Investigating the lived experience of recovery in people who hear voices: a narrative inquiry

Abstract

There is evidence of both clinical and personal recovery from distressing voices. However, the process of recovery over time is unclear. The overall aims of this thesis were 1) to produce a systematic review and synthesis of existing studies employing narrative inquiry to examine the process of recovery, across disorders and 2) to investigate recovery from distressing voices using narrative inquiry and to use this to critically appraise Romme et al.’s (2009) notion of recovery. Results of the systematic review indicated the following processes were implicated in recovery process across studies: rebuilding a positive sense of self and identity (including agency, self-worth), hope, occupation and activity, acceptance and support, contributing / helping others and making sense of or reframing experiences. Participants emphasised that the recovery process was not linear, and involved integrating their experiences and a transformation of self. Narrative inquiry contributed uniquely to understanding recovery processes and was subsequently employed to investigate the lived experience of recovered voice-hearers. Results revealed two divergent recovery typologies emerging after a period of despair/exhaustion: 1) turning toward/empowerment, which involved developing a normalised account of voices, building voice-specific skills, integration of voices into daily life and a transformation of identity and 2) turning away/protective hibernation, which involved harnessing all available resources to survive the experience and wherein participants emphasised the importance of medication in recovery. Results indicate the importance of services being sensitive and responsive to a person’s recovery style at any given time and their readiness for change. Coming to hold a normalised account of voice-hearing and the self, and witnessing of preferred narratives by others, were essential in the more robust turning toward recovery typology.