Common themes and cognitive biases in the negative thoughts of women with recurrent genital herpes: clinical reflections and implications for cognitive behaviour therapy

There is a relatively high prevalence of psychological distress among individuals with recurrent genital herpes. Clinical experience suggests that women who experience psychological distress typically present to clinical psychology services with similar negative thoughts and cognitive biases. The current paper describes seven themes that were common in the negative thoughts of five women presenting with psychological distress associated with recurrent genital herpes. Simple content theme analysis was used to analyse assessment and therapy session notes. Themes included: negative perceptions of the self and sex/sexual history; concerns about the risk and responsibility of transmitting the virus to sexual partners; concerns about the experience of disclosure and the possibility of rejection following disclosure; and misinterpretation of bodily sensations. A number of cognitive biases were evident in the women's negative thoughts. Cognitive biases included catastrophising, predicting the future, all-or-nothing thinking and self-blame. Implications for the practice of cognitive behaviour therapy with individuals who are distressed by a diagnosis of recurrent genital herpes are discussed.