Emotional earthquakes in the landscape of psychosis: an interpretative phenomenology
Jonathan Hutchins, John Rhodes, Saskia Keville
The Cognitive Behaviour Therapist January 1, 2016 Peer reviewed DOI: 10.1017/s1754470x16000167
Summary
People with psychosis experience intense emotions before, during, and after psychotic episodes, including distress, confusion, blame, guilt, and hope. Interviews with eight participants from an early psychosis service revealed four emotional themes: struggling with life distress before psychosis, a transformed world with intense emotion during psychosis, self-critical blame and guilt after breakdown, and a mix of confusion, despair, and hope afterward. The findings suggest that normalizing these emotions can improve engagement with services, and that assessing self-criticism, despair, and hope is clinically important.
Study at a glance
| Design | qualitative study |
|---|---|
| Sample size | 8 |
| Population | individuals from a local Early Intervention in Psychosis service |
| Key finding | Individuals with psychosis experience distinct emotional patterns before, during, and after psychotic episodes, including distress, intense emotion, self-criticism, and a mixture of confusion, despair, and hope. |
Abstract
AbstractTraditionally studies have neglected emotion in psychosis, possibly as a consequence of psychiatry's emphasis on psychotic symptoms rather than individuals’ lived experience of emotions before, during and after psychotic episodes. This study sought to investigate how individuals experienced their emotions and delusions in the context of psychosis. A qualitative Interpretative Phenomenological Analysis (IPA) research methodology was used. Semi-structured interviews were conducted with a purposively sampled group of eight participants recruited from a local Early Intervention in Psychosis service. Four themes were generated by the analysis. The first highlighted emotional experiences prior to the onset of psychosis: ‘struggling with life distress’. The second highlighted the intense emotional experience within psychotic experiences: ‘transformed world and intense emotion’. The third theme highlighted self-critical tendencies in the post-onset phase of psychosis: ‘blame and guilt after the breakdown’. The final theme highlighted a mixture of emotions in the post-onset phase: ‘confusion, despair and hope’. There were many clinical implications highlighted in the study including the value of normalizing participants’ emotional experiences in order to promote engagement in services and of assessing for self-criticism, despair and hope following the psychotic experience, alongside therapeutically addressing the varying levels of emotional experiences before, during and after a psychotic breakdown.