“I feel closer now”: experiences of relationships during and after a first episode of psychosis

ABSTRACT

Background

Social impairment has long been associated with psychosis, but recently a more nuanced understanding of how relationships are impacted by psychosis is emerging, taking into account both positive social changes (e.g. improved relationships, increased empathy for others) as well as challenges (e.g. stigma, shame).

Methods

Ten participants were recruited from two early intervention services to participate in semi-structured interviews pertaining to their lived experience of psychosis. Thematic analysis was conducted on data related to social experiences during and after psychosis.

Results

Participants reported a wide spectrum of experiences. Social withdrawal was common and sometimes enacted to protect oneself or others. Some participants reported feelings of confusion, shame, and guilt, resulting in internalized stigma and making it difficult to navigate relationships, especially after an experience of psychosis. Many participants reported positive social changes, including new, more meaningful, and closer relationships.

Discussion

Recovery and adaptation following psychosis is not a linear process, and signs of both distress and growth may occur in parallel. Likewise, social withdrawal and connection may take place simultaneously or successively. More attention should be paid in both research and practice to the myriad ways in which psychosis impacts relationships and how this matters to service users.

KEYWORDS:

• First episode psychosis
• withdrawal
• shame
• post-traumatic growth
• social functioning

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17522439.2023.2288604

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Dr. Louise Lennihan Arts & Sciences Grant, CUNY Graduate Center; Social Sciences and Humanities Research Council of Canada [752-2015-0433].