Embodiment of Severe and Enduring Mental Illness: Finding Meaning in Schizophrenia

Abstract

For many individuals, schizophrenia is a severe and enduring illness. While nurses need to understand the symptomatology of the illness in order to provide specific care and treatment, it also is important to find out how people with schizophrenia embody the illness. Capturing this knowledge will help nurses to provide more appropriate care to these individuals. This paper, which is taken from a larger qualitative study, reports the lived experience of young adults with schizophrenia. Three main themes emerged from the data, which highlighted how these individuals found meaning in schizophrenia. The first theme,"embodied temporality: illness as a catastrophic experience,"portrayed how schizophrenia affected participants' temporality or lived time. The second theme,"embodied relationality: illness as a mediator of social relationships,"reflected how the illness affected their relationships with others. The third theme,"embodied treatment: medications side effects as burdensome,"illustrated how the side effects of antipsychotic medications distorted the individual's perception of his or her body and how it compromised the ability to establish and maintain sexual relationships. The findings are important to mental health nurses because they highlight the need to be sensitive to how people with schizophrenia find meaning in their illness experience and to incorporate this knowledge into the care that they provide.

What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis

“…Medication side-effects also impact upon physiological homeostasis, potentially increasing appetite and sleep (McCann & Clark, 2004;Rofail et al, 2009), and causing physical pains (Roe et al, 2009); being "like hell… like a screw being tightened in your brain" (Usher, 2001, p. 148).…”

“…Whether relations brake down due to the actions of participants, or the actions of others, reconnecting with people is not easy (Mauritz et al, 2009;Schulze et al, 2003), due to factors such as medication side-effects, poor communication skills (Skodlar et al, 2008), and stigma (Diaz-Caneja et al, 2004), as well as the need to potentially mend fences (Krupa et al, 2010;McCann & Clark, 2004). The aid to recovery of a supportive network of friends, particularly friends with a sense of humour (Lencucha et al, 2008), and social relationships generally are frequently stressed (McCann & Clark, 2004;Schon et al, 2009). This can result in a lower probability of suicide (Skodlar et al, 2008), aid a return to work, in turn further aiding social relations (Kennedy-Jones et al, 2005;Gee et al, 2003;Perry et al, 2007;Woodside et al, 2006).…”

“…However, isolation may also be due Redmond et al, 2010) due to a lack of resources such as confidence, energy, and friends (Redmond et al, 2010) and housing (Warren & Ball, 2000). Psychosis also profoundly impacts on sexuality, due to problems including medication-related weight gain (Volman, 2007) and medication-related sexual dysfunction (Chernomas et al, 2000;McCann & Clark, 2004). Sex for the purpose of reproduction is often discouraged; "You mention to the psychiatrist that you want to have a child and he says 'no, that's not possible, don't even think of it" (Gonzalez-Torres et al, 2007, p. 19), which many patients later regret (Chernomas et al, 2000).…”

“…Sources of hope include the support of family and friends (Wagner & King, 2004;Perry et al, 2007), friendships enduring with old friends (Schon et al, 2009), medication (Usher, 2001), positive attitudes from clinicians and confidence about recovery (Green et al, 2008), Meta-synthesis of qualitative studies of psychosis 13 being diagnosed (Dilks et al, 2010), the prospect of work or education (Usher, 2001;Perry et al, 2007;Liu et al, 2007), religion/spirituality (Humberstone, 2002;Drinnan & Lavender, 2006;McCann & Clark, 2004;Wagner & King, 2003), and understanding and/or meeting other people going through the same thing (Coffey et al, 2008;Powell et al, 2006;Newton et al, 2007;Schon et al, 2009). Patients hope for restoration of family relationships, close interpersonal relationships, employment, energy, health, spiritual fulfillment or just a 'normal' life (Chernomas et al, 2000;Koivisto et al, 2004;Gould, 2005;Noh et al, 2000).…”

Understanding empowerment, meaning, and perceived coercion in individuals with serious mental illness

“…1 Only a handful of studies have investigated logotherapy or even the more general concept of meaning in people with SMI, with the available literature supporting the need to consider the meaning construct with respect to symptom presentation and management (e.g., Chaudhary & Sharma, 1976;Gonsalvez & Gon, 1983;McCann & Clark, 2004).…”