Describing the indescribable: A qualitative study of dissociative experiences in psychosis.

<h4>Background</h4>Despite its long history, dissociation remains under-recognised clinically, partly due to difficulties identifying dissociative symptoms. Qualitative research may support its recognition by providing a lived experience perspective. In non-affective psychosis, identific...

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Autores principales:	Emma Černis, Daniel Freeman, Anke Ehlers
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d177cbcd5ae7419e849895c9be061dac
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spelling	oai:doaj.org-article:d177cbcd5ae7419e849895c9be061dac2021-12-02T20:11:29ZDescribing the indescribable: A qualitative study of dissociative experiences in psychosis.1932-620310.1371/journal.pone.0229091https://doaj.org/article/d177cbcd5ae7419e849895c9be061dac2020-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0229091https://doaj.org/toc/1932-6203<h4>Background</h4>Despite its long history, dissociation remains under-recognised clinically, partly due to difficulties identifying dissociative symptoms. Qualitative research may support its recognition by providing a lived experience perspective. In non-affective psychosis, identification of dissociation may be particularly important given that such experiences have been implicated its development and maintenance. Therefore, this study aimed to understand in the context of psychosis: what it is like to experience dissociation; the impact dissociation might have; what factors begin, maintain or end dissociative experiences; and what beliefs people hold about dissociation.<h4>Methods</h4>Qualitative interviews were carried out with twelve NHS patients with non-affective psychosis diagnoses and experience of dissociation. Data were analysed using Thematic Analysis.<h4>Results</h4>Dissociation involves subjective strangeness, unreality, disconnection, and shifts in perception. It impacts on mental health (including psychotic experiences), daily functioning, emotional connection, and can lead to social withdrawal. Stress, fatigue, and excessive internal focus may be involved in development and maintenance. Participants found it very difficult to describe the experience of dissociation, and, as a result, often did not mention it to others. Even when shared, interviewees reported that their descriptions were misunderstood and therefore they did not receive information or support specific to dissociation. The consensus was that experiences of dissociation are negative, but that understanding them better helped to enable coping.<h4>Conclusions</h4>The core subjective experience of dissociation appears to be a felt sense of anomaly (FSA), and we therefore suggest clinicians proactively enquire about such experiences. Dissociation is distressing, and has multiple impacts, but can easily be overlooked due to difficulties describing it and behavioural similarities to negative psychotic symptoms such as withdrawal.Emma ČernisDaniel FreemanAnke EhlersPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 15, Iss 2, p e0229091 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Emma Černis Daniel Freeman Anke Ehlers Describing the indescribable: A qualitative study of dissociative experiences in psychosis.
description	<h4>Background</h4>Despite its long history, dissociation remains under-recognised clinically, partly due to difficulties identifying dissociative symptoms. Qualitative research may support its recognition by providing a lived experience perspective. In non-affective psychosis, identification of dissociation may be particularly important given that such experiences have been implicated its development and maintenance. Therefore, this study aimed to understand in the context of psychosis: what it is like to experience dissociation; the impact dissociation might have; what factors begin, maintain or end dissociative experiences; and what beliefs people hold about dissociation.<h4>Methods</h4>Qualitative interviews were carried out with twelve NHS patients with non-affective psychosis diagnoses and experience of dissociation. Data were analysed using Thematic Analysis.<h4>Results</h4>Dissociation involves subjective strangeness, unreality, disconnection, and shifts in perception. It impacts on mental health (including psychotic experiences), daily functioning, emotional connection, and can lead to social withdrawal. Stress, fatigue, and excessive internal focus may be involved in development and maintenance. Participants found it very difficult to describe the experience of dissociation, and, as a result, often did not mention it to others. Even when shared, interviewees reported that their descriptions were misunderstood and therefore they did not receive information or support specific to dissociation. The consensus was that experiences of dissociation are negative, but that understanding them better helped to enable coping.<h4>Conclusions</h4>The core subjective experience of dissociation appears to be a felt sense of anomaly (FSA), and we therefore suggest clinicians proactively enquire about such experiences. Dissociation is distressing, and has multiple impacts, but can easily be overlooked due to difficulties describing it and behavioural similarities to negative psychotic symptoms such as withdrawal.
format	article
author	Emma Černis Daniel Freeman Anke Ehlers
author_facet	Emma Černis Daniel Freeman Anke Ehlers
author_sort	Emma Černis
title	Describing the indescribable: A qualitative study of dissociative experiences in psychosis.
title_short	Describing the indescribable: A qualitative study of dissociative experiences in psychosis.
title_full	Describing the indescribable: A qualitative study of dissociative experiences in psychosis.
title_fullStr	Describing the indescribable: A qualitative study of dissociative experiences in psychosis.
title_full_unstemmed	Describing the indescribable: A qualitative study of dissociative experiences in psychosis.
title_sort	describing the indescribable: a qualitative study of dissociative experiences in psychosis.
publisher	Public Library of Science (PLoS)
publishDate	2020
url	https://doaj.org/article/d177cbcd5ae7419e849895c9be061dac
work_keys_str_mv	AT emmacernis describingtheindescribableaqualitativestudyofdissociativeexperiencesinpsychosis AT danielfreeman describingtheindescribableaqualitativestudyofdissociativeexperiencesinpsychosis AT ankeehlers describingtheindescribableaqualitativestudyofdissociativeexperiencesinpsychosis
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Describing the indescribable: A qualitative study of dissociative experiences in psychosis.

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