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Living with Suicide: Collective Narrative Practice with People Experiencing Ongoing Suicidality

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Living with Suicide: Collective Narrative Practice with People Experiencing Ongoing Suicidality Living with Suicide: Collective Narrative Practice with People Experiencing Ongoing Suicidality Cheryl Hunter A thesis submitted in partial fulfilment of the requirements of the University of East London for the degree of Professional Doctorate in Clinical Psychology May 2020 Acknowledgements My everlasting gratitude and admiration to each project contributor, who brought their hearts to the project. It was an honour to hear their stories and do this work together. I will carry your stories with me, always. To both community groups, for inspiring me, supporting the project, and creating wonderful, open spaces for people to be themselves. To Dr Maria Castro Romero and UEL for enabling me to carry out this work. Especial thanks to Maria’s thoughtful supervision, which enriched my experience and thinking about narrative research and collective narrative practice. To Steve, my partner, and Catherine and John, my parents, for all their support and love, and for seeing strength in me for me. To the trainees who have been my support in the last three years, who give me hope in a future where everyone feels welcomed and seen. To Thursday nights. You will do (and have done) so many amazing things. I can’t wait to see the next thing! To Eve, for all the wonderful conversations and the whole-hearted belief in the value of this work. In awe of your passion and creativity. To Glyn, for our friendship. Your presence is still felt. To Dr Poots, for his eagle eye and generosity. To cups of tea and conversation with loved ones. Page 2 of 204 Table of Contents Acknowledgements ............................................................................................ 2 Abstract .............................................................................................................. 6 1. Introduction ..................................................................................................... 7 1.1 My Position ......................................................................................................................... 7 1.2 Definitions ........................................................................................................................... 8 1.3 Context .............................................................................................................................. 10 1.3.1 Prevalence and Trends .......................................................................................... 10 1.3.2 UK Context ................................................................................................................ 11 1.3.3 Impact ......................................................................................................................... 12 1.3.4 Understandings of, and Responses to, Suicide .............................................. 13 1.3.4.1 Biological/Medical ................................................................................................ 13 1.3.4.2 Psychological and Psycho-therapeutic .......................................................... 16 1.3.4.3 Sociological and Socio-Political ....................................................................... 19 1.3.4.4 Cultural and Community .................................................................................... 22 1.4 Summary of Context ....................................................................................................... 25 1.5 Literature Review ............................................................................................................ 26 1.5.1 Suicidal Thoughts and Feelings .......................................................................... 27 1.5.2 Self-Harm ................................................................................................................... 28 1.5.3 Suicide Attempts ..................................................................................................... 30 1.5.4 Reasons for Living .................................................................................................. 31 1.5.5 Ongoing Suicidality................................................................................................. 32 1.6 Summary of Literature Review .................................................................................... 33 1.7 Relevance to Clinical Psychology .............................................................................. 34 1.8 Research Aims and Questions .................................................................................... 34 2. Methods ......................................................................................................... 37 2.1 Epistemology and Ontology ......................................................................................... 37 2.2 Social Justice and Epistemic Injustice ...................................................................... 38 2.3 Methodology ..................................................................................................................... 39 2.4 Recruitment ...................................................................................................................... 39 2.4.1 Sites and Gatekeeping ........................................................................................... 39 2.4.2 Sampling .................................................................................................................... 40 2.4.3 Inclusion and Exclusion Criteria ......................................................................... 40 2.5 Ethical Issues ................................................................................................................... 42 2.5.1 Ethical Approval....................................................................................................... 42 Page 3 of 204 2.5.2 Informed Consent .................................................................................................... 42 2.5.3 Collective Resource Creation ............................................................................... 42 2.5.4 Data Issues ................................................................................................................ 43 2.5.5 Protection of Participants ..................................................................................... 43 2.5.6 Relational Aspects .................................................................................................. 44 2.5.7 Protection of Researcher....................................................................................... 45 2.6 Data Collection ................................................................................................................. 45 2.6.1 Collective Narrative Practice ................................................................................ 46 2.6.2 Workshops ................................................................................................................ 47 2.6.3 Interviews .................................................................................................................. 48 2.6.4 Creative Workshop and Collective Resources ................................................ 48 2.6.5 Transcription ............................................................................................................ 49 2.7 Narrative Analytic Approach ........................................................................................ 49 2.7.1 Narrative Definition ................................................................................................. 50 2.7.2 Narrative Analysis ................................................................................................... 50 2.7.3 Analytic Steps .......................................................................................................... 51 2.8 Presentation ...................................................................................................................... 52 2.9 Reflexivity .......................................................................................................................... 53 2.10 Evaluation ....................................................................................................................... 53 3. Analysis ......................................................................................................... 55 3.1 Text Conventions ............................................................................................................ 55 3.2 Analytic Process ............................................................................................................. 55 3.3 Individual Narratives ...................................................................................................... 58 3.4 Adele – “No us and them”(1181) ................................................................................. 58 3.4.1 “A burden to others” (288-289) ............................................................................ 59 3.4.2 “Not a broken person” (1065) ............................................................................... 62 3.4.3 “Nice bright sky and then all the clouds” (1217-1218) .................................. 63 3.5 Willow – “Eventful child” (825) .................................................................................... 65 3.5.1 “A princess locked in a castle” (725) ................................................................. 67 3.5.2 “A new life amongst uplifting people”(1080) ..................................................
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