Thornhill, Hermione; (2002) Recovery from psychosis : Stories of escape, enlightenment and endurance : A qualitative study of 15 accounts of recovery after one or more psychotic episodes, using interpretative phenomenological analysis and narrative analysis. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

The aim of the present study was to explore recovery from psychosis. Gaps in the literature were identified, specifically with regard to a lack of research focusing on recovery, non-clinical populations, and the subjective experience of psychosis and recovery. The first aim of the study was to explore psychological and emotional themes which emerged across accounts of recovery from psychosis. The second aim of the study was to examine the kind of stories individuals told about their recovery, allowing for a focus on the narrative aspects of the accounts as wholes, for example their genre, tone, core narrative, kinds of social and cultural language and metanarratives drawn upon, as well as key 'turning points' and 'stuck points'. Semi-structured interviews were conducted with fifteen individuals who described themselves as recovered or recovering from psychosis. The Interviews were transcribed in full. They were analysed using Interpretative Phenomenological Analysis (IPA) in order to examine the psychological and emotional themes which emerged. Narrative analysis was used to analyse the narrative aspects of the accounts. Four clusters of themes emerged from the IPA analysis: the first cluster examined the importance of making sense of the psychosis for recovery, whether as linked to previous experiences of trauma, or to a physical condition, or to part of being a creative, sensitive person, for example. The second cluster addressed themes of the responses to psychosis, by the self, others and systems: whether they were characterised by fear and co-ercion, for example ('beating up') or understanding and acceptance ('tea and sympathy'). The third cluster 'Telling stories', focused on the theme of 'Deception and silence versus honesty and openness', examining the kinds of stories which were told within different contexts. The fourth cluster, 'Working out where you stand' addressed wider themes of human rights and responsibilities within social, political and legal frameworks. In the narrative analysis it was found that the narratives could be categorised as narratives of 'escape', 'enlightenment' and 'endurance'. This suggested different understandings of and pathways to recovery, linked to different experiences of psychosis and different experiences within the mental health system. Key aspects which emerged in the analysis of language, meta-narratives, turning points and stuck points, were the roles of agency, identity and meaning in the recovery process. Recovery was seen to be a fundamentally dialogic process in which the person who has experienced psychosis is able or unable to exercise their autonomy, make meaning from their experiences and hold onto or create a valued identity in interaction with those around them and within wider systems. The results are discussed in light of other research in the field and implications of the study are suggested. The need for future research to elaborate on the findings is stressed.

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