rotary files in the martensitic state: a systematic review.Background: There are many factors which effect the cyclic fatigue resistance of Nickel titanium or NiTi files. The metal can exist in a soft martensitic state which is thought to improve the resistance to cyclic fatigue. The NiTi alloy transforms from one state to the other at a certain temperature and various factors can modify this transition temperature. Temperature effects the state of the metal so the way the file acts at intracanal temperature is significant. Most cyclic fatigue tests have been carried out at room temperature. Objectives: Identifying martensitic files and whether the resistance to cyclic fatigue is greater in these files at intracanal temperature. Methods: A PICOS is used to formulate the review question. It provides a framework to develop inclusion and exclusion criteria. Search terms are used on the databases Science Direct, Wiley, PubMed and Google Scholar. A single reviewer screened the results, applying inclusion and exclusion criteria. The results are analysed and a descriptive analysis carried out. A Joanna Briggs checklist for cohort studies is used to assess the quality of the studies. An assessment of bias in the primary studies and bias in the review process is carried out. Keywords: cyclic fatigue, martensitic, intracanal temperature, CM files, Gold files, Blue files, EDM files. Results: The overall quality of the included studies was judged as moderate. However, cyclic fatigue testing methods have no standardisation, so it is difficult to compare studies. Many studies did not show evidence of sample size calculation and this was not taken into consideration by the scoring system for quality assessment. Within the limitations of the study it is found that at intracanal temperature, Hyflex EDMTM is potentially martensitic, existing in the R-phase which is considered to be a martensitic phase. It is also found that a wide range of 30.8 °C – 36 °C exists for intracanal temperature. Conclusions: Within the limitations of the study it is found that the Hyflex EDM file is martensitic at intracanal temperature and has a higher cyclic fatigue resistance than the other martensitic phase files. Most of the martensitic phase files identified possessed a greater cyclic fatigue resistance than the other files tested.
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AKR1C3 inhibition by curcumin, demethoxycurcumin, and bisdemethoxycurcumin: an investigationBackground: Aldo-keto reductase 1C3 (AKR1C3) has been shown to be overexpressed in cancers due to its regulatory roles in cell proliferation and differentiation. Curcumin, known to have anti-tumour properties, and its analogues demethoxycurcumin (DMC) and bisdemethoxycurcumin (BDMC) were studied to determine their inhibitory effects on the AKR1C3 enzyme. Methods: AKR1C3 was purified and analysed to determine its protein concentration in transformed Escherichia coli (E. coli) cells. Enzyme assays equaling 1 mL contained 2.82 mg/mL AKR1C3, 50 μM of 3 mM NADPH, and varying volumes of potassium phosphate (50 mM, pH 6.5), 9,10-phenanthrenequinone (PQ), and inhibitors were measured at 340 nm. The Vmax, Km, KI, and 2 of AKR1C3 in the presence and absence of inhibitors were determined using a non- linear regression analysis on Fig.P Software. Results: PQ alone found Vmax = 0.47 IU/mg, Km = .435 μM, Ki = 6.29 μM, and 2 = 0.946. Inhibitor potency was BDMC > DMC > curcumin in the presence of 1 μM PQ. Further analysis of BDMC indicated mixed inhibition (Vmax = 0.46 IU/mg, Km = .406 μM, Ki = 1.59 μM, and 2 = 0.970). Further analysis of PQ at higher concentrations found a divergence from Michaelis-Menten kinetics, with a decrease in AKR1C3 activity after Vmax was reached. Conclusions: BDMC was the more potent inhibitor of AKR1C3 in transformed E. coli compared to DMC and curcumin. The results suggest mixed inhibition of AKR1C3 in the presence of BDMC. Additional analysis of PQ at higher concentrations saw a loss of Michaelis-Menten kinetics as the activity of AKR1C3 decreased after reaching Vmax. This requires further examination.
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Life Expectancy: Lower for Nursing Homes or Residents?This paper assesses the relevance of organisational change theory and management decision making theory in the nursing home industry and whether these changes are forced upon organisations in this sector due to the current financial climate. It specifically looks at a nursing home which is located on the Wirral Peninsula, Merseyside. This particular nursing home was recently taken over by new owners and therefore a new management team was introduced. Finally the paper attempts to determine whether nursing homes can survive is this current period of financial instability and whether the nursing home industry can cope with the decrease in government funding and the increase in the demand for nursing homes. The findings of this research paper shows communication of change is a big issue in this particular organisation and that this has resulted in changes in morale and stress levels and therefore change has had psychological impacts on the employees. The paper suggests that there is a clear hierarchy when it comes to decision making and that even the manager has limited power when it comes to the final decision and it is the owners that have the final say in the decision making of the organisation. The evidence of this paper suggests that the organisations priority is making the nursing home profitable. The employees, the deputy matron and the manager all were clear in stating this. This therefore suggests that profits come before the interests of the employees and the residents. Evidence however suggests that the owners have little choice but to prioritise profit or face going the same way as many other nursing homes in the local area and closing down. This paper concludes that the nursing homes long term viability is at risk due to the decrease in government funding and therefore the organisation has less income meaning that cutbacks have to be made which effects the quality of the organisations service and this puts extra pressure on the nursing home, starting with the employees and going right the way through the organisation to the owners to be able to continue to meet the required standards that is expected of them. Eventually there will be a breaking point and the organisation will not be able to be profitable and meet the required standard that the regulations stipulate. The task that faces the nursing home industry becomes even more difficult due to the growth in population and the life expectancy of people increasing. So can nursing homes outlive the residents in the long run?
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Manipulation of Human Immunodeficiency Virus Restriction Factors: RPRD2, SERINC3 and SERINC5Background: There is a need for a newer approach to tackle human immunodeficiency virus (HIV) due to limitations of the current antiretrovirals, innate cell restriction factors offer such opportunity. This study seeks to characterise three novel HIV restriction factors and explore their therapeutic potentials. Methods: Jurkat cell line was treated with polyinosinic-polycytidylic acid (poly I:C), a toll-like receptor-3 agonist (TLR3), at different concentrations (5 µg/ml, 10 µg/ml, 20 µg/ml) and (4 µg/ml, 8 µg/ml, 12 µg/ml) and untreated controls. Its effects on cellular proliferation were observed over many hours. A bioinformatic search of Regulation of nuclear pre-mRNA domain-containing 2 (RPRD2) and Serine incorporator 3 and 5 (SERINC3 and SERINC5) were conducted to predict for nuclear localisation signal (NLS) and potential ubiquitination and Sumoylation sites in the proteins using online NLS Mapper, UbPred and GPS-SUMO tools respectively. Small interference RNA (siRNA) transfection of Jurkat cell line was done to knockdown karyopherin alpha 2 (KPNA2) using Lipofectamine 3000. Western blot analysis was done to assess transfection efficiency. Results: Jurkat cells treated with 5 µg/ml, 10 µg/ml and 20 µg/ml proliferated more than the control while those treated with 4 µg/ml, 8 µg/ml and 12 µg/ml proliferated less with statistical significance between the untreated and 4 µg/ml concentration at 72 hours (p = 0.021).RPRD2 was the only protein that has NLS (RDPFHSLKRPRPPFARGPPFFAPKRPFFP)at position 1430 with a score of 9.8. RPRD2 has a site predicted each for SUMO interaction and sumoylation consensus (p = 0.022), SERINC3 had six sites for SUMO interactions and 2 for sumoylation non-consensus, all with no statistical significance and SERINC5 has a significant SUMO interaction site at position 44-48 (p = 0.049). The predicted ubiquitination sites for RPRD2 were 44 (ten with high, 27 with medium and seven with low confidence respectively), SERINC3 had four sites (two with medium and low confidence each) and SERINC5 had three (one with high, medium and low confidence each). The KPNA2 knockdown was not successful. Conclusion: HIV restriction factors present a potential therapeutic target; adequate characterisation of these proteins is important towards fashioning drugs in this regard. Keywords: Toll-like receptor 3, Polyinosinic-polycytidylic acid (poly I:C), Nuclear localisation signal, Sumoylation, Ubiquitination, Karyopherin alpha 2 (KPNA2)
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‘Am I not a Man, whose nature is frail, and prone to error?’ An evaluation of Matthew Lewis’s The Monk as a work of tragedyThis dissertation is an argument for the re-evaluation of Matthew Lewis’s Ambrosio the Monk as a figure of tragedy instead of villainy. By identifying the characteristics of tragedy within the Gothic text, Ambrosio can be shown to fulfil the tenets of the tragic hero as established by Aristotle. Because of this, the reader can experience the tragic response of catharsis because of the pity and sympathy that Ambrosio as a tragic hero can inspire in the reader. For sympathy to be extended to the Gothic, a Romantic sensibility of the primacy of the self, analogous to that of the Renaissance humanist, must be established. The development of this Romantic Sensibility is explored with acknowledgement of the influence upon it by the Renaissance tragedians, thus establishing a chain of literary connections from the ancient tragedy to the Romantic Gothic. By recognising the shared humanity of the Gothic villain and the reader, the sympathy and pity necessary for the tragic response is extended to the Gothic villain which is transformed to a figure of tragedy.
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A Heuristic Study of Counsellors’ Understanding and Experience of the Nature of Shame and the Impact of Shame on Therapeutic Contact.The aim of this qualitative heuristic research study was to provide insight into the lived experience of shame and the impact of shame on the therapeutic relationship. The experience of the researcher is found within the study, integrating her own experience with the personal accounts of the participants and the literature on shame. Semi-structured interviews were conducted using four experienced, qualified therapists who were grounded in their understanding of shame. A latent thematic analysis was used to analyse the data. As this was a heuristic study the researcher also kept a reflective journal throughout the process. The following five themes emerged: understanding of shame; physiology of shame; socially constructed aspects of shame, impact of shame and shame and therapy. Shame was found to be innately felt by humans with specific physical characteristics including blushing, downcast eyes and feeling small. The content of what is perceived as shameful can be culturally, gender and experientially specific. Shame is established as an intrinsic part of society in establishing norms and boundaries. However, excess of shame is indicated as a factor in P. T. S. D., mental health problems, social isolation and violence against self or others. In this study silence, negative self-talk and resistance were found to be both characteristic behaviour developed as defence against further shaming and combined with support, compassion and connection factors in reparative growth. There is potential for shame to cause a rupture in the therapeutic relationship. However, where shame is worked with in therapy it can be a source of therapeutic growth. Counsellor awareness of shame processes, self-regulation and self-care were indicated as important for working with shame to ensure modelling a grounded presence for the client. All four participants work on shame had influenced their choice of therapy as a career. However, none of the participants had received any training about shame during their initial training. The findings emphasised the need for including working with personal shame in both professional development and counselling training courses. This research supports previous research and provides opportunities for further research.