A Narrative Analysis of Psychiatric Survivors’ Experiences of Recovery

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A Narrative Analysis of Psychiatric Survivors’ Experiences of Recovery ABSTRACT RECOVERED VOICES, RECOVERED LIVES: A NARRATIVE ANALYSIS OF PSYCHIATRIC SURVIVORS’ EXPERIENCES OF RECOVERY by Alexandra Lynne Adame The discourse of the medical model of mental illness tends to dominate people’s conceptions of the origins and treatments of psychopathology. This reductionistic discourse defines people’s experiences of psychological distress and recovery in terms of illnesses, chemical imbalances, and broken brains. However, the master narrative does not represent every individual’s lived experience, and alternative narratives of mental health and recovery exist that challenge our traditional understandings of normality and psychopathology. Using the method of interpretive interactionism, I examined how psychiatric survivors position themselves in relation to the medical model’s narrative of recovery. In its inception, the psychiatric survivor movement created a counter-narrative of protest in opposition to the medical model’s description and treatment of psychopathology. Since then, the movement has moved beyond the counter-narrative and has constructed an alternative narrative; one that is not defined in opposition to the master narrative but instead participates in an entirely different discourse. RECOVERED VOICES, RECOVERED LIVES: A NARRATIVE ANALYSIS OF PSYCHIATRIC SURVIVORS’ EXPEREINCES OF RECOVERY A Thesis Submitted to the Faculty of Miami University in partial fulfillment of the requirements for the degree of Master of Arts Department of Psychology by Alexandra Lynne Adame Miami University Oxford, OH 2006 Advisor: _______________________________ Roger M. Knudson, Ph.D. Reader: ________________________________ Larry M. Leitner, Ph.D. Reader: ________________________________ William B. Stiles, Ph.D. Table of Contents Introduction..........................................................................................................................1 Narrative Psychology...............................................................................................1 History of Psychiatric Survivor Movement .............................................................5 Narratives of Recovery ............................................................................................9 Survivors’ Perspectives on Recovery ....................................................................12 Medical Model as Master Narrative ......................................................................17 Researcher’s Positioning in Relation to Current Study .........................................20 Method ...............................................................................................................................22 Interview and Recruitment Procedure ...................................................................22 Analysis of Narratives............................................................................................23 Results................................................................................................................................25 Dialogical Positioning of the Researcher’s Voice .................................................25 Presentation of Results...........................................................................................26 Recovery as a Process............................................................................................27 Recovery from the Mental Health System.............................................................29 Surviving Trauma ..................................................................................................34 An Epiphany of Human Compassion ....................................................................35 Recovered Voices, Recovered Lives .....................................................................37 The Myth of Incurability........................................................................................41 Deconstructing Recovery.......................................................................................44 Recovery and the Good Life..................................................................................46 It’s Not All About Me: Destiny and the Good Life...............................................51 Consciousness-Raising and Participation in Counter-Cultural Communities .......53 Discussion..........................................................................................................................59 Traditional Constructions of Recovery: Recovery as a Process, Recovery from the Mental Health System, and Surviving Trauma................................................59 Turning Point: An Epiphany of Human Compassion............................................61 Revisioning Recovery: Recovered Voices, Recovered Lives, and the Myth of Incurability.............................................................................................................62 Turning Point: Deconstructing Recovery ..............................................................63 Re-Constructing Recovery: Destiny and the Good Life........................................64 The “Empty Self,” American Psychology, and the Good Life..............................67 References..........................................................................................................................71 Appendix A........................................................................................................................75 Appendix B ........................................................................................................................77 Appendix C ........................................................................................................................78 ii Acknowledgements This project would not have been possible without the help of Ruta, Will, Oryx, and Cheryl who graciously agreed to participate and share their life stories with me. I am extremely grateful to each of them for the opportunity to hear and learn from their narratives of recovery. I would also like to thank my thesis advisor, Roger Knudson, for his support, encouragement, and valuable feedback he gave me from the beginning to the end of this project. Many thanks to the members of my thesis committee, Larry Leitner and Bill Stiles, for their helpful feedback and suggestions for strengthening the presentation of the thesis. Finally, I would like to thank Rachel Hamilton, Anthony Pavlo, and Darren Del Castillo for their continued friendship and support throughout the course of this project. iii Recovered Voices, Recovered Lives: A Narrative Analysis of Psychiatric Survivors’ Experiences of Recovery People live in a storied world filled with many discourses, narratives, archetypes, metaphors, and knowledge with differing degrees of privilege within various societies. In order to organize their existence within this world, persons narrate their experiences and in doing so create life narratives that relate their past to their present and imagines possible storylines of the future. The organization and structure of a person’s life narrative provides insight into one’s psychological meaning-making processes. People’s life narratives are never static, changing constantly in relation to new experiences and interactions. My interest in narrative analysis grew out of wanting to understand why people tell their stories in a particular way. I look at what cultural, social, or political discourses shaped their telling and structure of the narrative, and how they use language and metaphor to give a voice to their experiences and feelings. A group of individuals who identify themselves as psychiatric survivors has been steadily growing in numbers, strength, and voice since the early 1970s. Most psychiatric survivors are vocally critical of the current mental health system and its symptom- focused, medical model approach. This critique applies both to the model’s treatment practices and its way of conceptualizing mental distress and recovery. Beresford (1999) points out that “survivors are increasingly challenging the medicalisation of their distress and perceptions and rejecting psychiatry’s preoccupation with causation and its denial of their feelings and legitimacy” (Beresford, 1999, p. 45). As a future clinical psychologist and ally of the survivor movement, I am interested in survivors’ subjective experiences of emotional distress as well as how each individual defines and narrates the recovery process. Using Denzin’s (2001) method of interpretive interactionism, I interviewed several psychiatric survivors about their experiences of recovery, analyzed and interpreted their narratives in relation to the dominant social discourse of the medical model of mental illness. Narrative Psychology Over the past twenty years, many psychologists have taken a narrative turn in their way of thinking about people in dialogical relation to others and their social world (e.g., Bruner, 1990; Frank, 1995; Hawkins, 1999; Josselson, 1995; Klienman, 1988; McLeod, 1997; Polkinghorne, 1988; Robinson & Hawpe, 1986; Sarbin, 1986; Schafer, 1992; Spence, 1982; White & Epston, 1990). For example, Sarbin (1986) has written extensively about how people think, dream, communicate, and construct their identities in narrative form. Because of people’s tendency to story their existence in narrative form, Sarbin proposes the idea of narrative as a root metaphor for psychology, and describes his narratory principle “that human beings think, perceive, imagine and make moral choices according to narrative
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