Sense of self, adaptation and recovery in patients with psychosis in a forensic NHS setting

Abstract

Qualitative methods have been used to explore users' recovery from psychosis. These studies have highlighted the importance of hope and redefining sense of self as being important aspects of the recovery process. To date there have been no studies that have collaborated with users in high-security forensic settings to develop an experiential perspective of recovery in psychosis. This study used a social constructionist version of grounded theory to develop an experiential account of recovery in psychosis. Thirteen individuals who had experience of psychosis and were residing in a high-security setting were interviewed in depth about their experiences of recovery. The interviews were transcribed and analysed using the social constructionist version of grounded theory. Contrasting accounts of recovery were apparent from the way in which participants spoke about their experiences. Some participants gave rich and reflective accounts of their recovery. These participants spoke about the nature of past experiences and the importance of those experiences in contextualizing their problems, and reflected on the implications of this on the tasks of recovery. In contrast, other participants' transcripts tended to be short and unelaborated. Recovery tasks seemed to be segregated from previous experiences and their reflection on their experience of psychosis seemed minimized. However, all participants spoke about the importance of developing relationships with staff and family. The development of relationships influenced how participants redefined themselves. Implications for clinical practice and further research are reviewed.

What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis

“…Yet individuals are not typically suicidal at this stage as they are absorbed in dealing with their experiences (Skoldlar et al, 2008). This fear often remains, or is amplified, by hospital admission (Laithwaite et al, 2007). Positive aspects of the experience may also exist, such as a feeling of connection with the universe (Kinderman et al, 2006;Nixon et al, 2010a).…”

“…Sideeffects of anti-psychotic medication can also lead to changes in both self-identity and selfesteem, often through weight gain and sexual dysfunction (Johnstone et al, 2009;Laithwaite et al, 2007;Roe et al, 2009). …”

“…The security of a reliable body may be lost, with a loss of physiological homeostasis including altered sleeping patterns (Gee et al, 2003;Geanollos, 2005;Laithwaite et al, 2007;Nixon et al, 2010b), eating patterns, and new somatic pains (Koivisto et al, 2002).…”

“…Relationships with mental health professionals and hospital staff can also be instrumental to Meta-synthesis of qualitative studies of psychosis 15 recovery (Cook et al, 2009;Laithwaite et al, 2007;Nixon et al, 2010a). (Mackrell & Lavender, 2004;Tooth et al, 2003;Shea et al, 2010) and demonstrate constancy (Lencucha et al, 2008).…”

La psychothérapie individuelle de la schizophrénie: mise en perspective de son histoire, de ses développements récents et de ses orientations nouvelles

“…Il implique plutôt la sortie d'un état dans lequel le soi est vécu comme affaibli en tant que pôle de vitalité et d'initiatives, parfois au point que les personnes ressentent quasiment un vide à sa place [32]. La restauration de l'expérience de soi peut représenter, en un sens, un processus plus personnel, dans lequel les personnes se reconnaissent capables de prendre en main leur propre rétablissement et, par là d'atteindre d'autres objectifs, tels que l'approfondissement des liens avec les autres, le retour au travail ou la poursuite des études [44].…”