Abstract
While interest has grown steadily in understanding how persons with schizophrenia appraise their disorder and subsequently move towards recovery, the nature of the impact of awareness or admission of schizophrenia on various domains of quality of life has remained a matter of debate. At the level of both theory and empirical study, it has been alternately argued that acknowledgement of ones mental illness is a key to and a detriment to recovery. Acknowledgement of illness has been recognized as something essential in order for a person to be able to make informed decisions about the future, to free oneself from blame for difficulties linked with illness and to form sustaining bonds with others. From another view, however, “awareness of illness” has been suggested as a barrier to recovery because it represents the acceptance of a system of social power in which ones individuality and dignity is diminished. Indeed empirical studies suggest both awareness and lack of awareness have significant risks associated with them. In this chapter we review this evidence and suggest that the impact of insight on quality of life may be mitigated by the degree to which persons have internalized stigmatizing beliefs about their illness. Clinical and theoretical implications are discussed.
Keywords: Insight, quality of life, schizophrenia, recovery, psychosocial function, symptoms, narrative, hope
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