Negotiating belonging and identity across the life course: A qualitative study using Social Identity Mapping with people with psychosis

A core part of how we understand ourselves comes from the groups we feel we belong to. Having positive, meaningful group memberships, or 'social identities', has been linked to better wellbeing in people diagnosed with psychotic disorders, yet little attention has been paid to how individuals with psychosis experience social identities and changes in belonging across the life course. Personal recovery in psychosis has been described as centred on identity and connection: it may be useful therefore to consider the experiences of people with psychosis from the perspective of the Social Identity Approach to Health (SIAH). This study used Social Identity Mapping (SIM) as the basis for semi-structured interviews (n = 28). Thematic analysis, conducted by a team drawing on wide-ranging expertise (lived experience, clinical psychiatry and social psychology), generated four themes: (1) Pre-symptom social identity conflict and non-belonging: 'I'm just something in-between'; (2) Psychosis tears identity apart: 'The map would have been blank'; (3) Social identification is both a risk and a requirement for recovery: 'Everyone wants to belong to some certain group or another'; and (4) Lack of identification with people with psychosis: 'Do I feel a part of that group? Not really, no'. This SIM-supported interview approach uncovered new insights into how people negotiate social identification before, during and after psychosis. Social identification may be a protective factor, and social identity-strengthening interventions should be evaluated as means of improving quality of life and social functioning.