‘... You feel like the one that got left behind’: a narrative inquiry into the friendships of people who have endured mental health difficulties

Abstract

Aims: To explore insights between friendship and mental health through a critical narrative inquiry. To conceptualise friendship and inform public health approaches to loneliness and mental health. Method: Seventeen interviews were conducted with middle-age people who had experienced mental health difficulties. Stories were subjected to a narrative analysis and interrogated further using critical theory. Results: Compassion in friendship reduces alterity and loneliness, and results in mutual discovery of dignity in relation to distress and stage of life. This is not achievable in all friendship. Conclusion: The temporary encounter of friendship can provide new bases for authentically relating. Through dignity and authenticity, friendship can contribute to mental health and reduce loneliness. Suggestions are made to inform public health approaches to friendship.

Friendship theory for public health research and practice: a critical realist review

“…in spite of historic harm in relationships, however, friendship is sought across the lifespan for its capacity to validate established and emerging expressions of one's self, providing 'relief' from historically entrenched experiences to one's self and from others. 13 The person affected may utilise a range of strategies to retain friendship that benefit those they are in relation with (such as developing a greater tolerance of their friend over and above that towards themselves) and different 'health-identities' are brought into relation; identifying with others who also experience mental ill-health, identifying with historic, long-serving friends, and identifying with friends who are unaware of the difficulties. 14 Spontaneous friendships and intentional friendship studies show that friendship brings qualities made attainable through relating: becoming more outgoing and active, improved subjective wellbeing, reductions in psychiatric symptoms, and a sense of having a trusted place in the social world as a 'normal' person.…”

“…Such moral orienteering to one another may account for the experiences of regaining a trusted place in the social world as a 'normal' person (as found in studies of befriending schemes for people who have experienced mental ill-health) or the experience of 'relief' from historically entrenched experiences of one's self and other. 13 The theory also suggests a form of exchange-and-equity in friendship based on perceived 'worth' or status of the person experiencing ill-health, which may be over-simplifying the previous analysis of how different identities and mutual qualities, and therefore corresponding virtues, are brought into relation. A more contemporary version of Aristotle's thesis can be found in Honneth's theory of recognition.…”

“…In spite of historic harm in relationships, however, friendship is sought across the lifespan for its capacity to validate established and emerging expressions of one’s self, providing ‘relief’ from historically entrenched experiences to one’s self and from others. 13…”

“…17 The theory defines a passive role to those in friendship as merely receiving some objectively evaluated ‘reward’ or ‘cost’, rather than the meaningful rationalisations often given by those affected and how those in friendship actually re-orient to one another. 13 Partly because of its behaviourist account of rewards and costs driving relationships and partly because there is an assumption of some form of objectively beneficial social ‘productivity’ towards one another, this theory is underpinned by a moral positioning towards self-interest and self-sufficiency. This ironically, undermines much of the friendship phenomena and qualities the theory is attempting to explain.…”