Mental Representation of the “Self” in Relation to the External Environment Among Women with Depression: Conceptual Design of an Authentic Self Restoration Model

Abstract

Background: Depression shatters the mirror of identity and darkens the self-image. In women, the burden of roles and expectations is often accompanied by self-silencing, a subtle undercurrent that pushes the authentic voice into the shadows and turns their existential experience into a battlefield of meanings. Objectives: This study aimed to examine the mental representation of the "self" in women with depression and to develop a conceptual framework for authentic self-restoration. Methods: A qualitative design using thematic analysis was employed. Data were collected through in-depth semi-structured interviews with twelve women in Isfahan. Transcripts were analyzed in MAXQDA through four stages: line-by-line identification of meaning units, clustering of codes into categories, integration of clusters around self-representation, and extraction of overarching themes. Trustworthiness was ensured through independent review, intercoder agreement, participant validation, and an audit trail comprising analytic memos and codebook versions. Results: Thematic analysis indicated that women with depression experienced multiple patterns of self-representation: the conforming self, the critical self, the repressed self, the aspirational self, the fragmented self, and the denied self. These patterns emerged through interactions between internal dynamics (including negative core beliefs, anxiety, suppressed emotions, and a lack of self-compassion) and external sociocultural pressures (including social expectations, unsupportive relationships, family demands, and norms related to emotional restraint and achievement-oriented values). Gendered expectations imposed on women, such as the simultaneous performance of family and social roles and pressure to achieve success, intensified fragmentation, aspiration, and the denial of genuine emotions. Within the Authentic Self Reconstruction Model, these patterns were organized into a transformative process comprising four stages: Renaming, Renarrating, Integration, and Consolidation. This process was intended to facilitate the restoration of a coherent, authentic, and integrated self. Conclusions: The Authentic Self Reconstruction Model was developed in four phases—Renaming, Renarrating, Integration, and Consolidation—to restore psychological coherence and personal agency. By incorporating social and cultural dimensions, it provides a person-centered framework for depression intervention. Importantly, the model’s emphasis on self-states and reconstructive processes suggests that it may serve as a transdiagnostic framework, applicable across multiple forms of psychological vulnerability. Nevertheless, its preliminary nature and small sample size underscore the need for further empirical validation.