Academic journal article Perspectives in Psychiatric Care

Reconnecting: The Client Experience of Recovery from Psychosis

Academic journal article Perspectives in Psychiatric Care

Reconnecting: The Client Experience of Recovery from Psychosis

Article excerpt

PROBLEM. To understand the experience of recovery from psychosis from the consumer/client perspective.

METHODS. A naturalistic, qualitative design with an ethnographic method for data analysis. Subjects (N = 10) were interviewed prior to and during the initial year of treatment with clozapine or risperidone.

FINDINGS. Participants described recovery from psychosis as a process that started with improvements in their thinking and feeling, and extended to a series of reconnections with their environment. These reconnections included staff and family. Thinking moved from being focused on their internal self to a larger world.

CONCLUSIONS. A person's recovery from psychosis involves the entire self, bringing all components of physical, emotional, mental, and spiritual aspects of themselves into their experiences of life.

Search terms: Atypical neuroleptics, psychosis, recovery, schizophrenia

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A vast amount of literature exists regarding the signs, symptoms, and management of psychosis. However, studies that follow clients qualitatively through the lived experienced of psychosis and recovery have been missing in the literature. Introduction of a second generation of atypical medications provided an opportunity to study the process of recovery from psychosis.

The authors explored the process of recovery or non-recovery with patients over the initial year of treatment with clozapine or risperidone. The immediate purpose of this investigation was to describe the subjective experiences of individuals with psychoses during the process of recovery or non-recovery. The ultimate goal is to improve the quality of care and support available to meet the needs of the client.

Literature Review

A limited amount of literature was found regarding recovery or non-recovery from psychosis. Studies looking at recovery among people with schizophrenia have generally focused on observation of symptoms. Rating scales such as the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), or the Clinical Global Impression (CGI) have traditionally been used to record these observations of symptoms. Each of these measures involves an "expert" assessing symptom severity. Very little attention, however, has been paid to the personal and subjective experience of individuals recovering from psychosis. Some articles reviewing clients' experience while taking antipsychotic medication have commented on the subjective experience being clinically significant, but frequently missed (Awad, 1993; Awad, Hogan, Voruganti, & Heselgrave, 1995; Hogan & Awad, 1992).

The Experience of Psychosis

Few qualitative studies have described the experience of psychoses. Estroff (1989) examined the subjective experience of schizophrenia; she believed that schizophrenia affects not only a person's cognitive and emotional being, but also self-identity. Gudeman (1966) studied the phenomenology of delusions through a case analysis of one person treated over several years and several admissions to hospital; he described the seductive nature of delusions, suggesting they provide a means to an end. To maintain delusions, however, the person must limit other information that may challenge the delusions. Howard (1966) reported a phenomenological analysis of hallucinations, describing them as having a perceptual character, in that they appear clearly and vividly in objective time and space. Unlike "real" perceptions, they spring "into being in a primal matter with no relation of causality to the surround (or lack thereof)" (p. 213).

Larkin (1979) analyzed the form and content of hallucinations of 10 people during acute and remission phases of schizophrenia. Subjects in this study continued to perceive hallucinations as real when they were in either phase, and frequently experienced both auditory and non-auditory hallucinations in both phases. …

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