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The subjective experience of negative symptoms : characteristics of emotional withdrawal

Le Lievre, James A., Schweitzer, Robert, & Barnard, Alan (2011) The subjective experience of negative symptoms : characteristics of emotional withdrawal. In Geekie, Jim, Randall, Pattie, Lampshire, Debra, & Read, John (Eds.) Experiencing Psychosis : Personal and Professional Perspectives. Routledge, East Essex, pp. 187-196.

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    Abstract

    According to the diagnosis of schizophrenia in the DSM-IV-TR (American Psychiatric Association, 2000), negative symptoms are those personal characteristics that are thought to be reduced from normal functioning, while positive symptoms are aspects of functioning that exist as an excess or distortion of normal functioning. Negative symptoms are generally considered to be a core feature of people diagnosed with schizophrenia. However, negative symptoms are not always present in those diagnosed, and a diagnosis can be made with only negative or only positive symptoms, or with a combination of both.

    Negative symptoms include an observed loss of emotional expression (affective flattening), loss of motivation or self directedness (avolition), loss of speech (alogia), and also a loss of interests and pleasures (anhedonia). Positive symptoms include the perception of things that others do not perceive (hallucinations), and extraordinary explanations for ordinary events (delusions) (American Psychiatric Association, 2000). Both negative and positive symptoms are derived from watching the patient and thus do not consider the patient’s subjective experience.

    However, aspects of negative symptoms, such as observed affective flattening are highly contended. Within conventional psychiatry, the absence of emotional expression is assumed to coincide with an absence of emotional experience. Contrasting research findings suggests that patients who were observed to score low on displayed emotional expression, scored high on self ratings of emotional experience. Patients were also observed to be significantly lower on emotional expression when compared with others (Aghevli, Blanchard, & Horan, 2003; Selton, van der Bosch, & Sijben, 1998). It appears that there is little correlation between emotional experience and emotional expression in patients, and that observer ratings cannot help us to understand the subjective experience of the negative symptoms.

    This chapter will focus on research into the subjective experiences of negative symptoms. A framework for these experiences will be used from the qualitative research findings of the primary author (Le Lievre, 2010). In this study, the primary author found that subjective experiences of the negative symptoms belonged to one of the two phases of the illness experience; “transitioning into emotional shutdown” or “recovering from emotional shutdown”.

    This chapter will use the six themes from the phase of “transitioning into emotional shutdown”. This phase described the experience of turning the focus of attention away from the world and onto the self and the past, thus losing contact with the world and others (emotional shutdown). Transitioning into emotional shutdown involved; “not being acknowledged”, “relational confusion”, “not being expressive”, “reliving the past”, “detachment”, and “no sense of direction” (Le Lievre, 2010). Detail will be added to this framework of experience from other qualitative research in this area. We will now review the six themes that constitute a “transition into emotional shutdown” and corresponding previous research findings.

    Impact and interest:

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    ID Code: 47501
    Item Type: Book Chapter
    Additional Information: Extensive scientific research has been conducted into understanding and learning more about psychotic experiences. However, in existing research the voice of subjective experience is rarely taken into consideration. In this book, first-person accounts are brought centre-stage and examined alongside current research to suggest how personal experience can contribute to professional understanding, and therefore the treatment, of psychosis. Experiencing Psychosis brings together a range of contributors who have either experienced psychosis on a personal level or conducted research into the topic. Chapters are presented in pairs providing information from both personal and research perspectives on specific aspects of psychosis including: hearing voices, delusional beliefs, and trauma as well as cultural, existential and spiritual issues. Experts from the field recognise that first and foremost psychosis is a human experience and that those who suffer from psychotic episodes must have some involvement in any genuine attempts to make sense of the experience. This book will be essential reading for all mental health professionals involved with psychosis. The accessible style and compelling personal histories will also attract service users and their families. Table of Contents Geekie, Randal, Read, Lampshire, Introduction. Roe, Lysaker, The Importance of Personal Narratives in Recovery from Psychosis. Dillon, Recovery from 'Psychosis'. Davidson, Hurrying Slowly: Initial Steps Towards Recovering from Psychosis. Bidois, A Cultural and Personal Perspective of Psychosis. Lambrecht, Taitimu, Exploring Culture, Subjectivity and Psychosis. Randal, Subjective Experience of Spirituality and Psychosis. Lukoff, Spirituality and Psychosis. Lauveng, When You Have Lost Yourself, There's Really Not Very Much Left. Geekie, The Uncertainty of Being: Existential Aspects of the Experience of Psychosis. Byrne, At Risk of Developing Psychosis: A Personal Account. Hardy, At Risk of Developing Psychosis: The Research Perspective. Boevink, Corstens, My Body Remembers; I Refused: Childhood Trauma, Dissociation and Psychosis. Read, Research into the Subjective Experience of, and Beliefs about, the Link Between Psychosis and Bad Things Happening. Lampshire, The Sounds of a Wounded World. Beavan, Myriad Voices Myriad Meanings: Review of the Research into the Subjective Experience of Hearing Voices. Wraphire, Deluded Loner. Campbell, Morrison, Subjective Experiences of Delusions and Paranoia. Longden, Negative Symptoms: More, Not Less. Lievre, Schweitzer, The Subjective Experience of Negative Symptoms: Characteristics of Emotional Withdrawal. Neugeboren, I Called You My Brother. Read, Magliano, The Subjective Experience and Beliefs of Relatives of People who Experience Psychosis. Randal, Geekie, Read, Lampshire, Concluding Comments.
    Keywords: schizophrenia, lived experience, phenomenology, social, emotions
    ISBN: 9780415580335
    Subjects: Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > PSYCHOLOGY (170100) > Health Clinical and Counselling Psychology (170106)
    Divisions: Current > QUT Faculties and Divisions > Faculty of Health
    Current > Institutes > Institute of Health and Biomedical Innovation
    Current > Schools > School of Nursing
    Current > Schools > School of Psychology & Counselling
    Copyright Owner: © 2012 Selection and editorial matter, Jim Geekie, Patte Randal, Debra Lampshire and John Read; individual chapters, the contributors
    Copyright Statement: All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.
    Deposited On: 07 Dec 2011 07:42
    Last Modified: 09 Dec 2011 03:46

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