Critical thinking and psychiatric knowledge: psychosis as a contested area

In 2014, the British Psychological Society and Division of Clinical Psychology (BPS/DCP) published a report outlining the multiple ways of thinking about psychosis or “schizophrenia” beyond a dominant bio-medical framing. They highlighted that psychosis is a contested area. One area of contention has been the role of dissociation as a response to traumatic experiences leading to psychosis. The current literature review aimed to evaluate the role for dissociation in the relationship between trauma and psychosis. Eighteen, peer-reviewed journal articles were included. There was evidence that dissociation is an important aspect of the relationship between trauma and psychosis. The type, frequency and chronicity were found to be important factors. The mechanisms of dissociation remain to be elucidated. The current research study aimed to engage psychiatrists in narrative accounts of their understanding of psychosis as a contested area considering the BPS/DCP report. Semi-structured interviews were conducted with 12 participants at both trainee and qualified level. Critical Narrative Analysis was used which comprises six stages. The results highlighted the role of power, the barriers to opportunities for exposure to alternative views, and the role of dialogue and reflexivity. The Critical Appraisal considers, using a reflective account, the strengths and limitations of the current research, along with reflections on the whole research process.