Psychotherapies for the Psychoses: Theoretical, Cultural and Clinical Integration

By John F.M. Gleeson; Eóin Killackey et al. | Go to book overview

Chapter 11
Fragmentation, invalidation and
spirituality:
Personal experiences of psychosis – ethical,
research and clinical implications

Jim Geekie and John Read


Introduction

I was 150 per cent convinced it was spiritual voices. Then I get told by the
teacher it was not. Then I get told one minute it’s a psychotic breakdown.
Then I get told you’re not hearing them. Then I get told it’s your own
mind talking to itself. Then I get told it’s your higher self. I don’t know
quite frankly what to believe. You know, do I have to keep coming here
every time I hear what I think is a spiritual voice?

The quote above, from a client of a first-episode psychosis (FEP) service struggling to make sense of her experience of psychosis, captures several of the themes explored in this chapter on the individual’s experience of psychosis: a sense of fragmentation of self, of being invalidated by others and a quest for spiritual meaning. The quote raises two important questions regarding psychotic experiences: what are we to make of them and what should we do about them? Clearly, for this individual and others who have such experiences, as well as for those working clinically in this field, these are not mere academic questions. Rather, they are questions which are both profoundly philosophical (regarding the meaning of experience) and pragmatic (how to respond to these experiences). Both the philosophical and the pragmatic are of central importance to any discussion on the nature and meaning of psychosis as evidenced by research such as that by Wagner and King (2005) who found that existential needs (the search for meaning and the need for spirituality) are the most pressing needs identified by those who have psychotic experiences.

In this chapter our focus is on the individual’s experience and understanding of psychosis, as expressed in routine clinical meetings with one of us (Jim Geekie) in his role as clinical psychologist with a FEP service in New Zealand. We begin by outlining our theoretical framework, before considering findings and implications from our research into understandings of psychotic experiences.

To begin, it is necessary to comment on the language used in this chapter. It is with some reluctance that we use the term ‘psychosis’, a term used

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