Coping with Illness Experiences in Patients with Schizophrenia: The Role of Peacefulness

Background: The relationship between spirituality and schizophrenia is a largely unexplored, yet important area of research in psychiatry given its role in recovery from mental illness and in long-term care. Peacefulness, as one of the primary consequences of spirituality, was found to be most prominently associated with the emotional well-beings. This analysis aims to explore the concept of peacefulness among schizophrenic patients and its effect on their illness experiences. Methods: Eighteen early-stage schizophrenic patients were recruited from the outpatient clinic of a hospital in Hong Kong for an in-depth individual interview. Data were analyzed with grounded theory techniques. Results: Peacefulness has an emotional component and a cognitive component. The participants described peacefulness as a carefree state of mind that consisted of an inner sense of tranquility (the emotional component) and perceived freedom (the cognitive component). Their illness experiences were a vicious circle that was formed and maintained by distress (negative emotions) and preoccupation (distorted cognition). They believed that an inner sense of tranquility (the emotional component) facilitated the regulation of their distress, leaving them more cognitive resources to stabilize their chaotic minds, whereas perceived freedom (cognitive component) created an intra psychic moment and space with no stress to free the patients from their preoccupation. Conclusion: Peacefulness is able to break the vicious circle of patient's illness experiences by moderating distress and preoccupation. In addition, it may help promote patients' personal resilience and self-efficacy, which are important for coping with residual symptoms, maintaining the patients' mental health and preventing relapse.