Self, World and Meaning: a Phenomenological Mixed-Methods Investigation of Delusions in Early Psychosis

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Visualisation of psychosis

There are three dimensions and aims to this PhD project:

  1. Empirical dimension: To characterise how people experience and make sense of changes in the sense of self, lived world and meaning, in relation to the onset of delusional phenomena in early psychosis
  2. Philosophical and ethical dimension: To critically examine our current understanding of delusions in early psychosis, and develop a novel phenomenologically-informed conceptual framework which challenges epistemic and hermeneutical injustice in mental health
  3. Clinical dimensions: To develop a phenomenologically-informed intervention for improving understanding and communication of delusional experiences in the mental health encounters

The details

In the context of psychosis research, delusions have been predominantly studied from the perspective of cognitive psychology. In line with cognitive models, much emphasis has been placed on abnormalities or biases in reasoning as key factors for understanding and explaining delusions. According to this view, delusions represent maladaptive beliefs about the world one inhabits, and are often taken to be inherently dysfunctional.

While delusions might contain errors of fact and are often distressing, recent philosophical and psychological literature has suggested that certain delusions can be experienced as enhancing one’s sense of meaning in life. However, empirical research into the experience and meaning of delusions in early psychosis is still lacking.

Utilising a cross-disciplinary and mixed-methods approach, the aim of this project is to rigorously characterise the experience of delusion from different perspectives and explore the ways in which delusions are lived as a human experience. The aim is to overcome prejudices, tackle power imbalances in the clinical encounter, and move towards a more open and engaged interdisciplinary discussion.

Graduate researcher profile: Rosa Rituanno

Picture of Rosa

What did you do before you started your PhD?

Before undertaking my joint PhD programme, I completed my speciality training in General Adult Psychiatry in Italy, at the University of Verona, and obtained my specialist diploma in Psychiatry with academic distinction in 2016. My final year also included a research placement in the UK, in which I led as part of a collaboration between the universities of Verona, Warwick and Birmingham. My research investigated the role of childhood trauma in the development of psychopathology in a large cohort of patients with first-episode psychosis and culminated in a dissertation that was awarded a distinction in the final diploma examination in Psychiatry.

This placement provided a unique opportunity to gain skills in collaborating with different research teams internationally. Throughout my psychiatry residency, I was interested in the phenomenological approach to mental illness, and I trained in phenomenological psychopathology at the Scuola di Psicoterapia Fenomenologico-Dinamica in Florence. Prior to this, I received my medical degree with distinction (Laurea summa cum laude in Medicina e Chirurgia) at the University of Padua, Italy.

What are the challenges of your research role?

My research is highly interdisciplinary and involves working across many different research fields, paradigms, and methods such as those belonging to psychiatry, psychology, and philosophy. This is at the same time one of the most exciting and challenging aspects of the programme, as you need to be able to shift flexibly and promptly between very different perspectives and ways of looking at the world. It also involves learning new research methods (for instance qualitative and quantitative), as well as different languages of communication and writing (such as medical-scientific and philosophical).

Sometimes, trying to be an expert in everything may feel like (and is) an impossible and overwhelming task! However, once you accept your limits, there are many exciting benefits and advantages to this kind of learning such as being able to make connections between concepts and theories across traditionally separate disciplines and promote new learning relationships between currently siloed fields.

What is the best part of your research role?

As a psychiatrist, working in the field of early intervention, I have had the privilege of working with many young people experiencing the onset of psychosis. The result has been to instill in me a powerful motivation to continuously improve my understanding of the person’s own perspective, to establish a meaningful and restorative dialogue that can help them make sense of distressing experiences and promote personal recovery. My research role provides a unique opportunity for me to learn from people with lived experience of psychosis, and translate my academic knowledge into clinical practice, with the potential to improve real-world clinical outcomes. To this end, undertaking a period of collaborative work in Melbourne at Orygen will be invaluable experience, given the strong track record of cutting-edge psychosis research and innovative clinical services for youth mental health.

Where do you wish to go after your PhD? Do you want to enter industry or continue doing more research in academia?

Although it is still early in my PhD journey, I’m committed to lifelong interdisciplinary learning and wish to continue practicing as a clinical academic psychiatrist. I very much enjoy teaching and mentoring, and in future I also hope to be able to support young researchers interested in developing interdisciplinary skills and knowledge across philosophy, psychiatry and the medical humanities.

Supervision team

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