Exploring the theoretical and empirical foundations of a ‘radical normalisation’ approach to psychosis

Abstract

Normalising psychotic phenomena is considered to be a useful tool in psychological interventions for psychosis as it reduces stigmatisation, improves therapeutic alliance, combats distress, and entails greater hope for recovery. However, while the usefulness of normalisation is acknowledged, there still remains the mainstream clinical view that psychotic experiences are the manifestations of abnormal brain function. Recently, this view has come under scrutiny with growing evidence for psychotic-like experiences in the ‘normal’ (non-clinical) population. Following these findings, the current thesis explores the case for developing a radical normalisation approach to psychosis, which goes beyond just clinical usefulness, and instead places psychotic experience within the realm of normal brain function. This exploration is comprised of both a theoretical and empirical component. The theoretical paper reviews multi-level models of information processing, and applies a multi-level framework to formulating core psychotic phenomena. The suggestion is that by illustrating the actions of different levels of processing, this formulation draws attention to the genuine emotional meaning of psychotic experiences; i.e. those aspects which are functional, healthy, and equivalent to the experiences of the non-clinical population. The empirical study approaches these explorative questions from a different angle by directly comparing the psychotic-like experiences of clinical and non-clinical participants. Twelve participants, six in each group, are interviewed about their initial psychotic-like ‘out-of-the-ordinary’ experience (OOE), and their data are analysed using the qualitative method of Interpretative Phenomenological Analysis (IPA). Inter-group comparisons of emergent themes reveal similarities in both contextual triggers and subjective nature of OOEs, but differences in the way these experiences are then incorporated in their personal and social contexts. This suggests that psychotic-like OOEs, themselves, do not determine the development of a clinical psychotic condition, and might therefore be recognised, both theoretically and clinically, as normal and meaningful aspects of psychological functioning.

Date of Award	2010
Original language	English
Awarding Institution	University of Oxford
Supervisor	Emmanuelle Peters (Supervisor) & Matthew Knight (Supervisor)