Schizotypal-Stabilization Ritual (SSR).

A Functional Framework for Symbolic and Ritualized Stabilization in Schizotypal Trait Expression.

Dr. Gregory Lyons, PsyD, LCPC,

01/01/2026.

A practice that can be identified in past and current clinical and research literature is the frequent conceptualization of schizotypal traits presented in individuals who use a form of dissociation, which can be seen as a form of behavioral eccentricity or cognitive distortions, based on maladaptive belief systems. There exist some basic descriptive, identifiable characterizations that lightly describe these practiced observable features, but the purpose, or possibly the underrepresentation, of the functional roles these ritualized behaviors may serve for some individuals with schizotypal trait expressions remains unclear.

Recent observations of clients who are in current therapeutic care present with practices that may suggest their practice of symbolic thinking and ritualized practices can function as stabilizing mechanisms, contributing to emotional regulation, perceptual grounding, and continuity of self-experience. For certain individuals, these behaviors may operate as adaptive responses to internal or environmental instability rather than as indicators of intrinsic psychopathology.

To address the possible existence of a conceptual gap in the approach and treatment of behavioral issues in psychotherapeutic practice, the approach of this paper is to possibly introduce the term Schizotypal-Stabilization Ritual (SSR), as a descriptive, non-diagnostic framework for understanding how symbolic, ritualized, and meaning-making behaviors created by individuals who have experienced a long-term diagnoses such as Bipolar disorder, Attention Deficit Hyperactivity disorder, Borderline Personality disorder, and possibly Generalized Anxiety Disorder with the intent to promote or obtain psychological stabilization while they are experiencing heightened symptoms aligned with these or other mental behavioral diagnosis.

SSR attempts to identify selected behaviors commonly viewed as fantastical and maladaptive and to examine their potential regulatory and organizational functions. Focusing on function rather than form, SSR aims to contribute to more nuanced, ethically grounded interpretations of symbolic and ritualized behavior within schizotypal trait expression.

Introduction.

Schizotypal traits can be seen to occupy a complex position within clinical psychology, which often exists at the intersection of creativity, perceptual sensitivity, interpersonal difficulty, and symbolic cognition (Claridge, 1997; Nelson et al., 2013). Some contemporary diagnostic frameworks tend to use generalization to define observable deviations from normative cognition or behavior, frequently interpreting symbolic thinking, unusual belief systems, or ritualized practices as markers of maladaptation or latent pathology (American Psychiatric Association, 2022). While such models provide diagnostic reliability and clinical structure, they may insufficiently account for the functional and regulatory roles these behaviors can serve for some individuals.

There are some studies that may suggest that symbolic cognition and an individual's attempt to use internal meaning-making processes may function as adaptive responses to psychological instability, uncertainty, or perceptual sensitivity, particularly in individuals with elevated schizotypal traits (Kwapil & Barrantes-Vidal, 2015; Nelson et al., 2013). These ritualized behaviors, which can be broadly defined to show an individual's attempt to support emotional regulation, predictability, and try to identify coherence under conditions which can be identified as moments of stress or ambiguity (Hobson et al., 2018; Seligman & Brown, 2010). It can be perceived that symbolic and ritualized practices need not be inherently pathological but may instead reflect compensatory stabilization strategies.

The introduction of SSR is to implement a descriptive, non-diagnostic conceptual framework intended to capture these functional dynamics. SSR is offered as a model for understanding how symbolic organization, ritualized repetition, and meaning-based practices may contribute to emotional regulation, perceptual grounding, and identity stability in individuals expressing schizotypal traits. Importantly, SSR does not redefine diagnostic criteria, nor does it suggest that all ritualized behaviors are adaptive or benign. Rather, it provides a functional lens through which clinicians and researchers may more carefully evaluate the role of symbolic and ritualized processes in schizotypal trait expression, with attention to context, flexibility, insight, and overall functioning.

Conceptual Background.

Some clinicians have identified schizotypal traits as being associated with unusual perceptual experiences, cognitive eccentricity, interpersonal discomfort, and heightened sensitivity to internal and external stimuli (Claridge, 1997; Kwapil & Barrantes-Vidal, 2015). There is data that exists which can be interpreted to show that schizotypal traits exist along a continuum of personality and experience, rather than constituting a categorical disorder in and of themselves (Claridge & Beech, 1995). Some studies suggest that individuals exhibiting elevated schizotypal features retain behavioral functioning in reality testing, insight, and adaptive functioning, particularly outside periods of acute stress (Nelson et al., 2013; Fonseca-Pedrero et al., 2018). This can invite a closer examination of the functional roles that associated behaviors may serve.

The approach contains the idea that, in a broader context, symbolic cognition can represent a core human capacity rather than a pathological anomaly. Symbolic thinking can help individuals build an understanding using a practice that, within their own subconscious reflections, can represent abstract, emotional, or perceptually ambiguous experiences through metaphor, narrative, imagery, and ritualized meaning systems (Cassirer, 1944; Lakoff & Johnson, 1980). It can be argued that some of these processes may be seen as basic attributes, foundational to language, culture, identity formation, and emotional regulation across populations. There is the possibility that symbolic cognition and ritualized behavior are not unique to schizotypal trait expression, but also can be seen as ubiquitous features of psychological organization that may become more salient under conditions of uncertainty or instability.

The idea is that ritual, broadly defined, can possibly be interpreted as being examined across psychological, anthropological, and neuroscientific literatures as a mechanism for creating predictability, reducing uncertainty, and reinforcing identity coherence (Hobson et al., 2018; Seligman & Brown, 2010). There are some experimental and observational studies that possibly suggest that ritualized actions, which can be interpreted to be culturally shared or subconsciously constructed, may help individuals reduce anxiety, enhance perceived control, and possibly stabilize emotional responses during periods of stress (Brooks et al., 2016; Hobson et al., 2018). These effects may appear to operate through both cognitive structuring and physiological regulation and can possibly be seen as supporting ritual’s role and as a stabilizing psychological process rather than a superstitious byproduct.

From a regulatory perspective, this can mean that symbolic systems can possibly enable individuals to encode diffuse emotional states or anomalous perceptual experiences into structured, interpretable forms. This can suggest that when an individual's internal coherence is threatened through such incidents, such as heightened perceptual sensitivity, identity diffusion, or environmental unpredictability, ritualized symbolic practices may emerge as compensatory strategies that restore psychological equilibrium (Kirmayer et al., 2015). This may present as creating idiosyncratic forms which are directly relevant to the individual and act as a broadly adaptive function, including anxiety containment, perceptual grounding, and continuity of self-experience.

Literature can be identified to possibly suggest that symbolic and ritualized behaviors may  not be reflexively interpreted as maladaptive or pathological within schizotypal trait expression. Instead, it could possibly be examined as a meaningful regulatory responses situated along a continuum of adaptive human behavior.

The Schizotypal-Stabilization Ritual (SSR) Framework.

SSR can be defined as an individual's use of symbolic, ritualized, or meaning-based behaviors that can be applied by them as a function to support emotional regulation, perceptual organization, and identity coherence in individuals who are experiencing health symptoms that are aligned with their specific diagnosis. These behaviors can be seen as functionally adaptive responses rather than intrinsic pathology and may persist over time without progression to psychosis, loss of insight, or significant functional impairment (Claridge, 1997; Kwapil & Barrantes-Vidal, 2015).

This form of subconscious framing can be seen to align with dimensional models of schizotypy, which emphasize variability in expression and outcome, including adaptive and non-clinical manifestations of schizotypal traits (Claridge & Beech, 1995; Fonseca-Pedrero et al., 2018). SSR can be seen as the attempt of individuals to use symbolic and ritualized practices as regulatory mechanisms that can organize their experience under conditions of heightened perceptual sensitivity, emotional intensity, or environmental unpredictability.

Core functional components of SSR can include the individual's attempt to use symbolic encoding of experience to formalize acceptance of the issue or experience, and the use of ritualized repetition of a thought or mental process to reduce emotions or feelings during a triggering event, and can be seen as an attempt to maintain the predictability and containment of the outcome. The process can include the individual's use of identity reinforcement in the hopes of maintaining the feeling of perceptual grounding. Symbolic encoding can be seen to help the individual to diffuse emotional or perceptual material to be represented in structured, interpretable forms, consistent with broader theories of symbolic cognition and meaning-making (Cassirer, 1944; Lakoff & Johnson, 1980). The practice of ritualized repetition can be seen as an attempt to foster predictability, contribute to anxiety reduction, and give the individual a sense of perceived control. These processes reflect other instances of these practices that can be empirically identified and possibly associated with ritual behavior across psychological contexts (Brooks et al., 2016; Hobson et al., 2018).

Identity reinforcement and perceptual grounding can be seen as a practice to further support continuity of self-experience, particularly in individuals vulnerable to identity diffusion or perceptual ambiguity. Phenomenological research on schizotypy and self-disturbance suggests that structured meaning systems may serve compensatory functions by stabilizing self-boundaries and interpretive coherence (Nelson et al., 2013; Sass & Parnas, 2003). When examined constructively, these components can form a stabilizing system that could mitigate anxiety, reduce cognitive fragmentation, and preserve functional organization.

Developmental And Environmental Origins.

SSR is hypothesized to emerge through interactions between possible early cognitive, environmental, and personal conditions that can be identified as differences in perceptual and emotional sensitivity. Developmental research can be found that may show that children exposed to environmental unpredictability, emotional inconsistency, or chronic stress can often adopt symbolic or ritualized strategies to restore a sense of predictability, safety, and internal coherence (Fonagy et al., 2002; van der Kolk, 2014). These behavioral practices or strategies can be seen as not inherently pathological but reflect adaptive attempts to regulate affect and maintain psychological stability in the absence of consistent external structure.
Symbolic routines that may be found in childhood, such as repeated imaginative narratives, meaningful object arrangements, or idiosyncratic rituals, can be described as mechanisms through which children may be able to organize overwhelming emotional or perceptual experiences to be deconstructed or analyzed later. (Winnicott, 1971). It can be hypothesized that individuals with heightened perceptual sensitivity, who enact symbolic practices, may help them maintain their objectivity and remain salient, providing a structured medium through which ambiguous or anomalous experiences can be interpreted and contained (Claridge, 1997; Kwapil & Barrantes-Vidal, 2015). It is possible that these behaviors can develop in the context of intact reality testing and insight, distinguishing them from early psychotic processes.

For these individuals, the application of these practices over time and the repeated reliance on symbolic or ritualized strategies may consolidate into stable cognitive and behavioral patterns that persist into adolescence and adulthood. Longitudinal and phenomenological studies of schizotypy suggest that while some individuals experience increased vulnerability under stress, others demonstrate continuity of adaptive functioning through compensatory meaning-making systems (Debbané et al., 2015; Fonseca-Pedrero et al., 2018).

SSR can be understood as a developmental extension of early regulatory strategies rather than a regressive or deteriorative process.

As an individual ages, SSR may manifest as structured symbolic practices, attachment to meaningful objects, internally maintained narratives, or repetitive cognitive rituals that organize perception and emotion. These practices can be implemented to regulate stress, preserve identity continuity, and manage perceptual ambiguity, particularly during periods of heightened emotional demand or environmental instability (Sass & Parnas, 2003; Nelson et al., 2013). Rather than indicating psychopathological progression, the persistence of such rituals may reflect a stabilized adaptive equilibrium that supports functioning while mitigating anxiety and cognitive fragmentation. Developmental and environmental perspectives may contribute to showing that SSR represents a continuity of adaptive regulatory strategies shaped by early experiences, individual sensitivity, and contextual demands.

Clinical Implications.

The SSR framework can aid as a perceptive adaptation to clinical assessment, formulation, and therapeutic engagement. Clinicians may be able to adjust their approach to try to evaluate function before form when encountering symbolic or ritualized behaviors in individuals with what may seem to be schizotypal traits. Behaviors that can appear idiosyncratic or unconventional may nevertheless serve stabilizing roles related to emotional regulation, perceptual grounding, or identity coherence. Efforts made by the clinician may cause a harmful disruption if they try not to understand, disrupt, or extinguish such behaviors without considering or gaining a further understanding of how their client may have created these practices to maintain a form of their regulatory function. This could possibly increase distress, exacerbate anxiety, or destabilize psychological organization (Sass & Parnas, 2003; Nelson et al., 2013).

From a formulation standpoint, SSR encourages clinicians to adopt a meaning-centered and context-sensitive stance, emphasizing curiosity rather than correction. Therapeutic inquiry may focus on the personal significance, perceived necessity, and situational flexibility of ritualized practices, rather than on surface-level conformity to normative behavior. This approach aligns with broader phenomenological and recovery-oriented models, which emphasize respect for subjective experience and preservation of adaptive coping strategies when possible (Davidson et al., 2005; Parnas & Henriksen, 2014).

Ideally, SSR can be used as a subtle approach towards the application of therapeutic goals, which could suggest flexibility over elimination. Interventions could shape into an approach involving a collaborative exploration of whether a given ritual or symbolic practice remains adaptive across contexts, identifying circumstances in which it becomes restrictive or distressing, and supporting the development of alternative regulatory strategies when needed. Such work may include gradual expansion of tolerance for ambiguity, strengthening of affect regulation capacities, and enhancement of reflective insight without invalidating the stabilizing roles (Fonagy et al., 2002; Kwapil & Barrantes-Vidal, 2015).

It should be noted that SSR does not advocate for the reinforcement of maladaptive behavior, nor does it suggest that all ritualized practices should be preserved. The applicable practice of SSR should be used by the clinician through the act of ethical discernment, helping them to carefully differentiate between stabilizing behaviors that support functioning and those that contribute to impairment or risk. This idealization can be seen as particularly salient in differential assessment, where ritualized behaviors may superficially resemble compulsions, delusional ideation, or culturally incongruent practices. SSR can be seen to provide a framework for navigating these distinctions while possibly minimizing the risk of over-pathologization.

If a clinician finds it applicable, SSR may be used in clinical training and supervision to encourage practitioners to reflect on their own biases regarding normality, symbolic cognition, and unconventional coping strategies. By reframing certain behaviors as potentially adaptive responses rather than automatic targets for correction, SSR can be seen to support a more nuanced, ethically grounded, and therapeutically attuned approach.

Boundary Conditions & Differential Considerations.

The consideration or application of the SSR framework requires careful differentiation from other psychological phenomena involving ritualized or repetitive behavior. Without such clarification, symbolic and ritualized practices may be misinterpreted as compulsions, delusions, culturally normative rituals, or neurodevelopmental routines. SSR is not intended to collapse these distinct constructs, but rather to delineate a specific functional pattern characterized by symbolic meaning, contextual flexibility, and preservation of insight. For instance, identification of obsessive compulsive behavioral practices can possibly be identified as being based on primarily fear-driven behaviors performed to neutralize perceived threats or prevent anticipated harm, often accompanied by intrusive, ego-dystonic obsessions and significant distress if rituals are interrupted (American Psychiatric Association, 2022; Abramowitz et al., 2009). SSR behaviors can be seen as meaning-driven stabilization-themed practices rather than threat-driven. The implementation of these practices may be done in order to assist the individual to organize experience, regulate affect, or maintain identity coherence. Individuals engaging in SSR-like practices generally retain awareness of the symbolic nature of their behaviors and demonstrate greater flexibility in modifying or contextualizing them when circumstances change.

Psychotic delusions can be identified by fixed, false beliefs held with strong conviction despite contradictory evidence and impaired reality testing (APA, 2022). The concept of SSR works to reexamine the delusional elements or practices that are present in the individual's processes. This may involve the clinician and the client subjectively examining symbolic meanings, and the symbolic interpretations discussed, reflected upon, or revised without destabilization.

SSR must also be differentiated from culturally normative or religious rituals, which are socially shared, transmitted, and reinforced within collective meaning systems (Seligman & Brown, 2010). While SSR may incorporate culturally informed symbols, its defining feature lies in idiosyncratic, individually constructed rituals developed primarily for personal stabilization rather than communal practice. Importantly, SSR does not pathologize cultural or religious ritual; instead, it emphasizes the contextual function and subjective role of ritualized behavior in psychological regulation.

SSR should be responsibly applied as a conceptual framework without conflating adaptive symbolic regulation with psychopathological processes. This differentiation supports ethical clinical interpretation, minimizes over-pathologization, and reinforces SSR’s role as a functional, non-diagnostic lens.

Ethical Considerations.

Ethical application of the SSR framework requires particular caution due to the possible historical tendency within mental health disciplines to pathologize symbolic, unconventional, or non-normative modes of meaning-making. Individuals with schizotypal traits have frequently been interpreted through deficit-based or risk-focused models, increasing the likelihood of mislabeling adaptive strategies as symptoms requiring correction (Claridge, 1997; Parnas & Henriksen, 2014). SSR explicitly seeks to counter this tendency by emphasizing functional assessment, contextual understanding, and proportional clinical response.

A central ethical concern addressed by SSR can be considered as the risk of over-pathologization. Symbolic and ritualized behaviors that do not produce significant distress, impairment, or risk may nonetheless attract clinical scrutiny due to their deviation from normative expectations. Ethical practice requires clinicians to distinguish between difference and disorder, particularly when behaviors serve regulatory or stabilizing functions for the individual (Kwapil & Barrantes-Vidal, 2015). Premature labeling or intervention may undermine coping strategies, erode therapeutic trust, and exacerbate psychological vulnerability.

Clinician bias and interpretive framing represent additional ethical challenges. Research indicates that clinicians’ personal belief systems, cultural backgrounds, and theoretical orientations can influence how symbolic behaviors are interpreted and responded to in therapy (Sue et al., 2009; Wendt & Gone, 2012). Without deliberate self-reflection, practitioners may inadvertently impose normative or culturally bound assumptions about rationality, meaning, or acceptable coping. SSR therefore supports an ethically grounded stance of reflective humility, encouraging clinicians to examine their own reactions and assumptions when encountering unfamiliar or idiosyncratic symbolic practices.

Cultural context is particularly salient in ethical evaluation. Ritualized behavior, symbolic objects, and meaning-making practices are embedded within cultural, spiritual, and subcultural traditions that may not align with dominant clinical norms (Kirmayer, 2012). Ethical use of SSR requires sensitivity to cultural variation and an explicit avoidance of interpreting culturally sanctioned rituals as indicators of psychopathology. Rather than isolating behavior from its sociocultural meaning, SSR emphasizes contextualized understanding and collaborative inquiry.

From a relational ethics perspective, SSR aligns with recovery-oriented and person-centered models that prioritize autonomy, dignity, and collaborative meaning-making (Davidson et al., 2005). Ethical engagement involves inviting individuals to articulate the personal significance of their symbolic practices, exploring perceived benefits and limitations, and jointly evaluating whether such behaviors remain supportive across contexts. This collaborative approach reduces power imbalances and respects the individual’s agency in determining the role of ritualized practices in their psychological life.

Finally, SSR underscores the ethical responsibility to recognize boundary conditions. While the framework emphasizes respect for adaptive meaning systems, it does not exempt clinicians from intervening when behaviors become rigid, impairing, or associated with risk to self or others. Ethical application therefore involves ongoing assessment, documentation of clinical reasoning, and transparency regarding limits of tolerance. SSR functions as an interpretive aid—not a justification for neglecting safety, informed consent, or professional accountability.

Limitations & Future Directions.

SSR is proposed as a conceptual and interpretive model rather than an empirically validated construct, which makes it subject to several important limitations. SSR has not yet been operationalized into measurable variables, nor has it been tested through experimental, epidemiological, or clinical outcome studies. This means that it currently does not permit causal claims regarding the efficacy, prevalence, or long-term impact of symbolic or ritualized behaviors within schizotypal trait expression. Its current contribution lies in hypothesis generation and conceptual clarification rather than empirical generalization.

SSR relies heavily on phenomenological and functional interpretation. The use of SSR strongly presents the practices involving ethical caution and contextual assessment. The use of interpretations of symbolic meaning and adaptive function can, and most likely does, vary across clinicians, cultural settings, and theoretical orientations. With this in mind, the applications of SSR can and most possibly will remain inconsistent across settings. Future work should therefore prioritize the development of structured interview guides or rating frameworks to improve consistency and transparency.

SSR should under no circumstances be used or interpreted as a protective justification for all ritualized or symbolic behavior. The emphasis of SSR is based on adaptive function and how it could possibly necessitate careful boundary maintenance. Empirical research will be needed to clarify under what conditions symbolic and ritualized practices shift from stabilizing to restrictive, distressing, or impairing. Longitudinal designs examining flexibility, insight, and functional outcomes would be particularly valuable in addressing this concern.

Future research directions for SSR are well-suited to qualitative and mixed-method approaches. In-depth phenomenological interviews with individuals exhibiting schizotypal traits could elucidate subjective experiences of meaning-making, ritualization, and perceived stabilization. Such methods have proven effective in advancing understanding of self-experience and symbolic cognition within the schizophrenia spectrum (Parnas et al., 2005; Nelson et al., 2013). Additionally, longitudinal observational studies could examine how stabilization rituals evolve across developmental stages and under varying environmental stressors.

SSR is not intended as a standalone explanatory model, diagnostic construct, or treatment protocol. It is offered only as a hypothetical approach to serve as a complementary interpretive lens that may enhance clinical formulation, ethical decision-making, and research inquiry when used alongside established diagnostic and theoretical frameworks.

Conclusion.

SSR can be seen to offer a functional, non-diagnostic perspective on symbolic and ritualized behaviors. It can possibly be a way to interpret behaviors solely as indicators of maladaptation or latent pathology. SSR can help identify behavioral practices that individuals with a behavioral diagnosis enact as adaptive strategies that may contribute to emotional regulation, perceptual grounding, and continuity of self-experience under conditions of internal or environmental instability.

SSR can be seen as a way to boost the concept involving contextualized interpretation. Developmentally, stabilization rituals may be seen to emerge as adaptive responses to early unpredictability or heightened perceptual sensitivity and consolidate into enduring regulatory strategies. It encourages careful assessment of meaning, flexibility, and functional impact, supporting therapeutic approaches

SSR is intentionally bounded in scope. It does not propose a diagnostic category, treatment protocol, or explanatory replacement for established models of schizotypy or psychosis-spectrum phenomena. It is solely offered as a complementary interpretive lens that may enhance clinical formulation, ethical decision-making, and research inquiry when applied judiciously.

Future empirical work, particularly qualitative and longitudinal studies, will be necessary to further examine the conditions under which stabilization rituals support adaptive functioning or become restrictive.

SSR was created to situates symbolic and ritualized behavior in clients within a continuum of human meaning-making and self-regulation. It is the hope that the introduction of the concept of  SSR may contribute to a more nuanced, respectful, and clinically attuned understanding of schizotypal trait expression. There is a hope that this concept may encourage clinicians and researchers to reconsider how difference, adaptation, and pathology are distinguished within contemporary psychological practice.

References.

Abramowitz, J. S., Taylor, S., & McKay, D. (2009). Obsessive–compulsive disorder. The Lancet, 374(9688), 491–499. https://doi.org/10.1016/S0140-6736(09)60240-3

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). APA Publishing.

Brooks, A. W., Schroeder, J., Risen, J. L., Gino, F., Galinsky, A. D., Norton, M. I., & Schweitzer, M. E. (2016). Don’t stop believing: Rituals improve performance by decreasing anxiety. Organizational Behavior and Human Decision Processes, 137, 71–85. https://doi.org/10.1016/j.obhdp.2016.07.004

Cassirer, E. (1944). An essay on man: An introduction to a philosophy of human culture. Yale University Press.

Claridge, G. (1997). Schizotypy: Implications for illness and health. Oxford University Press.

Claridge, G., & Beech, T. (1995). Fully and quasi-dimensional constructions of schizotypy. In A. Raine, T. Lencz, & S. A. Mednick (Eds.), Schizotypal personality (pp. 192–216). Cambridge University Press.

Davidson, L., O’Connell, M., Tondora, J., Styron, T., & Kangas, K. (2005). Recovery in serious mental illness: A new wine or just a new bottle? Professional Psychology: Research and Practice, 36(5), 480–487. https://doi.org/10.1037/0735-7028.36.5.480

Debbané, M., Barrantes-Vidal, N., Schultze-Lutter, F., & Kwapil, T. R. (2015). Psychosis proneness and positive schizotypy: The role of developmental and environmental factors. Schizophrenia Bulletin, 41(Suppl. 2), S358–S365. https://doi.org/10.1093/schbul/sbu191

Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the development of the self. Other Press.

Fonseca-Pedrero, E., Debbané, M., Schneider, M., Badoud, D., Eliez, S., & Barrantes-Vidal, N. (2018). Schizotypal traits in the general population: Characterizing risk profiles. Schizophrenia Bulletin, 44(Suppl. 2), S214–S224. https://doi.org/10.1093/schbul/sbx165

Hobson, N. M., Schroeder, J., Risen, J. L., Xygalatas, D., & Inzlicht, M. (2018). The psychology of rituals: An integrative review and process-based framework. Personality and Social Psychology Review, 22(3), 260–284. https://doi.org/10.1177/1088868317734944

Kirmayer, L. J., Gómez-Carrillo, A., & Veissière, S. (2017). Culture and depression in global mental health: An ecosocial approach to the phenomenology of psychiatric disorders. Social Science & Medicine, 183, 163–168. https://doi.org/10.1016/j.socscimed.2017.04.034

Kwapil, T. R., & Barrantes-Vidal, N. (2015). Schizotypy: Looking back and moving forward. Schizophrenia Bulletin, 41(Suppl. 2), S366–S373. https://doi.org/10.1093/schbul/sbu186

Lakoff, G., & Johnson, M. (1980). Metaphors we live by. University of Chicago Press.

Nelson, B., Parnas, J., & Sass, L. A. (2014). Disturbance of minimal self (ipseity) in schizophrenia: Clarification and current status. Schizophrenia Bulletin, 40(3), 479–482. https://doi.org/10.1093/schbul/sbt169

Parnas, J., & Henriksen, M. G. (2014). Disordered self in the schizophrenia spectrum. Harvard Review of Psychiatry, 22(5), 251–265. https://doi.org/10.1097/HRP.0000000000000040

Sass, L. A., & Parnas, J. (2003). Schizophrenia, consciousness, and the self. Schizophrenia Bulletin, 29(3), 427–444. https://doi.org/10.1093/oxfordjournals.schbul.a007017

Seligman, R., & Brown, R. A. (2010). Theory and method at the intersection of anthropology and cultural neuroscience. Social Cognitive and Affective Neuroscience, 5(2–3), 130–137. https://doi.org/10.1093/scan/nsq024

Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K. (2009). The case for cultural competency in psychotherapeutic interventions. Annual Review of Psychology, 60, 525–548. https://doi.org/10.1146/annurev.psych.60.110707.163651

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

Wendt, D. C., & Gone, J. P. (2012). Rethinking cultural competence: Indigenous perspectives. Transcultural Psychiatry, 49(2), 206–222. https://doi.org/10.1177/1363461511425622

Winnicott, D. W. (1971). Playing and reality. Tavistock.