Sense of self in recovery from severe mental illness

Abstract

This report based on research interviews conducted with persons struggling to recover from prolonged psychiatric disorders suggests that the rediscovery and reconstruction of an enduring sense of the self as an active and responsible agent provides an important aspect of improvement. This process of developing a functional sense of self in the midst of persisting psychotic symptoms and dysfunction is described, and its implications for understanding severe mental illness and processes of change are discussed. It is suggested that viewing the development of a dynamic sense of self as central to the improvement process provides a coherent thread which ties together diverse research findings concerning factors influencing course and outcome of illness. It is also suggested that for treatment and rehabilitation to elicit and foster a more functional sense of self, models of improvement will need to allow for, and encourage, a more active and collaborative role for the person with the disorder.

Social Networks for Mental Health Clients: Resources and Solution

“…The findings indicate that more people could be helped if networks were established among vulnerable groups with less social support (Wilson et al 1999, Hardiman 2004, Dorvil et al 2000, Granerud and Severinsson 2007 and more network qualities -like a stronger focus on the satisfaction of universal human needs -were integrated into professional practices (Davidson and Strauss 1992, Spaniel et al 2002, Borg and Topor 2003, Aderhold and Stastny 2007, Borg 2007. Also network meetings where professionals and network members meet on a more equal basis (Seikkula 2000) is a model with promising qualities, not the least in order to compensate for the exposed situation of people with weak networks.…”

Determinants of functioning and well-being among individuals with schizophrenia: An integrated model

“…Qualitative studies also suggest that proactive coping and goal striving may be crucial aspects of the process of coping with schizophrenia. Davidson and Strauss (1992) and others (Sells, Stayner, & Davidson, 2004) described how persons with severe mental illness who expressed themes of the discovery of themselves as active agents in their qualitative narratives displayed significant improvement in global functioning in a longitudinal study. This process, which Davidson and Strauss termed the construction of "sense of self," frequently involved the discovery of ways of recapturing a sense of purpose through daily activities.…”

“…These links are hypothesized based on the perspective that people ultimately, by way of their coping efforts, alter their environments and enduring personality characteristics in small but meaningful ways. Despite suggestions from the qualitative research described in the preceding section that proactive coping efforts can play a role in transforming the identity of people with severe mental illness (Davidson & Strauss, 1992), these hypotheses are largely conjectural and have yet to be tested in research.…”

Effects of “Dual Focus” Mutual Aid on Self-Efficacy for Recovery and Quality of Life

“…Increased self-efficacy or sense of mastery has been identified as a primary process associated with recovery from mental disorders (Shaffer and Gambino, 1978;Rosenfeld, 1987;Anthony, 1993;Davidson and Strauss, 1992;Coursey et al, 1991). Persons with serious mental disorders are variously described as having low self-efficacy or feelings of powerlessness and hopelessness (Hays and Buckle, 1992;Rosenfeld, 1992).…”

“…Self-efficacy, also termed "perceived autonomy" or "sense of mastery," was the strongest or second strongest predictor of quality of life in several studies involving mental health patients (Ritsner et al, 2003;Zissi et al, 1998;Mercier and King, 1994;Arns and Linney, 1993;Rosenfeld, 1992). Persons recovering from mental disorders indicate a desire to regain their "self-confidence" (Coursey et al, 1991) and a "functional sense of self" (Davidson and Strauss, 1992), concepts similar to self-efficacy. In a related line of research, the construct of optimism, which has a component of personal agency, has been strongly linked to psychological well-being (Scheier and Carver, 1992;Wrosch and Scheier, 2003).…”