Mapping the Value Changes in Depression and Recovery

doi:10.1017/9781108883535.013

Chapter 11 - Mapping the Value Changes in Depression and Recovery

from Part III - Common Clinical Conditions: The Relevance and Usefulness of a Values-Based Approach

Published online by Cambridge University Press: 24 June 2025

Robert B. Dudas

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Robert B. Dudas

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Robert B. Dudas: Affiliation:
Cambridgeshire and Peterborough NHS Foundation Trust

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Summary

The person’s values determine the meaning structure of the world they live in and drive their actions. The depressed patient’s values tend to change dramatically over the weeks and usually return to normal. At the height of their illness, patients can constantly feel that they are transgressing important personal and group values.

Examining the values at play is similar to creating a map with three dimensions: (1) the level of organization/proximity to primary stakeholders; (2) the hierarchy; and (3) the temporality of values. The patient’s values can be misaligned with those of others temporarily owing to the illness, and value-mapping can facilitate realignment. Changes in value hierarchy are often necessary for recovery. These changes can be dramatic and can happen at a faster pace whilst the person is becoming ill and during recovery.

The patient can be temporarily cut off from the values they would normally hold. Besides records of their former wishes and collateral information, sources of knowledge about value changes include peer support workers, first-hand narratives, philosophical and social scientific studies, media reports, and art portrayal of depression. Changes in one’s life narrative are also essential for recovery and resilience. The patient’s social environment, including the professionals, can facilitate (or hinder) this.

Keywords

depression values-based practice phenomenological psychopathology life-world analysis hermeneutics value-mapping hierarchy of values temporality of values life narrative recovery

Information

Type: Chapter
Information: Values in Psychiatry
Managing Complexity and Advancing Solutions
, pp. 157 - 173

DOI: https://doi.org/10.1017/9781108883535.013 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2025

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References

Andrews, A. B. 2006. Social History Assessment. Thousand Oaks, CA: SAGE.Google Scholar

Bruner, E. M. 1984. Introduction: The opening up of anthropology. In Bruner, E. M. (ed.), Text, Play, and Story: The Construction and Reconstruction of Self and Society. Washington, DC: American Ethnological Society, pp. 1–16.Google Scholar

Charland, L. C. & Zachar, P. 2008. Fact and Value in Emotion. Amsterdam: John Benjamins.10.1075/ceb.4CrossRef Google Scholar

Chen, E. 2020. Recovering the Context in Psychopathology. In Marková, I. S. & Chen, E. (ed.), Rethinking Psychopathology. Cham: Springer, pp. 65–72.10.1007/978-3-030-43439-7_8CrossRef Google Scholar

Dudas, R. B. 2022. Values-based practice: How can history taking help psychiatrists explore the values involved in clinical decision-making? British Journal of Psychiatry Advances, 28, 153–162.Google Scholar

Fazel, H. 2012. Exploring the influence of social threat and value reinforcement on emotional reactions to value transgressions. Unpublished PhD thesis, University of Manitoba.Google Scholar

Fernandez, A. V. & Wieten, S. 2015. Values-based practice and phenomenological psychopathology: Implications of existential changes in depression. Journal of Evaluation in Clinical Practice, 21, 508–513.10.1111/jep.12313CrossRef Google Scholar PubMed

Friedrich, M. J. 2017. Depression is the leading cause of disability around the world. Journal of the American Medical Association, 317, 1517.Google Scholar

Gask, L. 2015. The Other Side of Silence: A Psychiatrist’s Memoir of Depression. Chichester: Vie Books.Google Scholar

Haan, S. D. 2020. Enactive Psychiatry. Cambridge : Cambridge University Press.10.1017/9781108685214CrossRef Google Scholar

Hersch, E. L. 2008. A phenomenologist’s view of the omnipresence of the evaluative in human experience. In Charland, L. C. & Zachar, P. (eds.), Fact and Value in Emotion. Amsterdam: John Benjamins, pp. 193–209.10.1075/ceb.4.11herCrossRef Google Scholar

HM Government 2007. Mental Health Act 2007, c. 12. London: National Archives. www.legislation.gov.uk/ukpga/2007/12/contents.Google Scholar

Horowitz, M. J. 2014. Clarifying values in psychotherapy. Psychodynamic Psychiatry, 42, 671–679.10.1521/pdps.2014.42.4.671CrossRef Google Scholar PubMed

Maiese, M. 2021. An enactivist reconceptualization of the medical model. Philosophical Psychology, 34, 962–988.10.1080/09515089.2021.1940119CrossRef Google Scholar

Mattingly, C. 1991. The narrative nature of clinical reasoning. American Journal Occupational Therapy, 45, 998–1005.10.5014/ajot.45.11.998CrossRef Google Scholar PubMed

National Health Service (NHS) n.d. The NHS values [the six values of the NHS Constitution]. www.healthcareers.nhs.uk/working-health/working-nhs/nhs-constitution.Google Scholar

Peterson, D. (ed.) 1982. A Mad People’s History of Madness. Pittsburgh, PA: University of Pittsburgh Press.10.2307/j.ctt5vkg9sCrossRef Google Scholar

Richards, V. & Lloyd, K. 2017. Core Values for Psychiatrists. College Report CR204. London: Royal College of Psychiatrists. https://shorturl.at/78V2q.Google Scholar

Rokeach, M. 1973. The Nature of Human Values. New York: Free Press.Google Scholar

Schwartz, S. H. 1992. Universals in the content and structure of values: Theoretical advances and empirical tests in 20 countries. Advances in Experimental Social Psychology, 25, 1–65.10.1016/S0065-2601(08)60281-6CrossRef Google Scholar

Stanghellini, G. & Mancini, M. 2017. The Therapeutic Interview in Mental Health: A Values-Based and Person-Centered Approach. Cambridge: Cambridge University Press.10.1017/9781316181973CrossRef Google Scholar

Styron, W. 2001. Darkness Visible: A Memoir of Madness. London: Vintage.Google Scholar

Vervaeke, G. A. C., Vertommen, H. & Storms, G. 1997. Client and therapist values in relation to drop-out. Clinical Psychology and Psychotherapy, 4, 1–6.10.1002/(SICI)1099-0879(199703)4:1<1::AID-CPP97>3.0.CO;2-W3.0.CO;2-W>CrossRef Google Scholar

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