Display options
Share it on

Int J Soc Psychiatry. 2020 Nov;66(7):724-730. doi: 10.1177/0020764020934516. Epub 2020 Jun 26.

A critical narrative analysis of psychiatrists' engagement with psychosis as a contentious area.

The International journal of social psychiatry

Therese O'Donoghue, Jon Crossley

Affiliations

  1. Department of Neuroscience, Psychology and Behaviour, George Davies Centre, University of Leicester, Leicester, UK.

PMID: 32588699 PMCID: PMC7430097 DOI: 10.1177/0020764020934516

Abstract

BACKGROUND: Psychosis, characterised by altered perceptions or interpretations of reality, remains a contested area. Lately, perspectives and conceptualisations of psychosis that have traditionally been more peripheral have gained greater recognition. Both the British Psychological Society and Critical Psychiatry Network have highlighted some contentious areas in recent publications.

AIMS: The aim was to use critical narrative analysis to consider what facilitates and inhibits medical professionals with clinical experience of psychosis to engage with the topic of psychosis as a contentious area.

METHOD: Semi-structured interviews were conducted with 12 medical professionals, who were at trainee or qualified level with a minimum of 6 months' clinical experience within psychiatry, across three Trusts within the United Kingdom. This purposive sample had a diverse range of perspectives regarding psychosis. Critical narrative analysis comprising six distinct stages, informed the analysis.

RESULTS: Participants positioned themselves broadly within one of three groups: biological psychiatrists, critical psychiatrists and those more conflicted. Narrative analysis was undertaken for each participant before being integrated for this article. The research highlighted several factors which either limit or facilitate opportunities within the psychiatric profession to engage with a plurality of views regarding psychosis. These included the significance of power and hierarchy within the profession, the role of dialogue and the prevalence of reflexivity within the profession.

CONCLUSION: A pattern was identified of psychiatrists generally associating with like-minded others and not engaging with wider evidence regarding psychosis, partly as a result of the inherent threats to the power and hierarchy of the profession. This led to new ideas being widely unknown or undervalued, potentially to the disservice of clinical practice.

Keywords: Psychosis; critical narrative analysis; critical psychiatry

References

  1. Br J Psychiatry. 2010 Feb;196(2):92-5 - PubMed
  2. World Psychiatry. 2019 Feb;18(1):88-96 - PubMed
  3. Psychol Med. 2009 Jun;39(6):967-76 - PubMed
  4. BMJ. 2001 Mar 24;322(7288):724-7 - PubMed
  5. Curr Opin Genet Dev. 2012 Jun;22(3):238-44 - PubMed
  6. Biol Psychiatry. 2006 Jul 15;60(2):81-3 - PubMed
  7. Lancet. 2009 Jan 17;373(9659):234-9 - PubMed
  8. Schizophr Bull. 2016 May;42(3):538-41 - PubMed
  9. Br J Psychiatry. 2012 Dec;201(6):430-4 - PubMed
  10. Int J Law Psychiatry. 1996 Winter;19(1):1-25 - PubMed
  11. BJPsych Bull. 2016 Aug;40(4):212-6 - PubMed
  12. Nat Genet. 2008 Sep;40(9):1053-5 - PubMed
  13. Br J Psychiatry. 2014 Feb;204(2):93-5 - PubMed
  14. Curr Opin Psychiatry. 2015 May;28(3):264-8 - PubMed
  15. BMJ. 2002 Apr 13;324(7342):900-4 - PubMed
  16. Schizophr Bull. 2017 Mar 1;43(2):253-256 - PubMed
  17. Int J Ment Health Nurs. 2009 Apr;18(2):116-25 - PubMed

MeSH terms

Publication Types