A qualitative study of people’s experiences of sleep and paranoia

This thesis comprises of a literature review and a research report. The literature review utilised meta-methodology and meta-synthesis to generate a contextualised account of the subjective experience of psychosis from Interpretative Phenomenological Analyses (IPA) research. In the meta-methodology, 25 papers were systematically reviewed for methodological and contextual data. In the meta-synthesis, 23 accounts pertaining to the experience of psychosis were synthesised. The review generated four themes relating to the experience of psychosis: 1. shattered reality, 2. being labelled with psychosis, 3. regaining control, and 4. understanding and rebuilding. The meta-synthesis themes indicated cognitive processes, explanatory models and recovery processes in psychosis. In addition two methodological points, reflexivity and diversity were highlighted. These findings have implications for research and clinical practice, particularly pertaining to empowering approaches in recovery. The second part of this thesis was an IPA study exploring the experience of psychosis and sleep problems in eight people who self-identify as experiencing these phenomena. Three superordinate themes emerged from the analysis: 1. a mind which won’t switch off, 2. the impact of living with a mind which won’t switch off, and 3. trying to getting relief. These themes indicated that people who experience paranoia and sleep problems described lifelong experiences of sleep and paranoia. Insomnia, nightmares, worry and vigilance to threat were pervasive and exhausting experiences for participants. These experiences had a wide ranging impact on daily functioning, relationships and wellbeing. Strategies, such as meditation, were helpful to ‘calm the mind’. Currently, it was felt that there is inadequate understanding or support for people with these experiences, particularly concerning sleep. The clinical implications of using interventions to target specific difficult experiences, such as nightmares, and identifying individuals ‘at-risk’ were discussed.