Vulnerabilidad física estructural de redes vitales

Participants described being stripped of individuality and identity, which often awakened feelings of being seen as nobody or just as a diagnosis. Thus, common experiences were related to the vicious cycle of being misunderstood or misjudged, as well as pathologised, objectified or even demonised. As a consequence, former patients reflected on their transitions from being a human to becoming a disease or even a worthless or an inadequate entity. Patie ts ide tit see ed losel asso iated with their actions on the ward. Such could be conceptualised as a form of reductionism and nihilism that seemed to have induced further suffering in individuals. This common theme depicts a transition from a subject to an object (becoming part of the collective group or a symptom) and was often associated with a sense of being profoundly dehumanised, which results in changes of o e s su je ti e experience of the self. Scheff and Retzinger (2001) proposed that psychiatric treatment often separates an individual from their identity. It seems, therefore that diminishment or a loss of self is tied to the deprivation of ke aspe t of o e s e iste e (such as freedom). As Dinos et al. (2004) highlighted, a patient no longer possesses

liberty to form or develop their identity in their own chosen direction, which was termed as ps hiat i so ialisatio . I di iduals also des i ed ho p ofessio als ideas felt imposed, which consequently forced them to comply or mould to the staff perceptions by adopting a false persona, which often meant discarding their true self and identity. It was experienced as losing oneself or parts of self. In addition, an imposition of staff views, i o ju tio ith o e s ps hoti state led to the development of profound self-dou ts a d a i a ilit to alidate o e s su je ti e state. At times, this ea t that o e s authe ti it is compromised a d o e s a ilit for self-expression impaired, as f eel oi i g o e s opi io s is associated with various threats on the ward, hi h o l o pou ded o e s dist ess a d fu the dete io ated o e s elatio ship ith staff and oneself. The treatment on the ward was often experienced as profoundly repressive in many ways. Current findings are, therefore in line with some existing evidence suggesting that coercion, in the context of involuntary inpatient care, can be experienced as extremely distressing and impede ones sense of self-worth and efficacy, as well as perpetuate a wheel of conflict (Flynn and Bartholomew, 2003).

Thus, themes that dominate the findings centred on loss of self, loss of liberty, rights, and power often result in feelings of failure and inadequacy, which consequently impedes recovery, competence and agency and in fact, even shake elief i o e s a ilit to i flue e o e s fate o li e a fulfilli g life agai . The sense of hopelessness was often experienced as patients were confronted with the uncertainty regarding their discharge date. Evidence also exists that over exposure to acute ward environments may lead to dependency and the belief that functioning and recovery prospects a e e o d o e s ea h P ie e and Turner, 2003). In some cases, o e s position in the world felt altered, as individuals often reflected upon their sense of disillusionment with the helping services. It seems that involuntary hospitalisation can instil fear of services and future coercion affects o e s openness to seek help or in fact t a sfo o e s elatio ship ith the o ld, which points to the relevance of the concept of trust in mental health services (Brown et al., 2006 and 2008; Vassilev and Pilgrim, 2007). The absence of which, as argued, can be a detrimental and obscure path to recovery (Hall et al., 2001; Mollering, 2006; Elliot, 2004; Calnan and Rowe, 2008; Fenton et al., 1997).

Furthermore,shame and stigmatisation are also impacts of sectioning and often lead to isolation and disconnection from the world, which according to some authors has been referred as a loss of status, at which the core humiliation lies (Torres and Bergner, 2012; Svindseth et al., 2013). It also seems that the experience of involuntary commitment has a potential of crashi g o e s se se of safet i the o ld and frequently leads to a collapse of faith in justice. In particular, the belief in the i teg al a d u shaka le atu e of o e s hu a ights a d f eedo is violently

compromised. It almost seems that sectioning for some warrants almost an existential crisis that forces the individuals to re-evaluate the formerly perceived reality.

4.2.4 Discussion of Super-ordinate Theme Four: The Comforting and the Sanguine