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Living with Schizophrenia: a Phenomenological Investigation Andri Yennari View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Duquesne University: Digital Commons Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Fall 2011 Living with Schizophrenia: A Phenomenological Investigation Andri Yennari Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Yennari, A. (2011). Living with Schizophrenia: A Phenomenological Investigation (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/1389 This Immediate Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. LIVING WITH SCHIZOPHRENIA: A PHENOMENOLOGICAL INVESTIGATION A Doctoral Dissertation Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree Doctor of Philosophy By Andri Yennari August 2011 Copyright by Andri Yennari 2011 LIVING WITH SCHIZOPHRENIA: A PHENOMENOLOGICAL INVESTIGATION By Andri Yennari Approved July 8th, 2011 ________________________________ ______________________________ Russell Walsh, Ph.D. Will Adams, Ph.D. Associate Professor of Psychology Associate Professor of Psychology (Dissertation Director) (First Reader) ________________________________ ______________________________ Jessie Goicoechea, Ph.D. Daniel Burston, Ph.D. Assistant Professor of Psychology Chair of Psychology Department (Second Reader) _______________________________ James C. Swindal, Ph.D. Acting Dean, McAnulty College and Graduate School of Liberal Arts iii ABSTRACT LIVING WITH SCHIZOPHRENIA: A PHENOMENOLOGICAL INVESTIGATION By Andri Yennari August 2011 Dissertation supervised by Russell Walsh This study investigated the experience of living with schizophrenia through seven participants‟ accounts of the way they have been perceived and treated by others, as well as the way they viewed themselves after having been identified with the diagnosis of schizophrenia. Participants were recruited through psychologists at the mental health facility in which they received treatment and were interviewed by the researcher in that facility. To analyze the data of this study, an empirical phenomenological method was used to explicate the meaning of schizophrenia as it was experienced and lived by participants. In addition, this work included a hermeneutic component to interpret the data and explore implicit dimensions of the experiences described by participants. To make the approach as explicit as possible, the researcher employed reflexive procedures iv of acknowledging a priori assumptions, expectations, and presuppositions forming the frame of reference from which the phenomenon was understood. The aim of this empirical qualitative research was to explicate the “lived meaning” of the diagnosis of schizophrenia for particular individuals and then across the individuals. Though the original objective of the project was to focus on the impact of diagnostic labeling on individuals‟ lives, some of the themes that emerged addressed the experience of living with the mental illness of schizophrenia more broadly. Themes were grouped under two clusters to reflect the complexity of participants‟ experience. One cluster pertained to the issue of living with the diagnostic label of schizophrenia. Integral themes included the impact of diagnostic labeling on identity, concealment of the label in interactions with others, and facing ignorance and stigma. The other cluster was specific to schizophrenia as a disorder with which participants struggled. This cluster included themes pertaining to the frightening onset of the illness, the role of spirituality in coping with the illness, tension between trust and mistrust in interpersonal relationships, medication side effects and non-compliance, and perceptions of unhelpful and beneficial aspects of treatment. Findings of this study have important implications for research, clinical practice and public policy. Congruent with prior literature, findings indicate the positive impact of spirituality on coping with schizophrenia, treatment adherence and satisfaction, and self- efficacy. Furthermore, participant accounts demonstrated that the illness of schizophrenia has personal and interpersonal consequences beyond those resulting from diagnostic labeling. Findings also highlight the need for education and research to combat ignorance and stigma regarding schizophrenia. Moreover, negative and positive treatment v experiences provide feedback on potentially effective and ineffective aspects of treatment. This information can help mental health professionals become more aware of how they might improve the quality of care in order to facilitate patients‟ growth and recovery. vi ACKNOWLEDGEMENTS My heartfelt appreciation goes to the following individuals. First, I would like to thank the participants of this study for their contribution to the psychological knowledge of what it is like to live with schizophrenia. Without their reflective and insightful accounts this study would not have been possible. I would like to thank my Dissertation Chair Dr. Russell Walsh for offering me direction and encouragement and for his thorough editorial suggestions. I also thank Dr. Will Adams and Dr. Jessie Goicoechea for their constructive comments and suggestions which I utilized to improve this dissertation. I am thankful for Dr. Roy Chengappa‟s support, generosity and assistance in the recruitment of participants for this project. I owe thanks to Dr. Frank Ghinassi for his guidance and support throughout my years at Duquesne. I also thank James Yu for his friendship and emotional support throughout my graduate studies. I would like to say thank you to my parents Marios and Mary Yennari and brother Doros Yennaris for their continuing emotional support, love, advice and encouragement throughout my graduate studies and the dissertation process especially. I thank my beloved husband Derek for being a role model of motivation, determination, strong work ethic and perseverance. I am thankful for his love, advice, support and I am grateful for having him in my life. vii TABLE OF CONTENTS Page Abstract…………………………………………………………….………………......…iv Acknowledgements………...……………………………………………………………..vi Introduction………………………………………………………………………………1 Literature Review………………....……………..……………..………………………..9 The Diagnosis of Schizophrenia: A Brief History of Madness……………………...……9 Theories of Mental Illness and Stigma…………………………………………………..17 Social Labeling Theory - Scheff, Sarbin and Mancuso……………….…………17 Michel Foucault………………………………………………………………….20 Thomas Szasz…………………………………………………………………….21 Erving Goffman………………………………………………………………….23 Studies Supporting the Consequences of Psychiatric Labeling………………… ………25 Experimental Research…………………………………………………………..26 Autobiographical Accounts……………………………………...………………27 Non-Biomedical Views of Schizophrenia: Nature and Treatment………………………32 Harry Stack Sullivan: Interpersonal Theory and Psychotherapy…….…………..32 Frieda Fromm- Reichmann: Principles of Intensive Psychotherapy…………….34 Bertram P. Karon and Gary R. Vandenbos: Psychotherapy of Schizophrenia........36 Method..............................................................................................................................38 Research Question and Data Collection…………………………………………………40 Data Analysis…………………………………………………………………………….40 Results...............................................................................................................................47 viii Individual Interpretative Summaries………………………………………………..…...47 Devin‟s Experience of Living with the Diagnostic Label of Schizophrenia….…47 Barry‟s Experience of Living with the Diagnostic Label of Schizophrenia….….51 Daniel‟s Experience of Living with the Diagnostic Label of Schizophrenia……56 Shawn‟s Experience of Living with the Diagnostic Label of Schizophrenia……63 Jack‟s Experience of Living with the Diagnostic Label of Schizophrenia………67 Beatrice‟s Experience of Living with the Diagnostic Label of Schizophrenia…..71 Jenny‟s Experience of Living with The Diagnostic Label of Schizophrenia...….77 General Interpretative Summaries……………………………………………………….82 I. Living with the Diagnostic Label of Schizophrenia………………………………......82 1. Not Accepting the Schizophrenia Label as Defining One‟s Identity…………83 2. Concealing the Diagnostic Label of Schizophrenia……………………..……86 3. Facing Others‟ Ignorance about Schizophrenia………...…………………….89 4. Stigma………………………………………………………………...………91 II. Living with the Mental Illness of Schizophrenia……………………………………93 5. A Frightening Onset………………………………………………………..…93 6. Spirituality as Key to Self-Acceptance and Optimistic Life-Outlook…….….96 7. Tension between Trust and Mistrust…………………………………………98 8. Medication Side Effects and Noncompliance……………………….………101 9. Unhelpful Aspects of Treatment…………………………………………….105 10. Benefits of Treatment……………………………..……………………….107 Researcher Reflexivity……………………………………………………………….....110 Discussion……………………………………………………………..……………….117 ix Summary and Conclusions…………………………………………………...………143 Contributions and Limitations/Directions for Future Research…………..……146 References………………………………………………………………………..……149 Appendix A: Advertisement………………………………………………………….153 Appendix B: Consent Form…………………………………………………………..154 Appendix C: Interview Transcripts………………………………………………….156
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