“Hope crept in”: A phenomenological study of mentally ill artists’ biographic narrative

Background: The ways in which involvement in art practice may support a recovery trajectory in the lives of the mentally ill are well documented although evidence is charged with lacking clarity and of being inconclusive. Numerous studies, however, indicate benefits such as cognitive distraction; ''derailing'' of negative thinking patterns; increased social capital; and enhanced sense of belonging. Aims: This study used narrative interviews to explore what meanings were made by people with mental health difficulties of engaging in an ongoing visual art practice. Methods: Phenomenological Interpretative Analysis (IPA) was used to analyse 50 interviews. Two superordinate themes of regression and progression were identified through which to explore the shifts in narrative between exploring one's past and looking ahead to the future. In this context, the theme of hope emerged, and the research explored the ways in which the individual's art practice was implicated in engendering and sustaining it. Results: Results suggest that artistic activity facilitated a contained autobiographical analysis and a reimagining of oneself in the future, in which hope played a fundamental part. Conclusion: This research suggests that a dialectic between despair and hope is facilitated by the autobiographic elements of an art practice. Through this movement from a perceived static past to a more fluid future is experienced.div_PaSAkerman S, Ouellette SC. (2012). What Ricoeur's hermeneutics reveal about self and identity and aesthetic experience. Theor Psychol, 22, 383-401. Bridges K, Brown L. (1989). Psychiatric patients work alongside artists on prize-winning project. Br Med J, 299, 532. Broderick S. (2011). Arts practices in unreasonable doubt? Reflections on understandings of arts practices in healthcare contexts. Arts & Health, 3, 95-109. Burgess R. (1984). In the field: An introduction to field research. London: Allen and Unwin. Butler J. (2005). Giving an account of oneself. New York, NY: Fordham University Press. Camic PM. (2008). Playing in the mud: Health psychology, the arts and creative approaches to health care. J Health Psychol, 13, 287-98. Charon R. (2006). Narrative medicine: Honoring the stories of illness. Oxford: Oxford University Press. Clarke D. (2003). Faith and hope. Aust Psychiatry, 11, 164-8. Colgan S, Bridges K, Brown L, Faragher B. (1991). A tentative start: Evaluation of alternative forms of care for chronic users of psychiatric services. Psychiatr Bull, 15, 596-8. Crossley ML. (2000). Narrative psychology, trauma and the study of self/ identity. Theor Psychol, 10, 527-46. Csikszentmihalyi M, Csikszentmihalyi IS. (Eds). (1988). Optimal experience: Psychological studies of flow in consciousness. Cambridge, MA: Cambridge University Press. Drake JE, Winner E. (2012). Confronting sadness through art-making: Distraction is more beneficial than venting. Psychol Aesthet Creat Arts, 6, 255-61. Dufault K, Martocchio BC. (1985). Hope: Its spheres and dimensions. Nurs Clin North Am, 20, 379-91. 76 O. Sagan J Ment Health, 2015; 24(2): 73-77 Faulkner A. (2004). The ethics of survivor research: Guidelines for the ethical conduct of research carried out by mental health service users and survivors. Bristol: The Policy Press. Froggett L. (2008). Artistic output as intersubjective third. In: Clarke S, Hahn H, Hoggett P, eds. Object relations and social relations: The implications of the relational turn in psychoanalysis. London: Karnac Books, 87-112. Hopper E. (2001). On the nature of hope in psychoanalysis and group analysis. Br J Psychother, 18(2), 205-26. Hurwitz B, Greenhalgh P. (1998). Narrative-based medicine: Dialogue and discourse in clinical practice. London: BMJ Books. Kelaher M, Dunt D, Brman N, et al. (2014). Evaluating the health impacts of participation in Australian community arts groups. Health Promotion Int, 29, 392-402. Kleinman A. (1988). The illness narratives: Suffering, healing, and the human condition. New York, NY: Basic Books. Kwon P. (2000). Hope and dysphoria: The moderating role of defense mechanisms. J Pers, 68, 199-233. Lincoln YS, Guba EG. (1985). Naturalistic inquiry. Newbury Park, CA: Sage Publications. McAdams DP. (2008). Personal narratives and the life story. In: John OP, Robins RW, Pervin LA, eds. Handbook of personality: Theory and research (3rd ed.). New York: Guilford, 242-62, Chapter 8. McKechnie CC. (2014). Anxieties of communication: The limits of narrative in the medical humanities. Medical Humanities. Published online 28 May 2014. doi: 10.1136/medhum-2013-010466. O'Hara D. (2011). Psychotherapy and the dialectics of hope and despair. Couns Psychol Q, 24, 323-9. Omer H, Rosenbaum R. (1997). Diseases of hope and the work of despair. Psychother Theor Res Pract Train, 34, 225-32. Parkinson C. (2009). Invest to save: Arts in health - Reflections on a 3-year period of research and development in the North West of England. Aust J Arts Health, 1, 40-60. Parr H. (2006). Mental health, the arts and belongings. Trans Inst Br Geogr, 31, 150-66. Ricoeur P. (1970). Freud and philosophy: An essay on interpretation. Binghamton, NY: Yale University Press. Ricoeur P. (1986). Life: A story in search of a narrator. In: Doeser M, Kray J, eds. Facts and values. Dordrecht: Martinus Nijhoff. Russinova Z. (1999). Providers' hope-inspiring competence as a factor optimizing psychiatric rehabilitation outcomes. J Rehabil, 65, 50-7. Sagan O. (2014). Narratives of art practice and mental wellbeing: Reparation and connection. London: Routledge. Secker J, Hacking S, Spandler H, et al. (2007). Mental Health, social inclusion and arts: developing the evidence base. Available from: http://www.instituteofhealthequity.org/projects/mental-health-socialinclusion- and-arts- developing-the evidence-base [last accessed 20 June 2014]. Smith JA, Flowers P, Larkin M. (2009). Interpretative phenomenological analysis theory, method, research. London: Sage. Snyder CR. (1996). To hope, to lose, and hope again. J Pers Interpers Loss, 1, 3-16. Stickley T, Hui A, Morgan J, Bertram G. (2007). Experiences and constructions of art: A narrative discourse analysis. J Psychiatr Ment Health Nurs, 14, 783-90. Stickley T. (ed). (2012). Qualitative research in arts and mental health. Ross-on-Wye: PCCS Books. Swindells R, Lawthom R, Rowley K, et al. (2013). Eudaimonic wellbeing and community arts participation. Perspect Public Health, 133, 60-5.24pub4708pub