Understanding Illness Experience from the Perspective and Practice of Personal Construct Psychology

Abstract

Concepts of health and illness have changed across cultures and centuries along with methods of inquiry and treatment. In this article, illness experience is explored from the perspective of Personal Construct Psychology (PCP) and a coherent methodology of enquiry is proposed. A study of the medically unexplained symptoms of eye floaters is presented as an exemplification. Participants suffering from eye floaters perceive flashes and spots in their perceptive fields, but they do not necessarily have an eye disease. The aim of this study is to understand the experience of these participants, differentiate them, and propose a personalized care approach. Eye examinations and echography, individual semi-structured interviews were carried out and dependency grids were used. Qualitative analysis showed that the illness experience depended on the perception of the disease, the personal explanation given, the solutions tried, the trust placed in medicine, self-construction, and the dispersion of dependency. Cases exhibiting similar experiences were grouped based on these categories, and four illness trajectories were identified by referring to Kelly’s transitions: aggressiveness, threat, constriction, and guilt. These trajectories were subsequently verified in the context of other chronic illnesses, in the health attitudes of people without particular illnesses, and finally with the families of chronically ill children. In all these cases, a different health status or illness progression corresponded to each trajectory. These studies illustrate a new way to understand illness based on PCP and on a specific methodology of inquiry, which may be useful for future studies and clinical practice.