Assessed Danger-to-Others as a Reason for Psychiatric Hospitalization: An Investigation of Patients' Perspectives

Abstract

AbstractThis study investigated subjective experiences of nine men who had been psychiatrically hospitalized upon being assessed as "dangerous-to-others-due-to-a-mental-illness." Using a phenomenological interviewing approach, researchers helped subjects construct narratives of their pre-hospitalization experiences. The research illuminated aspects of life-contexts that were shared among all or nearly all subjects: feeling ostracized and alone; struggling with longstanding and pervasive feelings of inadequacy; experiencing a sense or a fear of having little or no control or options in life; and feeling emotionally depressed, misunderstood, and uncared for. Situations immediately preceding hospitalization were characterized by subjects experiencing threats to their sense of self-esteem that were of heightened intensity. In five cases, subjects reported anxiety related to self-fragmentation or becoming "nothing." Perceived threats to self-worth and self-structure were accompanied by anger and aggressive acts or impulses. In all cases, aggressive impulses and threats, and violence appeared to be in the service of self-validation and self-empowerment. In cases of violent behavior, an apparent function of the subjects' behaviors was toward self-consolidation. Based on findings, the researchers discuss implications consistent with humanistic psychology and existential psychotherapy principles and practices.