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Title: 'Schizophrenia' : a crisis of meaning : a heuristic exploration of the psychotherapeutic experiences of those who have a 'schizophrenia' diagnosis
Author: Cotton, Tom
Awarding Body: University of Roehampton
Current Institution: University of Roehampton
Date of Award: 2016
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The empirical aim of this heuristic study was to explore the psychotherapeutic experiences of those with a ‘schizophrenia’ diagnosis. The epistemological aim was to deconstruct the structures of knowledge underpinning the diagnosis. The ‘personal knowledge’ drawn from the researcher’s own experience of working as a psychotherapist and filmmaker with individuals who had the diagnosis, and of being a psychiatric patient in the past, was used as a way of furthering these aims. Along with the work of Moustakas and Polanyi, key discourses used were Heidegger, Laing and contemporary critical clinical discourses. Eight participants with a ‘schizophrenia’ diagnosis took part in open-ended, conversational interviews that yielded substantial detail about the phenomenon. A multiperspective chronological narrative of early life experience, ‘schizophrenic’ breakdown, treatment and recovery emerged during the analysis of data, and is preserved in the composite depiction of the group experience. It was found that exploring the meaningfulness of experiences was a core driver of recovery, and psychotherapy was most helpful when it facilitated this exploration. By contrast, psychotherapy, and treatment as a whole, that obstructed this exploration were found unhelpful. These findings led to the argument that, what is termed ‘personal meaning’, may be a key factor in recovery from ‘schizophrenia’, and psychotherapy that was helpful seemed characterised by Heidegger’s concept of ‘anticipating care’. Treatment governed by ‘medical meaning’ and ‘intervening care’, meanwhile, are argued to prolong a crisis of ‘personal meaning’, and potentially facilitate an ‘acute’ phase of ‘schizophrenia’, rather than recovery. This conclusion raises critical questions about NICE guidelines for ‘schizophrenia’, which seem rooted in ‘medical meaning intervening care’. As well as facilitating an ‘understanding’ approach (in Heidegger’s sense) to researching experience, one key outcome arising from the researcher’s autobiographical connection to the research was learning more about his own experiences, and how to speak about them.
Supervisor: Loewenthal, Derek ; Cayne, Julia Sponsor: Not available
Qualification Name: Thesis (Psych.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: schizophrenia ; diagnosis ; trauma ; experience ; meaning ; psychotherapy ; recovery