ABSTRACT
Psychosis is the most ineffable experience of mental disorder. We provide here the first co-written bottom-up review of the lived experience of psychosis, whereby experts by experience primarily selected the subjective themes, that were subsequently enriched by phenomenologically-informed perspectives. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of psychosis as well as family members and carers, representing a global network of organizations. The material was complemented by semantic analyses and shared across all collaborators in a cloud-based system. The early phases of psychosis (i.e., premorbid and prodromal stages) were found to be characterized by core existential themes including loss of common sense, perplexity and lack of immersion in the world with compromised vital contact with reality, heightened salience and a feeling that something important is about to happen, perturbation of the sense of self, and need to hide the tumultuous inner experiences. The first episode stage was found to be denoted by some transitory relief associated with the onset of delusions, intense self-referentiality and permeated self-world boundaries, tumultuous internal noise, and dissolution of the sense of self with social withdrawal. Core lived experiences of the later stages (i.e., relapsing and chronic) involved grieving personal losses, feeling split, and struggling to accept the constant inner chaos, the new self, the diagnosis and an uncertain future. The experience of receiving psychiatric treatments, such as inpatient and outpatient care, social interventions, psychological treatments and medications, included both positive and negative aspects, and was determined by the hope of achieving recovery, understood as an enduring journey of reconstructing the sense of personhood and re-establishing the lost bonds with others towards meaningful goals. These findings can inform clinical practice, research and education. Psychosis is one of the most painful and upsetting existential experiences, so dizzyingly alien to our usual patterns of life and so unspeakably enigmatic and human.
ABSTRACT
A reforma na saúde mental brasileira teve como grandes diretrizes, a experiência de desinstitucionalização italiana e do pensamento de Franco Basaglia. Estes, por sua vez, possuem bases e fundamentos em discussões e posições derivadas do pensamento fenomenológico (na filosofia) e de perspectivas da Psiquiatria fenomenológica, a partir de autores como Jaspers e Minkowski. O objetivo deste artigo é demonstrar as vinculações do pensamento fenomenológico na concepção da reforma da atenção à saúde mental brasileira. Para isso foi articulado teoricamente o pensamento destes autores na compreensão da saúde mental...
The reform of mental health had as major guidelines, the experience of Italian deinstitutionalization and Franco Basaglia's intellectual legacy. These, in turn, have bases and foundations in discussions and derivative positions of phenomenological thought (in philosophy) and phenomenological perspectives of Psychiatry, from authors such as Jaspers and Minkowski. The purpose of this article is to demonstrate the linkages of the phenomenological approach in the designing of the Brazilian reform of mental health care. Therefore was theoretically articulated the thought of these authors in the understanding of mental health...
La reforma a la salud mental tuvo como grandes directrices, la experiencia de desinstitucionalización italiana y el pensamento de Franco Basaglia. Estos, a su vez, tienen bases y fundamentos en los debates y posiciones en derivados del pensamiento fenomenológico (em la filosofía) y las perspectivas fenomenológicas de Psiquiatría, de autores como Jaspers y Minkowski. El propósito de este artículo es demostrar la vinculación del enfoque fenomenológico en el diseño de la reforma de la atención de la salud mental para el brasileño. Para ello se articula en teoría el pensamiento de estos autores en la comprensión de la salud mental...
Subject(s)
Humans , Brazil , Psychiatry , Mental Health/history , Person-Centered PsychotherapyABSTRACT
A reforma na saúde mental brasileira teve como grandes diretrizes, a experiência de desinstitucionalização italiana e do pensamento de Franco Basaglia. Estes, por sua vez, possuem bases e fundamentos em discussões e posições derivadas do pensamento fenomenológico (na filosofia) e de perspectivas da Psiquiatria fenomenológica, a partir de autores como Jaspers e Minkowski. O objetivo deste artigo é demonstrar as vinculações do pensamento fenomenológico na concepção da reforma da atenção à saúde mental brasileira. Para isso foi articulado teoricamente o pensamento destes autores na compreensão da saúde mental.(AU)
The reform of mental health had as major guidelines, the experience of Italian deinstitutionalization and Franco Basaglia's intellectual legacy. These, in turn, have bases and foundations in discussions and derivative positions of phenomenological thought (in philosophy) and phenomenological perspectives of Psychiatry, from authors such as Jaspers and Minkowski. The purpose of this article is to demonstrate the linkages of the phenomenological approach in the designing of the Brazilian reform of mental health care. Therefore was theoretically articulated the thought of these authors in the understanding of mental health.(AU)
La reforma a la salud mental tuvo como grandes directrices, la experiencia de desinstitucionalización italiana y el pensamento de Franco Basaglia. Estos, a su vez, tienen bases y fundamentos en los debates y posiciones en derivados del pensamiento fenomenológico (em la filosofía) y las perspectivas fenomenológicas de Psiquiatría, de autores como Jaspers y Minkowski. El propósito de este artículo es demostrar la vinculación del enfoque fenomenológico en el diseño de la reforma de la atención de la salud mental para el brasileño. Para ello se articula en teoría el pensamiento de estos autores en la comprensión de la salud mental.(AU)
