Look it up and you’ll find all kinds of nonsense up/downloaded as answer to that question, most commonly:
“Loss of contact with reality.”
What does that even mean?
For sure, whoever says that to you most assuredly has.
Truth is we don’t know, but it’s not as baffling as “experts” would have you believe and it doesn’t have to be as scary either.
The so called “symptoms” of “psychosis” are in fact experiences everyone will have – one in three will be experiencing at least one right now. Many are judgements made about stepping outside cultural norms. None have anything to do with test tubes and labs and bodily specimens.
So. this thing we call “psychosis” is not a separate “thing” that only some of us “have” or can have, but a state that any of us can, given challenging enough circumstances, find ourselves in: confused, disoriented, isolated and sacred.
You’ll not find it in medical text book but one of the most reliable ways to tell if others think you’re “in psychosis” is the expression on the face of people around you and the names they are calling you.
Most times it’s entirely understandable as an overwhelming state of being in which a person feels unsafe, and not disconnected but intimately and painfully connected with events in the present and past.
It pays to go carefully, and with compassion – despite popular myth that people in psychosis are violent they are more likely to be victims of violence, and a person who has been given a diagnosis “psychosis” is fifteen times more likely to have been abused as a child.
Most Docs and other “mental health professionals” don’t have a bloody clue, some do, eg –
- In Finnish Open Dialogue “psychosis” is conceived of not as a problem in one person’s brain but in the spaces and relationships between people, with language playing a key role.
- Jim van Os and PsychoseNet have more of a clue than most, and have developed an approach that is hopeful and based on noticing patterns in unique personal experience and building strengths and resilience.
Below is first three of PsychoseNet’s fourteen…
Principles for good care of psychosis
- It is scientifically impossible to make a clear distinction between psychosis and other experiences: one can view psychosis as a state during which personal emotions impact thinking and perception to such a degree that it becomes difficult for other people to understand. Psychosis is furthermore linked to alterations in motivation, mood and cognition. Psychosis is treatable, just like depression and anxiety.
- Over 15% of adolescents and young adults experience mild psychotic symptoms (eg. hearing voices or paranoia) over the course of normal development. In 80% of these, symptoms disappear by themselves – these people simply continue their life and their functioning is not affected.
- About 3.5% of the general population develops psychotic symptoms, combined with changes in motivation, mood and cognition, that are so severe that they require treatment. Their symptoms are part of a psychotic syndrome that manifests itself differently in each person. The name for this broad syndrome could be Psychosis Susceptibility Syndrome, or Psychosis Spectrum Syndrome – PSS abbreviated.
PsychoseNet’s 14 principles…
That’s a description so what’s the care? I once worked with a group of young people, all of whom had had two or more episodes of psychosis, and were pigeonholed in a `rehab’ unit (1970s) with the idea that this might keep them out of the old asylum system. I was a 3rd year student nurse with a background in psychology and, the theatre. I was called in to find out why a theatre/music program wasn’t working as hoped. I ended up writing, directing and generally managing the show that performed all over the state and was a huge success. Families became involved, a doctor’s wife (an artist) helped us paint the scenery, the men’s ward and workshop also made the sets. At no time did I consider myself anything except one of the team, I took off my uniform (the first in the hospital to do so) and before long so did many other staff members, and the performers, the `psychotics’ were NOT `different’, they were part of the team, expected to work and produce, and they did, wonderfully. In the 6 months that project ran, no one had a psychotic episode, not that interfered with their work on the show at least, on the bus home from the last performance, everyone did, and two months later my two most talented kids (21 & 18) were dead from suicide. It seems to me that if you offer respect and expectations as well as caring and belonging, you’re a long way along the path of helping people through the fear and terror, the loneliness and alienation that is so often at the core of psychosis. I don’t think anyone ever repeated that project after I, as a student, was moved on. A great shame as it had brought out the best in so many people, especially the staff, who, many for the first time I think, saw these kids as just, well kids, and not SICK people. Maybe this kind of thing could be a component for future alternatives to current practice that destroys far more than it helps.
Hi Deirdre, There is no “the care”.
Essentially people need to find themselves amongst others who treat them first as people; accept their experience as real and offer hope for a way out/ forwards..
Feeling unsafe, disconnecteds and powerless are core experiences common to all people labelled and cast out …
So being embraced as fellow humans, supported in finding/learning to [re]connect, and to act in the world are what any “care” needs to be about…
Thanks for your story, sounds like an example of what it can look like.
Sadly, also sounds all too familiar in that when the project ended it was back to the same old same old …
These kind of things are not difficult to fathom, nor are they expensive – and they are certainly not “the alternative”. It is the current system that is the alternative to treating people well.