Examining sense of self and identity in schizophrenia: A modified grounded theory study

Alterations or losses to one's sense of self and identity are identified in the literature as being an important aspect of the lived experience of schizophrenia. Research further implicates regaining a sense of self and identity as playing an important role in recovery and wellbeing in schizophrenia. Despite this, a comprehensive understanding of the specific component processes involved in changes to sense of self and identity in schizophrenia has not been clearly elucidated. The current study aimed to examine and characterize the major component processes involved in alterations to sense of self and identity in schizophrenia. Using qualitative methodology, eight adult participants (age range = 31 to 55 years old, M = 45; four cisgender women, one transgender man, three cisgender men) with schizophrenia or schizoaffective disorder were individually interviewed. The interview topics included: personal understanding of the nature of schizophrenia, self-perception prior to schizophrenia, changes in self-perception through experiencing schizophrenia, coping strategies, views on current sense of self and identity, and knowledge gained about oneself through experiencing schizophrenia. Interview transcripts with analyzed using a modified Grounded Theory methodology. Five participants completed member checking procedures to verify the interpretation of the data. The data supported the conceptualization of three over-arching categories reflecting significant component processes of change to sense of self and identity in schizophrenia: (1) disruptions and interruptions to sense of self and identity, (2) finding stability, and (3) multiple pathways to (re)building a sense of self and identity through finding meaning and purpose. While the individual experience may be idiosyncratic, the findings suggest that commonalities exist in the nature of changes to sense of self and identity. The findings also indicate how individuals with schizophrenia may benefit from interventions that focus on self and identity.