Abstract
Integration and sealing over have been described as clinically distinct coping
styles after psychosis. An integrative recovery is characterised by the patients
awareness of the continuity of their mental activity and personality before and through
recovery from psychosis. Patients who seal over at recovery tend to isolate the
psychotic experience. They view it as alien and disruptive to their lives and
consequently seek to encapsulate it (McGlashan, 1975). These descriptions represent
opposite ends of a continuum where people who tend to seal over generally have
poorer long term functional outcomes (McGlashan, 1987). The symptomatic aspects of
psychosis could be described as traumatic as could the experiences often associated
with a psychotic episode, e.g. involuntary hospitalisation, seclusion or sedation.
Further, sealing over appears to parallel the avoidance component of post traumatic
stress disorder (PTSD). This study is an attempt to investigate possible links between
recovery style after psychosis and experience of psychosis as a traumatic event. It is
hypothesised that people who seal over after psychosis are more likely to have
experienced their psychosis as traumatic, to have low perceived control over illness,
and be more likely to be depressed. Subjects who had experienced a psychosis within
the last year were given four self report questionnaires to complete: the Impact of
Event Scale (Horowitz, 1979), the Personal Beliefs about Illness Questionnaire
(Birchwood, Mason, MacMillan and Healy, 1993), the Recovery Styles Questionnaire
(Drayton, Birchwood and Trower, 1998), and the Beck Depression Inventory (Beck &
Beamesderfer, 1974). Integration and sealing over was also measured by an
independent rater using the Integration/Sealing Over Scale (McGlashan, 1987).
Statistical analysis was completed. Results indicated that intrusions were predictive of
a
tendency towards sealing over; intrusions, avoidance and low perceived control over
illness were predictive of depression. Conclusions were drawn and discussed in the
context of the relevant literature.
