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Battered, bruised and mended: an Interpretative Phenomenological Analysis of the experiences of middle-aged individuals with First Episode Psychosis

Mavia-Zajac, M. (2021). Battered, bruised and mended: an Interpretative Phenomenological Analysis of the experiences of middle-aged individuals with First Episode Psychosis. (Unpublished Doctoral thesis, City, University of London)


Research into first episode psychosis has developed considerably over the past two decades, mostly around experiences of younger people, with very little known about middle-aged individuals' experiences. Yet first episode psychosis in this age group is no rare event.

The purpose of this study was to gain a deeper understanding of how middle-aged individuals make sense of their experiences of becoming unwell and receiving treatment under the Early Intervention in Psychosis service.

Six participants (three females and three males) aged between 40 and 60 years were purposively sampled and interviewed using a semi-structured interview schedule. The interviews were audio-recorded and transcribed verbatim. The data were subjected to Interpretative Phenomenological Analysis.

Five superordinate themes emerged from the data: (a) "My Worst Nightmare," (b) "Not Myself," (c) Person of Interest, (d) Belittled, and (e) “Coming Out.” Together, these themes highlight the shattering of participants' identities, leaving them trapped in shame, and feeling like aliens. They also outline how a new self emerged as participants reframed their experiences and restored their identities.

The findings indicate how middle-aged individuals reflect on their first episode psychosis experiences with a mixture of wariness and gratitude suggestive of loss, growth and resilience, with what appears to be elements of Post Traumatic Growth being identified by several. They also suggest the need for all services that interact with these individuals to do so humanely and provide them with meaningful opportunities and resources to support the integrative processes following first episode psychosis. Additionally, there are implications for professionals and policymakers regarding the process of detaining individuals for hospitalisation, as the practices described by some of the participants appear to perpetuate the stigma of mental illness. Lastly, further clinical implications are for professionals working within Early Intervention in Psychosis services to consider incorporating restoration of identity as part of their treatment outcomes.

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