City Research Online

In the facets of powerlessness: agency as an essential aspect of the self

Wachowska, Anna (2017). In the facets of powerlessness: agency as an essential aspect of the self. (Unpublished Doctoral thesis, City, University of London)


Though in-patient psychiatric treatment remains an integral part of the mental health services, research that focuses on the exploration of patients’ experience remains scarce. Existing investigations mostly rely on quantitative methods that seem to produce inconclusive results or raise methodological concerns. The current qualitative research aims to explore how individuals’ experience and view their treatment in a closed psychiatric ward under section. The goal is to extract the meaning of such experiences and broaden the understanding of the impact it has on the individuals’ well-being and recovery process. Data was gathered from six former patients who had experienced psychosis at the time of their involuntary commitment onto a psychiatric in-patient ward. Semi-structured interviews were conducted, and an interpretative phenomenological analysis (IPA) was employed to investigate the data. The findings comprise of four superordinate themes: A struggle for recognition; Terrifyingly out of control - striving for a sense of agency; Transformation and loss; and The comforting and sanguine. The results suggest that involuntary hospitalisation to an in-patient ward not only provides a limited opportunity for recovery but can also be very distressing for the patient. The findings are aligned with the existing conceptualisations of involuntary treatment, potentially constituting a traumatic experience with debilitating impact upon individuals’ sense of self. The study also highlights the importance of the relationship with the ward staff, which seems pivotal in directly shaping patients’ perceptions and recovery. Involuntary detention to a psychiatric in-patient ward, however, is a complex process that may be influenced by various contextual factors, potentially triggering a wide range of responses. Thus, contradictory nature of the phenomenon is also unravelled; although individuals share stories of great losses, some significant potential gains have also been identified retrospectively. Findings, in relation to the existing literature, are discussed, and the limitations of the study are identified. Finally, the recommendations for practice and prospective future research are also analysed.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences > Psychology
Doctoral Theses
Doctoral Theses > School of Arts and Social Sciences Doctoral Theses
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