Shame and Experiences of Psychosis: A Qualitative Inquiry

Research reports a strong association between the experience of psychosis and shame, but there is a paucity of detailed information on the nature of this relationship. This qualitative study explored the relationship between shame and psychosis from the perspectives of people with lived experience of psychosis. Using a trauma-informed and shame-sensitive approach to research, fourteen adults from three mental health services completed semi-structured face-to-face interviews. Reflexive thematic analysis was used to develop four themes: (1) Psychosis can expose underlying shame; (2) Psychosis can cause shame; (3) Efforts to minimise, avoid, and resist shame; and (4) Shame can be triggered in mental health services. The study highlights that psychosis can both contribute to new experiences of shame and reactivate shame from past experiences. Greater consideration of how mental health services can be shame-sensitive is needed, particularly within efforts to provide trauma-informed care.