Constructing stories of the self following the first-psychotic episode and substance misuse

Abstract

This study aimed to explore the narratives of patients who have experienced a first episode psychosis with a known history of substance misuse. Therefore, the overarching aim of this study was that of gleaning the constructed life story of the participants. It is expected that this study increases the healthcare professionals’ and policy makers’ awareness over the patients’ subjective experiences. It aimed to examine the manner in which persons who suffered a first episode psychosis experience their selfhood and to identify any changes in their life script occurring after such an episode. For the purpose of this study, a qualitative approach was adopted. Following a minimum period of one year in remission of psychotic symptoms, five males participated in a semi—structured interview. Interviews were transcribed verbatim and analysed through a narrative analysis. Following Vetere and Dallos (2016) model, the analysis was divided into three parts: thematic, structure, and process analysis. Three dominant narratives were elicited: Losing the Grip; Me, Us, and Them and The Self. Participants’ narrative structures were analysed and possible ‘frozen narratives’ were identified, in line with Vetere and Dallos’ method of Narrative Analysis. Moreover, process analysis was conducted in order to analyse how the story was being narrated and how it was experienced by the participant and the researcher. Findings suggest that participants struggled on realising that their perceptions were not shared by the people around them. The difficulties they encountered to reach-out and to take on the patient’s role are evidenced Changes in their relationships with others, perceptions of life, and sense of self were highlighted. The need for continuity of care, improvement of setting and environment in the services and early intervention for psychosis were recommended.