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Living Outside Mental Illness

Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia

Foreword by John S. Strauss
Copyright Date: 2003
Published by: NYU Press
Pages: 227
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  • Book Info
    Living Outside Mental Illness
    Book Description:

    Schizophrenia is widely considered the most severe and disabling of the mental illnesses. Yet recent research has demonstrated that many people afflicted with the disorder are able to recover to a significant degree.Living Outside Mental Illness demonstrates the importance of listening to what people diagnosed with schizophrenia themselves have to say about their struggle, and shows the dramatic effect this approach can have on clinical practice and social policy. It presents an in-depth investigation, based on a phenomenological perspective, of experiences of illness and recovery as illuminated by compelling first-person descriptions.This volume forcefully makes the case for the utility of qualitative methods in improving our understanding of the reasons for the success or failure of mental health services. The research has important clinical and policy implications, and will be of key interest to those in psychology and the helping professions as well as to people in recovery and their families.

    eISBN: 978-0-8147-8535-5
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Foreword
    (pp. ix-x)
    John S. Strauss

    Let’s say you were living with a large group who, a couple of generations earlier, had made a very difficult journey west across a huge plain. They had had to develop from nothing the means of making that journey. Now, all of you are there at the edge of the mountains where they had settled. Some have made journeys into the mountain passes but never very far. You, on the other hand, want to go farther. But you have to develop means for crossing huge streams, for climbing steep rock faces, and you have gotten farther than anyone ever had....

  4. Acknowledgments
    (pp. xi-xii)
  5. Introduction
    (pp. 1-30)

    IF YOU HAVE PICKED UP THIS BOOK long enough to glance at this page—and not because it has been assigned to you as required reading by one of our friends—then it is most likely because you have an interest either in qualitative research or in schizophrenia. There may be a few of you who approach this book with interests in both topics; if so, welcome to an inviting, cozy, circle of your peers. It has been our experience that the area of overlap between these two interests, that is, qualitative psychological research and serious mental illness, is relatively...

  6. 1 Is There an Outside to Mental Illness?
    (pp. 31-60)
    Maria O’Connell, David Sells and Martha Staeheli

    HOW, THEN, TO BEGIN? By articulating what it is that we are interested in learning more about through our investigation. We may have framed our primary research question already, albeit implicitly, but it will be useful in guiding our efforts to make this question both focused and explicit. It is:

    How does the person who has schizophrenia affect the course and outcome of the illness?

    With our focus being on processes of improvement, in particular, we may frame this question more specifically as:

    How do the person’s experiences and activities affect processes of recovery in schizophrenia?

    Once these questions are...

  7. 2 Eliciting Narratives
    (pp. 61-92)

    WE WANT TO LEARN MORE about the ways in which people with schizophrenia may influence the course and outcome of the disorder and decided to do so by interviewing people who are currently living with the disorder (as opposed, e.g., to reading autobiographical accounts). Now what? Don’t we simply identify a number of people diagnosed with schizophrenia and ask them: “In what ways do you influence the course and outcome of your disorder?” No, we do not. The reasons we do not ask this type of question are manifold, and we will explore several of them in this chapter. We...

  8. 3 Understanding Narratives
    (pp. 93-125)

    WE MAY NOW BE FEELING relatively good about ourselves. With a bit of patience and some practice we have learned how to elicit rich, detailed narratives even from an isolated population of people who are perhaps not accustomed to being asked about their lives. This leaves us, though, in possession of hundreds of pages of verbatim transcripts from (typically) between 12–36 interviews, each lasting (again, typically) between 45–90 minutes. It is at this phase of the research that doctoral students who choose to conduct empirical qualitative studies for their dissertations begin, at times unexpectedly, to have nightmares. Why...

  9. 4 Living Inside Schizophrenia
    (pp. 126-158)

    WE HAVE COLLECTED OUR MAPS, filled our backpacks with supplies and our canteens with water, and are ready to set off on a more systematic exploration of lived experiences of schizophrenia. Conventional clinical wisdom cautions that this may be a journey from which there can be no return. “Once a schizophrenic,” this clinical voice murmurs, “alwaysa schizophrenic,” believing schizophrenia to be an invariably life-long condition. “Once a schizophrenic,” this voice murmurs, “onlya schizophrenic,” believing also that schizophrenia subsumes the entirety of the person affected by it (Davidson, Chinman, et al., 1999; Harding, Zubin, and Strauss, 1987). This chapter...

  10. 5 Living Outside Schizophrenia
    (pp. 159-198)

    IF WE HAVE PAINTED a vivid enough picture of the downward spiral that appears to unfold inexorably, and to lead thereby to the end-state of premature dementia first described by Kraepelin, then you should be left wondering how, or even if, recovery is possible in a condition like schizophrenia. If so, then we have done our job well in portraying the uphill, almost Sisyphean, battle people face in trying to overcome the effects of the disorder. We know from the outcome research reviewed in chapter 1, however, that partial to full recovery is, in fact, possible over time for many,...

  11. Conclusion
    (pp. 199-209)

    WHAT HAVE WE NOW LEARNED from our phenomenological analysis of first-person accounts of living with schizophrenia, and what implications do these findings hold for future research and for clinical and rehabilitative practice? We take up each of these issues in turn as we bring this volume to a close.

    Figure 7 depicts those elements of an emerging model of recovery from schizophrenia that we have been able to distill from over 100 open-ended, narrative interviews of people diagnosed with this disorder. Recalling our analogy from chapter 3, in which we suggested that phenomenological investigation is like becoming immersed in a...

  12. Epilogue
    (pp. 210-212)

    We began this investigation with the question:“How do the person’s experiences and activities affect processes of recovery in schizophrenia?”Our qualitative analysis indicated that experiences of being stigmatized and/or rejected by others, as well as those of failing at efforts to accomplish normative life tasks, make recovery more difficult. Being accepted and valued by others, as well as experiences of success, pleasure, and being generative, play important roles in promoting recovery. In addition, withdrawal, isolation, and absorption in idiosyncratic ways of making sense of one’s illness-related experiences make recovery a more remote possibility, while engagement in the world and...

  13. Works Cited
    (pp. 213-224)
  14. Index
    (pp. 225-227)
  15. About the Author
    (pp. 228-228)