Listening between the lines : how a theoretical framework prevents superficial analysis in qualitative research

As quantitative methods dominate the field of clinical psychology, qualitative inquiry struggles to live up to its full potential. The ubiquitous quantitative criteria and epistemology lead to a flawed idea of objectivity, pursued by many qualitative researchers in an attempt to be taken seriously. Therefore, they try to avoid any possible theoretical influence. This often creates a fear for really interpreting data. However, it seems that instead of leading to higher quality research, this rather leads to superficial analyses. In this chapter, I show, based on my own recent research regarding the experience of negative symptoms in psychosis, how theory-use led to more in-depth analyses. Our study consisted of an Interpretative Phenomenological Analysis of interviews with twelve patients with psychosis about their negative symptoms. During the earlier phases of research, we stayed close to the data and tried to bracket our theoretical assumptions as much as possible. However, when coming to our final analysis, we approached the data more through a theoretical lens. This way we were able to lift our analysis from what was rather a summary of what our participants told to a deeper understanding of the process of negative symptoms

Content matters, a qualitative analysis of verbal hallucinations

Auditory verbal hallucinations have traditionally especially been researched from a formbased approach, with content getting much less attention. In this article, we argue for the importance of looking at content to get a fuller understanding of the hallucinatory experience. Guided by Lacanian psychoanalysis, we conducted a thematic and a narrative analysis on interviews with 10 schizophrenic patients about their hallucinations. We discerned five themes in the data, which were based on Lacanian theory and had to do with existential questions: parenthood and authority, sexuality and relationships, gender identity, life in the light of death, and what does the other want? Furthermore, we added a theme for unclassified content. Narratively, we found that participants constructed a story of four steps about their hallucinatory experiences. These steps were disturbing events in the past posing an existential question, triggering event, period of confusion, and hearing voices that allude to existential themes. Participants succeed in different degrees in integrating their hallucinatory experiences in their own life history. These stories can be situated on a continuum by making use of three prototypical narrating styles: the meta-delusional, delusional, and chaotic narrative type. Overall, our analysis shows that hallucinations can both be thematically and narratively organized, by making use of a theoretical framework like Lacanian psychoanalysis. Our research demonstrates that hallucinatory contents are not random but are about existential issues imbedded in a life narrative. Future research would benefit of integrating content and form-based approaches

Experiencing negative symptoms in psychosis : a systematic qualitative review

Although negative symptoms of psychosis are frequently researched, the subjective experience of these symptoms is not often studied in detail. This paper addresses this shortcoming by reviewing qualitative research about first-person perspectives on negative symptoms. A systematic literature search using Web of Science, Scopus, PsychArticles, PubMed, CiNAHL and Embase revealed 12 relevant studies. Our review yields a model with five clusters: failing social interactions; experiences of disconnection; overwhelming psychotic experiences; an eroded self-image; and detrimental side effects of psychotropic medication. In the discussion, the authors conclude that disturbances underlying negative symptoms should be studied in greater detail, starting explicitly from theoretical frameworks like phenomenology or psychoanalysis

Negative symptoms in psychosis : failure and construction of narratives

Background Despite considerable scientific interest in the negative symptoms of psychosis, the subjective dimension of these experiences has barely been studied. Methods This paper aims at addressing this shortcoming by means of an Interpretative Phenomenological Analysis of semi-structured interviews with 12 participants with a psychotic disorder. Results The analysis yielded three major themes: 1) negative symptoms can be conceptualized as a failure of narratives to account for perplexing experiences participants are confronted with in psychosis; 2) negative symptoms challenge participants to make sense of them with meta-narratives; 3) participants highlight a withdrawn attitude towards life after psychosis. Conclusions The standard characterization of negative symptoms as a loss of normal functioning should be revised, as this does not match participants' subjective experiences. Negative symptoms rather represent hard to verbalize experiences. This difficulty of linguistic expression is not 20 a shortcoming of the person experiencing them, but characteristic of the experiences themselves

Narratives and recovery from negative symptoms in psychosis : a co-constructive study

POINTS OF INTERESTThis article explores how narratives can play a role in the recovery from negative symptoms of psychosis.This study is the result of a collaboration between researchers with and without lived experience of psychosis.Developing a personal narrative practice can help to regain a grip on life and as such to get out of a crisis. Narratives are especially helpful when you are able to claim ownership/authorship of them.Current mental health care still too often fails to recognize service users as active meaning making subjects, but rather approaches them as passive recipients of care. We believe such an attitude might unwittingly promote negative symptoms.Creating opportunities to develop and get recognition for one's narratives might foster recovery. Recovery is a hot topic in current psychosis literature. However, popular models on recovery, like CHIME-DTAR, fail to address the relationship with factors that might hamper recovery, like experiencing negative symptoms. This study explores how narratives can play a role in recovery from negative symptoms. As a mixed team of researchers, some with lived experience of psychosis, others with a background in clinical psychology or special needs education, we co-constructed an understanding of how narratives played a role in the experiences of Pete and Tanguy. Two major themes stood out: narratives can serve as points of support; and the importance of claiming ownership over your own narrative practice. The authors conclude that recovery can be promoted by creating opportunities for service users to articulate personal narratives and get recognition for these. Our collaborative approach not only highlighted these aspects, but also provided an opportunity for articulating narratives