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The ways in which individuals recognize and respond to emerging psychotic illness remain poorly understood. This retrospective study explored when and how individuals recognized changes in themselves and responded to these changes.This study used qualitative methods to explore when and how 15 individuals recognized changes and identified how they responded. Standardized information on the onset of psychosis was also collected.Themes relating to recognizing and responding to emerging psychosis were identified through qualitative analysis of interview transcripts. Themes included normalization, explanatory models, withdrawal, avoiding help, and coming to terms with psychosis.Participants recognized changes in themselves but tended not to understand the observed changes as part of a mental illness. Individuals avoided professional help because of stigma concerns and identified domains of recovery beyond the management of symptoms and medication. Qualitative methods offer a promising strategy for understanding subjective illness experience and suggesting psychosocial treatment approaches.