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Emotional earthquakes in the landscape of psychosis: an interpretative phenomenology

Published online by Cambridge University Press:  07 November 2016

Jonathan Hutchins*
Affiliation:
East London NHS Foundation Trust, Bedfordshire, UK
John Rhodes
Affiliation:
Central and North West London NHS Foundation Trust, London, UK
Saskia Keville
Affiliation:
Department of Psychology, University of Hertfordshire, Hatfield, Herts, UK
*
*Author for correspondence: Dr J. Hutchins, East London NHS Foundation Trust, Leighton Buzzard CMHT, Crombie House 36 Hockcliffe Street, Leighton Buzzard, Bedfordshire LU7 1HJ, UK (email: [email protected]).

Abstract

Traditionally 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.

Type
Original Research
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

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References

Recommended follow-up reading

Gumley, A, Schwannauer, M (2006). Staying Well After Psychosis: A Cognitive Interpersonal Approach to Recovery and Relapse Prevention. Chichester: John Wiley and Sons.Google Scholar
Meaden, A, Fox, A (2015). Innovations in Psychosocial Interventions for Psychosis: Working with the Hard to Reach. London: Routledge.CrossRefGoogle Scholar
Rhodes, J, Jakes, S (2009). Narrative CBT for Psychosis. London Routledge.Google Scholar
Rhodes, J (2012). Narrative CBT: Distinctive Features. London Routledge.Google Scholar

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision). Washington DC: American Psychiatric Association.Google Scholar
Bentall, RP, Corcoran, R, Howard, R, Blackwood, N, Kinderman, P (2001). Persecutory delusions: a review and theoretical integration. Clinical Psychology Review 21, 11431192.Google Scholar
Birchwood, M, Iqbal, Z, Upthegrove, R (2005). Psychological pathways to depression in schizophrenia studies in acute psychosis, post psychotic depression and auditory hallucinations. European Archives of Psychiatry and Clinical Neuroscience 225, 202212.CrossRefGoogle Scholar
Birchwood, M, Meaden, A, Trower, P, Gilbert, P (2002). Shame, humiliation, and entrapment in psychosis: a social rank theory approach to cognitive intervention with voices and delusions. In A Casebook of Cognitive Theory for Psychosis (ed. Morrison, A. P.), pp. 108131. Hove: Brunner-Routledge.Google Scholar
Byrne, R, Morrison, AP (2010). Young people at risk of psychosis: a user-led exploration of interpersonal relationships and communication of psychological difficulties. Early Intervention Psychiatry 4, 162168.Google Scholar
Campbell, M, Morrison, AP (2007). Comparing the experiences of patients with psychosis and individuals with no psychiatric history. Clinical Psychology & Psychotherapy 14, 751767.CrossRefGoogle Scholar
Davidson, L, Roe, D (2007). Recovery from versus recovery in serious mental illness: one strategy for lessening confusion plaguing recovery. Journal of Mental Health 16, 459470.Google Scholar
Freeman, D (2007). Suspicious minds: the psychology of persecutory delusions. Clinical Psychology Review 27, 425457.Google Scholar
Freeman, D, Dunn, G, Startup, H, Pugh, K, Cordwell, J, Mander, H, Cernis, E, Wingham, G, Shirvell, K, Kingdon, D (2015). Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis. Lancet 2, 305313.Google Scholar
Freeman, D, Garety, P (2003). Connecting neurosis and psychosis: the direct influence of emotion on delusions and hallucinations. Behaviour Research and Therapy 41, 923947.CrossRefGoogle ScholarPubMed
Fornells-Ambrojo, M, Garety, P (2009). Understanding attributional biases, emotions and self-esteem in poor me paranoia: findings from an early psychosis sample. British Journal of Clinical Psychology 48, 141162.CrossRefGoogle ScholarPubMed
Garber, J, Dodge, K (1991). The Development of Emotion Regulation and Dysregulation. Cambridge: Cambridge University Press.Google Scholar
Gilbert, P (2010). The Compassionate Mind. London: Constable Publishers.Google Scholar
Goldstone, E, Farhall, J, Ong, B (2011). Life hassles, experiential avoidance and distressing delusional experiences. Behaviour Research and Therapy 49, 260266.Google Scholar
Greenberg, SL (2004). Emotion-focused therapy. Clinical Psychology and Psychotherapy 11, 316.CrossRefGoogle Scholar
Goodliffe, L, Hayward, M, Brown, D, Turton, W, Dannahy, L (2010). Group person-based cognitive therapy for distressing voices: views from the hearers. Psychotherapy Research 20, 447461.Google Scholar
Gumley, A, Schwannauer, M (2006). Staying Well After Psychosis: A Cognitive Interpersonal Approach to Recovery and Relapse Prevention. Chichester: John Wiley and Sons.Google Scholar
Hayes, SC, Strosahl, D, Wilson, K (2004). Acceptance and Commitment Therapy: an Experiential Approach to Behavior Change. New York: Guilford Press.Google Scholar
Janoff-Bullman, R (1992). Shattered Assumptions: Towards a New Psychology of Trauma. New York: Free Press.Google Scholar
Krabbendam, L, Janssen, I, Bijl, RV, Vollebergh, WAM, van Os, J (2002). Neuroticism and low self-esteem as risk factors for psychosis. Social Psychiatry and Psychiatric Epidemiology 37, 16.Google Scholar
Linehan, M (1993). Cognitive-Behavioural Treatment of Borderline Personality Disorder (Diagnosis & Treatment of Mental Disorders). New York: Guilford Press.Google Scholar
Livingstone, K, Harper, S, Gillanders, D (2009). An exploration of emotion regulation in psychosis. Clinical Psychology & Psychotherapy 16, 418430.CrossRefGoogle ScholarPubMed
Møller, P, Husby, R (2000). The initial prodrome in schizophrenia: searching for naturalistic core dimensions of experience and behavior. Schizophrenia Bulletin 26, 217232.Google Scholar
Mohr, S, Borras, L, Betrisey, C, Pierre-Yves, B, Gillieron, C, Huguelet, P (2010). Delusions with religious content in patients with psychosis: how they interact with spiritual coping. Psychiatry 73, 158.Google Scholar
Morrison, A (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy 29, 257276.Google Scholar
Morrison, AP, Frame, L, Larkin, W (2003). Relation between trauma and psychosis: a review and integration. British Journal of Clinical Psychology 42, 331353.Google Scholar
Perry, Y, Henry, J, Grisham, J (2011). The habitual use of emotion regulation strategies in schizophrenia. British Journal of Clinical Psychology 50, 217222.Google Scholar
Pitt, L, Kilbride, M, Nothard, S, Welford, M, Morrison, AP (2007). Researching recovery from psychosis: a user-led project. Psychiatric Bulletin 31, 5560.CrossRefGoogle Scholar
Pruessner, M, Iyer, SN, Faridi, K, Joober, R, Malla, AK (2011). Stress and protective factors in individuals at ultra-high risk for psychosis, first episode psychosis and healthy controls. Schizophrenia Research 128, 2935.CrossRefGoogle Scholar
Read, J, van Os, J, Morrison, AP, Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330350.Google Scholar
Rhodes, J, Jakes, S (2000). Correspondence between delusions and personal goals: a qualitative analysis. British Journal of Medical Psychology 73, 211225.CrossRefGoogle ScholarPubMed
Rhodes, JE, Jakes, SC (2004). Evidence given for delusions during cognitive behaviour therapy. Clinical Psychology and Psychotherapy 11, 207218.Google Scholar
Rhodes, J, Jakes, S (2009). Narrative CBT for Psychosis. Hove: Routledge.Google Scholar
Rhodes, J, Jakes, S (2010). Perspectives on the onset of delusions. Clinical Psychology and Psychotherapy 17, 136146.Google Scholar
Rooke, O, Birchwood, M (1998). Loss, humiliation and entrapment as appraisals of schizophrenic illness: a prospective study of depressed and non-depressed patients. British Journal of Clinical Psychology 37, 259268.Google Scholar
Sass, L (2003). ‘Negative symptoms’, schizophrenia and the self. International Journal of Psychology and Psychological Therapy 3, 153180.Google Scholar
Schore, AN (1994). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Oxford: Psychology Press.Google Scholar
Smith, B, Fowler, D, Freeman, D, Bebbington, P, Bashforth, H, Garety, P, Kuipers, E, Dunn, G (2006). Emotion and psychosis: direct links between schematic beliefs, emotion and delusions and hallucinations. Schizophrenia Research 86, 181188.CrossRefGoogle ScholarPubMed
Smith, JA, Flowers, P, Larkin, M (2009) Interpretative Phenomenological Analysis: Theory Method and Research. London: Sage.Google Scholar
Tangney, J, Stuewig, J, Mashek, D (2007). Moral emotions and moral behaviour. Annual Review of Psychology 58, 345–72.Google Scholar
Wells, A (2008). Metacognitive Therapy for Anxiety and Depression. New York: Guilford Press.Google Scholar
Westermann, S, Lincoln, T (2011). Emotion regulation difficulties are relevant to persecutory ideation. Psychology and Psychotherapy: Theory, Research and Practice 84, 273287.CrossRefGoogle ScholarPubMed
White, RG, Gumley, AI, McTaggart, J, McConville, D, Cleare, S, McLeod, HJ, Mitchell, G (2015). Acceptance and commitment therapy for depression following psychosis: an examination of clinically significant change. Journal of Contextual Behavioral Science 4, 203209.Google Scholar
White, RG, McCleery, M, Gumley, AI, Mulholland, C (2007). Hopelessness in schizophrenia: the impact of symptoms and beliefs about illness. Journal of Nervous and Mental Disease 195, 968975.Google Scholar
Wilson, W (1998). Religion and psychosis. In: Handbook of Religion and Mental Health (ed. Koenig, H.), pp. 161173. San Diego: Academic Press.Google Scholar
Yardley, L (2000). Dilemmas in qualitative health research. Psychology and Health 15, 215228.Google Scholar
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