The development of psychopathology and difficulties of living a normal life can be investigated from many theoretical angles. Psychiatry and psychiatric epidemiology have often concentrated their endeavours listing possible risk factors that may lead to a diagnostic condition. These factors may be either somatic (genetics, intrauterine factors, birth risk) or psychosocial (rearing factors, attachment and other developmental factors). Within the psychodynamic and phenomenological tradition, the interest has concentrated on the first-person experience of different event that felt to be traumatic.

In this project we have followed this perspective but opened it up to a wider study of how this first-person experience are changed during interaction with the treatment system and the social service system. The data of our investigation stem from four separate projects focussing on the patients’ experiences of their disordered states of mind, and the symbolic interaction between professionals and patients in mental hospitals and community psychiatry. These data stems from three different projects accomplished between 1997 and 2007. The aim of re-analysing this empirical material is to make a conceptual study of the change in communicative functioning and social interaction characterising psychotic mental illnesses. Thus, we want to link cognitively deviant phenomena and identity disruptions with the ability to communicate in accordance with social conventions.

The investigation furthermore aims at integrating the assumed change in communicative functioning in a model of the interaction between the rehabilitation system and the patients in the course of their psychotic development. In this model the decline in communicative function is related to four distinct phases in the patients’ personal development and social interaction with others:

1. An initial phase where mental disturbances start affecting everyday life experience and social interaction. At this point this influence is experienced as an inner feeling without a clear idea of the origin of this change. Sometimes the origin is located in the external environment.
2. A second phase where the condition is acknowledged as illness, and relations to psychiatric institutions are being established. The social network has been reduced and partly lost.
3. A third phase during which the mental illness is sought mastered and stabilized. The person aims at establishing self-management through treatment and social support.
4. A final phase where the person has established a self-management of the illness and has developed an individual approach to dealing with problems now defined as an institutionally accepted disability.

For each of the phases we focus on specific dynamics of self-other structure, personality, coping and social roles. The re-analyses thus implies an alternative to classical medical phase-description outlined as a ‘premorbid phase’, a ‘pro-dromal and disease phase’ followed by an “illness phase”, and a ‘restitution and rehabilitation phase’. Network: ISA, International Sociological Association, Research Committee 49 on Sociology of Mental Health. CSP, Center for Sociological Psychiatric Research. A network of researchers within Sociology and Psychiatry.