Shame and Experiences of Psychosis: A Qualitative Inquiry.
Kimberley Davies, Sophie Isobel, Zachary Steel and 2 others
PMID 40415240WHAT IT FOUND
People with psychosis described shame as exposing hidden vulnerabilities, causing shame after behaviours, and being triggered by locked doors, restraint, medical language, and unequal staff relationships.
They described talking about experiences in their own words and having choices as ways to manage shame.
Key findings
01Participants described psychosis as exposing hidden shame and vulnerability, and as causing shame through behaviours and loss of control.
02Shame was triggered in services by locked doors, staff areas, inaccessible language, and coercive practices such as restraint.
03Participants described connecting with others and having choices in care as ways to manage shame.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included 14 people who were already engaged with services and willing to talk about shame, so it may not represent people who are not accessing care or who do not want to discuss shame. The services were in Sydney, and the care experiences described may not apply to other settings. Demographic details were not reported to protect confidentiality, so it is hard to know how varied the sample was. Talking about shame could itself activate shame, and participants may not have shared all relevant experiences. The study describes experiences and does not test whether shame-sensitive care changes outcomes.
The easy way to misread this
Do not read these themes as evidence that shame causes psychosis or that shame-sensitive care improves outcomes. The study describes participants' experiences in selected services and does not test an intervention.