‘It was like a lightning bolt hitting my world’: Feeling shattered in a first crisis in psychosis

ABSTRACT Background: The felt and emotional aspects of psychosis are poorly understood, however, their importance for the aetiol- ogy of, and recovery from, psychosis is increasingly accepted. Individuals experiencing psychosis often come into contact with mental health services during a crisis. Currently little is known about the emotional and felt aspects of this experience, yet this could support clinical intervention at this time. Aims: This research aims to gain an in-depth understanding of the lived, felt experiences of a first crisis in psychosis. Method: The study took a hermeneutic phenomenological perspective and utilised visual methods. Seven participants participated in idiographic, multi-modal interviews about their experiences. Results: Participants described their first crisis in psychosis as a shattering experience, entwined with their experiences of interpersonal trauma. In crisis, participants lost basic trust in the world; felt enveloped in a strange, threatening atmo- sphere, and lacked a sense of belonging. Conclusions: Attention to the felt aspects of a crisis indicate the existential, intersubjective and traumatic nature of the experience. Psychosocial, family and trauma-focused approaches that take into account the holistic, embodied and contextual nature of psychosis experiences seem best-placed to support treatment and research in this area.