Love and Incomprehensibility:The hermeneutic labour of caring for and understanding a loved one with psychosis

Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers’ perceptions impact the wellbeing of both parties. However, there is little research on how carers actually make sense of what their loved one is experiencing. Ten carers were interviewed about how they understood a loved one’s psychosis. Data were analysed using a hermeneutic-phenomenological approach. Three themes described the carers’ effortful quest to understand their loved one’s experiences while maintaining their relational bonds. Carers described psychosis as incomprehensible, seeing their loved one as incompatible with the shared world. To overcome this, carers developed hermeneutic ‘mooring points’, making sense of their loved one’s unusual experiences through novel accounts that drew on material or spiritual explanations. The findings suggest that informal carers resist biomedical narratives and develop idiosyncratic understandings of psychosis, in an attempt to maintain relational closeness. We suggest that this process is effortful – it is hermeneutic labour – done in the service of maintaining the caring relationship. Findings imply that services should better acknowledge the bond between carers and care-receivers, and that more relationally oriented approaches should be used to support carers of people experiencing severe mental health problems

Terror and Horror: Feelings, Intersubjectivity and ‘Understanding at the Edges’ in an Interview on a Suicide Attempt

This chapter explores how we can understand suicidal experience more fully and what it means to reach the edges of our understanding. It draws on the case of ‘Roddy’, a research participant whose account of his suicide attempt was marked by experiences of terror and horror. Drawing on phenomenological understandings about the epistemic importance of feelings, I make an argument that we need to critically explore our embodied intersubjective encounters and our emotional worlds, in order to more fully understand suicidal experience. Roddy’s traumatic suicide attempt is hard to communicate, but gaining others’ understanding is imperative for Roddy’s self-understanding and recovery. I consider the visceral and poetic language Roddy uses to help communicate the terror and horror of his experience. I then consider the implications of this—what happens to me, as the listener, when I reach the edges of my capacity for deep, authentic understanding. The chapter concludes with some thoughts about feelings, autobiographical narratives and understanding. I suggest that our communities need to develop more spaces where people can talk about the terror and horror of their suicide attempts safely and openly. I conclude that researchers (and perhaps also clinicians) need to honestly interrogate what happens for them at the edges of their understanding, when listening to such accounts