A “blip in the road”: experiences of identity after a first episode of psychosis

ABSTRACT

Introduction: Psychosis can affect identity in fundamental ways. Increasingly, those experiencing psychosis for the first time are enrolled in early intervention services. We sought to explore how individuals enrolled in such services felt their identity was impacted by their experience of psychosis.

Methods: In-depth interviews exploring themes related to identity and psychosis were conducted with 10 participants from two early intervention services in New York City.

Findings: The experience of psychosis alienated many participants from themselves, although participants differed in whether these experiences were meaningful to their self-understanding. Participants also varied in how they sought to explain their experiences of psychosis; some participants questioned their diagnoses and the explanations offered to them, whereas others tried to negotiate between a clinical description of psychosis and their own understanding of their experiences. Many participants also experienced positive changes following their experience of psychosis, including greater maturity, empathy, and compassion.

Discussion: Some participants appeared to take on recovery styles of both integrating and sealing-over in response to their experience of psychosis, while most participants’ reports were suggestive of post-traumatic growth. Several struggled to make sense of the explanatory frameworks offered to them, drawing from various explanatory frameworks in a form of bricolage.

KEYWORDS:

• Psychosis
• identity
• early intervention services
• recovery styles
• first episode psychosis
• post-traumatic growth

Acknowledgements

A number of people offered their time and guidance in support of this research and the development of the manuscript. Thank you to Anne Skrobala, Sarah Piscitelli, Sacha Zilkha, Ryan Lawrence, Sascha DuBrul, Morgan Haselden, PJ Williamson, Nannan Liu, Yael Holoshitz, Loren Dent, Beth Broussard, and Matthew Peters.

Disclosure of Interest

The authors have no conflicts of interest to report.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Biomedical explanations of psychosis have been observed to be protective, in that they can reduce feelings of responsibility for one's experiences, but this can be a double-edged sword, in that such explanations can also reduce the agency individuals feel with regards to their recovery (Lam et al., 2011; Lysaker et al., 2009).

Additional information

Funding

This work was supported by a doctoral scholarship from the Social Sciences and Humanities Research Council of Canada (752-2015-0433) and a Dr. Louise Lennihan Arts & Sciences Grant from the Futures Initiative of the CUNY Graduate Center.