Factors that help or hinder personal recovery in people with a schizophrenia diagnosis: a different sort of 'therapeutic' relationship

This collaborative study grew out of the lived, learned experience of the primary inquirer and co-inquirer, a diagnosed paranoid schizophrenic. Embracing a phenomenological (Heidegger, 1927/1962) participatory action attitude (Reason & Bradbury, 2001) using research as a tool to offer a practical alternative, the study aimed to generate knowledge to empower persons with a schizophrenia diagnosis by raising conscious awareness of what either helps or hinders personal recovery. A total of eight credible exemplars with experiences synonymous with a schizophrenia diagnosis participated in open dialogical interviews. An a priori open coding framework derived from my selective, guided interrogation of the personal recovery oriented literature was applied to and iteratively integrated with the inductively driven data which emerged from the interviews. Nine organising themes emerged which converged around three interdependent global themes: Context, Meaning Making and Identity Formation, Interpersonal Relationships and Organisational Culture – Systems. Figural to this intersubjective, contested and co-created multiversal space is a different sort of therapeutic relationship built on pragmatism, authenticity and a tolerant understanding and willingness to embrace and make meaning of disconcerting subjective experiences. The study generates knowledge to challenge and de-construct the essentially contested construct of schizophrenia along with the myths, misconceptions and negative stereotypes which maintain “it”, by raising conscious awareness of and redressing the inherent power imbalance in staff-client relationships and by privileging and validating the voices of the people who own the experience. These hitherto largely unheard voices support the call for an empowering “paradigm shift in relation to the experience that these [schizophrenia] diagnoses refer to” (BPS, 2014). The originality and challenge of this approach resides with fellow mental health and allied professionals willingly embracing incongruent disconcerting worlds, surrendering the privilege of professional disciplinary power and taking “on board that there is no us and them, there are only people trying to make the best of our situation” (Understanding Psychosis and Schizophrenia, 2014, p. 113).