Rethinking the concept of insight

Slade, Mike; Sweeney, Angela

doi:10.1002/wps.20783

Cited by 20 publications

(13 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For many individuals, recovery requires developing a complex and meaningful understanding of their distressing experiences, which re-establishes a sense of continuity in their life narrative and overcomes the disturbances of the awareness of identity 65,183,193,196,[236][237][238][239] : "Psychotic episodes don't happen out of nothing. There's always a reason for it.…”

Section: Psychological Treatments: Sharing and Comprehending One's Ex...mentioning

confidence: 99%

The lived experience of psychosis: a bottom‐up review co‐written by experts by experience and academics

et al. 2022

View full text Add to dashboard Cite

Psychosis is the most ineffable experience of mental disorder. We provide here the first co‐written bottom‐up review of the lived experience of psychosis, whereby experts by experience primarily selected the subjective themes, that were subsequently enriched by phenomenologically‐informed perspectives. First‐person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of psychosis as well as family members and carers, representing a global network of organizations. The material was complemented by semantic analyses and shared across all collaborators in a cloud‐based system. The early phases of psychosis (i.e., premorbid and prodromal stages) were found to be characterized by core existential themes including loss of common sense, perplexity and lack of immersion in the world with compromised vital contact with reality, heightened salience and a feeling that something important is about to happen, perturbation of the sense of self, and need to hide the tumultuous inner experiences. The first episode stage was found to be denoted by some transitory relief associated with the onset of delusions, intense self‐referentiality and permeated self‐world boundaries, tumultuous internal noise, and dissolution of the sense of self with social withdrawal. Core lived experiences of the later stages (i.e., relapsing and chronic) involved grieving personal losses, feeling split, and struggling to accept the constant inner chaos, the new self, the diagnosis and an uncertain future. The experience of receiving psychiatric treatments, such as inpatient and outpatient care, social interventions, psychological treatments and medications, included both positive and negative aspects, and was determined by the hope of achieving recovery, understood as an enduring journey of reconstructing the sense of personhood and re‐establishing the lost bonds with others towards meaningful goals. These findings can inform clinical practice, research and education. Psychosis is one of the most painful and upsetting existential experiences, so dizzyingly alien to our usual patterns of life and so unspeakably enigmatic and human.

show abstract

Section: Psychological Treatments: Sharing and Comprehending One's Ex...mentioning

confidence: 99%

The lived experience of psychosis: a bottom‐up review co‐written by experts by experience and academics

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Our work maps on and builds on established personal recovery frameworks in mental health such as the Connectedness, Hope and Optimism about the Future, Identity, Meaning in Life, and Empowerment (CHIME) framework. 12 This new emphasis within the mental health and social care system on personal recovery has underpinned significant innovation, including 19 randomized controlled trials of peer support work, 44 28 randomized controlled trials of the Individual Placement and Support approach to employment, 45 the development of education initiative called Recovery Colleges in 22 countries, 46 as well as the development of new academic disciplines such as survivor research 47 and Mad Studies. 48 The development of a recovery orientation within cardiac services has similar potential as a source of innovation.…”

Section: Discussionmentioning

confidence: 99%

Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction

Dreyer

Pavlo²,

Horne³

et al. 2021

JAHA

Self Cite

View full text Add to dashboard Cite

Background Although there has been movement in cardiology to advance patient‐centered approaches to postacute myocardial infarction (AMI) care, work remains to be done in aligning patient preferences with clinical care. Our objective was to characterize patients’ experience of AMI and treatment to develop a new conceptual framework of patient‐centered recovery in cardiology. Methods and Results We conducted in‐depth interviews with people who previously experienced an AMI (2016–2019). The interview focused on participants’ experiences of their recovery, which were audio‐recorded, transcribed verbatim, and analyzed using a phenomenological framework. The overarching theme described by the 42 participants was feeling like a “different person” after the AMI. This shift manifested itself in both losses and gains, each of which posed new challenges to everyday life. The experience appeared to be an active process requiring people to take responsibility for their health. In terms of loss, participants describe how the AMI threatened their sense of safety and security and led to social isolation, fragility, uncertainty about the future, and difficulty expressing emotions accompanied this new fear. A conceptual framework describing the relationship between AMI, identity change, and functioning was developed. Conclusions Participants experienced the AMI as an unexpected disruption in their lives that had far‐reaching effects on their daily functioning, and were resolved in numerous ways. The conceptual framework may assist in providing a theoretical basis for future interventions in cardiology that not only engage and retain patients in care but also improve long‐term adherence to secondary prevention and other aspects of self‐care.

show abstract

“…The role of first-person knowledge, as expressed in RRNs, is a focus in the emerging fields of survivor research (58) and Mad Studies (59). These new perspectives support re-appraisal of existing psychiatric concepts such as insight (60). To maximize participant engagement, in this study we did not explore participant views about the use of more diverse RRNs, such as those which contain knowledge which is new to professionals, or are critical of clinical practice.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education.Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education.Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted.Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements).Roe et al. Using RRNs in Clinical SettingsConclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress.

show abstract

Rethinking the concept of insight

Cited by 20 publications

References 7 publications

The lived experience of psychosis: a bottom‐up review co‐written by experts by experience and academics

The lived experience of psychosis: a bottom‐up review co‐written by experts by experience and academics

Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction

Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings

Contact Info

Product

Resources

About