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Meaning-making of the subjective experience of psychosis, when subject to a dominant psychiatric discourse: a dynamic phenomenological and discursive analysis

Baboulene, K. (2020). Meaning-making of the subjective experience of psychosis, when subject to a dominant psychiatric discourse: a dynamic phenomenological and discursive analysis. (Unpublished Doctoral thesis, City, University of London)

Abstract

Objectives
This study investigated the subjective, embodied lived experience of individuals who had experienced psychosis, in addition to the interplay and impact of dominant psychiatric discourse on the meaning-making process. Constructions of psychosis deployed, experiential phenomena expressed, and therefore implications for subjectivity, selfhood, and meaning-making, were explored.

Design
A dual focus methodology combining Interpretative Phenomenological Analysis (IPA) and Foucauldian Discourse Analysis (FDA) was utilised to explore both language and experience. Despite arguments that combining IPA and FDA creates epistemological/ontological conflicts due to dissonant theoretical underpinnings, adoption of a critical realist position permitted an integration of these approaches.

Method
Four individuals with experience of both psychosis and accessing mental health services were interviewed. Focussing on both discourse and embodied lived experience, transcribed interviews were analysed using a dual focus of IPA and FDA simultaneously, followed by an integrative analysis.

Results
Individuals described a meaning-making crisis, affected by disorientating unusual perceptual experiences in a relational context. Themes emerged pertaining to loss, trust, agency and a fight for a meaningful existence, in both the embodied lived experience and socially constructed nature of reality. Dominant psychiatric discourse was experienced as generally limiting, with implications for levels of recovery and meaningful existence.

Conclusion
A combined methodological approach enabled a comprehensive understanding of the dynamic interaction between language and the situatedness of embodied experience, coexisting dynamically within our personal and social realities. Meaning-making, and participants developing their own personal meaning, were found to be fundamental in experiencing life as meaningful, thereby creating hope for the future.

Recommendations for practice include prioritising the subjective lived experience of psychosis and acknowledging the socially constructed nature of our reality by creating a therapeutic encounter in which personal meaning can be made by drawing on a variety of culturally available discourses, rather than the imposition of meaning associated with dominant psychiatric discourse.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: Doctoral Theses
Doctoral Theses > School of Arts and Social Sciences Doctoral Theses
School of Arts & Social Sciences > Psychology
Date available in CRO: 14 Jul 2021 15:05
Date deposited: 14 July 2021
URI: https://openaccess.city.ac.uk/id/eprint/26434
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