The role of insight in the process of recovery from schizophrenia: A review of three views

摘要

At present there is debate about the importance of insight, or awareness of the consequences and experiences linked with schizophrenia, for recovery. One view suggests that insight is a precondition for treatment adherence and hence wellness. Another suggests that insight may be more destructive than helpful. In this article, we will review both perspectives along with supporting evidence, and offer a third view of the role of insight in recovery in an effort to resolve some of these paradoxical findings. We will argue that one way to make sense of these conflicting accounts and findings is to conceptualize insight not as the acceptance of a certain fact or set of facts, but as a process of personally making sense of experiences and consequences linked with schizophrenia. Furthermore, we will assert that, to be adaptive, this storied account of the experiences and consequences of schizophrenia must be understandable by others and also reject stigma or prevalent stereotypes of mental illness which cast persons diagnosed with schizophrenia as incompetent or dangerous. The importance of this perspective for the development of recovery-oriented interventions is discussed.