Recovering a Self in Psychosis

This presentation is based on the findings of over 30 years of qualitative studies involving persons with serious mental illnesses who have described the rediscovery and reconstruction of a sense of the self as an effective social agent in the world as integral to their recovery from psychosis. This program of research has its foundation in the consistent finding of over a century of clinical observation, dating back to Kraepelin and Bleuler, that psychosis is marked by a pronounced loss of a sense of self as an agent. What this body of descriptive clinical knowledge did not pay nearly as much attention to was the regaining of a sense of self as an essential thread of the process of recovery. Since the closures of state hospitals and the advent of community-based care, and as illustrated in a number of longitudinal outcome studies of psychosis published since the 1980s, what has become obvious is that many more people are able to recover from psychosis than was previously thought.

This presentation describes the basic tasks of being in recovery from the vantage point of the person with the mental illness, drawing out some of the implications for clinical practice based on what is known about the process of reclaiming and rebuilding of an effective sense of self as a social agent.