A multiple-case study exploring personal paradigm shifts throughout the psychotic process from onset to full recovery.

摘要

The aim of the dissertation was to explore how the personal paradigms of those who have recovered from long-term psychosis changed throughout the psychotic process, from onset to full recovery. My hope was that such an inquiry might provide us with useful information regarding what takes place during the psychotic process at the most fundamental (existential) level of experience, and that perhaps this information might offer some guidelines and perhaps even a more or less universal map that can be of service to others who are still struggling with psychosis.;Qualitative multiple-case study methodology was used to inquire into the experience of six participants who had suffered from long-term psychosis and who are now considered to be fully recovered. Data collection consisted of an initial questionnaire, one live interview of a minimum of one hour, and three follow-up email interviews. A quantitative instrument was also used (the Posttraumatic Growth Inventory) to supplement the qualitative data. Data analysis consisted of developing individual and cross case themes for each of six prefigured categories of experience: description of the anomalous experiences, the onset and deepening of psychosis, recovery, lasting personal paradigm shifts, lasting benefits, and lasting harms. After exhaustive analysis of the data, a theoretical model was formulated that assisted in discussing the implications of the data.;The results revealed that all six participants had striking parallels in their experiences with regard to all six categories of experience. The most central implications that emerged from the findings with regard to all participants are as follows: an overwhelming existential threat to the self apparently played an important role in the onset of psychosis; the psychotic process was likely initiated by the psyche as an attempt to regain equilibrium in the face of this threat; recovery was primarily assisted by reconnecting with hope, meaning, a sense of agency, and the cultivation of healthy relationships; psychiatry generally caused significantly more harm than benefit in the process of recovery; and the successful resolution of the psychotic process apparently involved a profound reorganization of the self along with significantly more lasting benefits than harms.