A New Definition of Psychosis
Psychosis is an antiquated word that leads to huge misunderstandings that play a large role oppressing a larger and larger portion of the population. For the past nine years I have run professional focus groups, going through the process of listening, exploring, reflecting, writing, seeking feedback and rewriting to get a better definition of psychosis.
Defining Psychosis, the Mainstream Way:
I remember using the mainstream definition as a young professional during the job I used to get me through my Master’s Program. Wondering how I was to connect with people who had delusions and voices that I clearly didn’t experience with my neurotic, highly-medicated self, I filled the white board with a list of labels and complicated words I was proud to be able to define. It was my college education that got me the job, and this was one way I could use it to be useful.
Hallucinations: reports of sounds (voices,) visuals, tactile sensations, tastes, and olfactory sensations that others do not experience
Delusions: “an idiosyncratic belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational . . .” In spite of the “preponderance of the evidence”
Disorganized Speech: Frequent derailment or incoherence): Word salad, tangential, or circumspect speech
- Attention Problems
- Flat affect
- Social Withdrawal
- Sexual Problems
The Errors of These Ways:
Life has taught me that the mainstream definition, as such, does little to depict what it feels like to have a break from reality. Indeed, not understanding this can cause a supporter to make things worse even when they have the best of intentions. Indeed, miscommunication, pain, and strained relationships often result once a sufferer has a break.
I now contend that this mainstream definition offers little helpful direction toward the healing that can be inevitable when a person accepts their situation, moves through it, and is not subjugated to the gross negligence of institutionalization.
I still remember some of the ridiculous conclusions I drew as a young clinician: for hallucinations, the answer was simple: ignore them; for delusions: I would recommend that the sufferer just think like everyone else does; and for disorganized speech the answer likewise seemed simple: do not speak, otherwise people will think something is wrong with you. I likely went so far as to make these assertions.
With what I know now, I don’t even believe that psychotic delusions exist. Sure errors, happen, but they do little to define the experience. Indeed, according to my current definition, the concept that delusions are wrong “in spite of a preponderance of the evidence” is a huge misrepresentation of what is happening.
For example, for years I heard fellow sufferers suggest that there are cameras in all televisions through which the government can spy on people. While I expressed as genuine an open mind to this idea as I could muster, I really didn’t think so. Then, the Wiki Leaks story broke, and I found out that the “delusional” people I work with were right after all. Once again, mainstream, Eurocentric ideas suggested that the world was flat.
Indeed, when the problem is defined as observable behavior, it fails to acknowledge the intrinsic value of the experiences to people who have them. It also fails to account for so much of what people go through when they are in the thick of it. So many anomalous perceptions turn out to be accurate.
I recall only one client who was brave enough to stand up to my degree and tell me that she felt she had a gift and that her experiences were valuable. I listened, but if I had truly accepted her help, it would have saved me years of torment.
What Happened to Me:
It wasn’t until I was thirty that I went through a psychotic break from reality or what I prefer to define as a message crisis. I was working amidst drug war politics and taking huge risks to promote safety for vulnerable and traumatized people. My boss threatened to fire me for associating with renegade activists. In fact, residents were dealing with violence and conspiracies in a large section 8 complex that was widely reported on in the paper.
For two years after my lengthily incarceration in a State Hospital, I moved around and was unable to find employment. I knew I could still work even though I was being followed. The only thing I had learned in the hospital was how to endure abuse and be prepared for utter squalor.
My best explanation for what had happened to me was that the mafia was following me. In fact, I had developed the idea that it was my own family who was responsible for the constant threats I was experiencing. Finally, I decided to trust my aunt, who was the black sheep of my father’s side of the family. She was able to attain a job for me making sandwiches at an Italian Deli.
Underemployed and harassed in the most controlling of ways for ten months, it would be a decade later when I would learn that that famous celebrity-chef I met and at one point surmised to be the local kingpin really was the kingpin just as I had suspected. It’s true that throughout my tenure at the deli, I surmised many people to be the kingpin, but still . . . When I returned to taking medications, I finally was able to get a social services job away from the deli. Eventually, I returned to work in mental health.
My Learning Process:
Nine years ago, I grew tired of running standard groups. In many cases, everyone in the group had experiences with psychosis, yet we all sat suppressing those experiences and were communicating in the language of the oppressor. I had heard about Hearing Voices Network groups in Europe, and I decided to create a specialty group in which I used my lived experience to further explore the experiences that people go through during psychosis.
Since that time, I have been deconstructing the concept of schizophrenia and reconstructing a definition for psychosis into eight components that might better reflect what people go through. I feel that the following eight components give the reader, supporters, and even provider-folks a better definition of what people who experience psychosis go through.
Psychosis Redefined in Eight Components:
- Special Messages:
These are a collection of triggering experiences that give usspecial information that others may not be aware of.
- Uncanny intuitions,
- Hearing voices,
- Sensing the thoughts of another,
- Tactile torture,
- Interpersonal feedback,
- Reading between the lines in media (TV, Movies, Newspapers,)
- Seeing clues in words,
- Seeing clues in numbers,
- Seeing clues in the world that surround you.
- Divergent Views:
Streams of thought about the way the world works that arise from special messages. These are thoughts that explain how the messages are possible. Often, only speculations, many divergent views we make aren’t wrong; in fact, many may be more correct than mainstream ideas (sometimes only in a sense though,) but most people will tell us they are wrong.
A state of mind in which we are straining to find the truth about special messages. This works with our powerful affect state and may seem like a way of surviving or exploring. Once we develop a divergent view we sleuth hard for more special message evidence to confirm correctness (a rational process.) As Special Messages build up we sleuth, and more divergent views get formed.
A hypothesis or educated guess as to the ultimate cause of the message. Just when the message is received, the pre-conscious theory explains why the message happened, who sent it. The theory is integral to our understanding of what the message means. Often the theory gets stuck on one causation modality (in sum I have developed five potential modalities that serve dozens and dozens of theories) and this drives us to sleuth intensely and make errors.
Tricksters are potentially false, negative divergent views that we receive in the process of making meaning of special messages. Recall that, in fact, special messages lead to both accurate and inaccurate divergent views. In crisis, tricksters may really be false, but if we believe in them strongly enough, they work with a negative self-fulfilling prophesy to come true. Thus, we think we are followed and we end up in the hospital where we really are followed. We think we are in danger, put out fearful energy, and people are more likely to be antagonistic and try to harm us. When tricksters come true it convinces us that we are right to fervently believe in the truth of all our messages and not entertain mainstream views.
- Retaliation Reactions:
Behaviors that exude strong emotional reaction to the whole divergent process:
- Glaring with angry or happy eyes
- Looking behind you for the possibility of tails
- Making gestures of prayer
- Talking with voices in public
- Coding our language as if we are talking to CIA agents.
- Talking in codes so that the people broadcasting our life on TV won’t be able to understand what we mean.
- Getting angry or entralled and treating someone in a way you wouldn’t otherwise.
- Walking backwards down the highway to make a statement.
- Barking at a passing bicycle because you are angry like a dog (which is god spelled backwards)
- Social Sanctions:
These are punishments like: involuntary hospitalization, seclusion, restraint, incarceration, loss of housing, loss of employment, loss of social role, social rejection, public ridicule, loss of family financial support, anger and resentment, loss of respect and validation.
- In short, stigma is a real process that leads others to label us according to our reaction behavior.
- Stigma labels carries with them stereotypical assumptions that lead to social sanctions (external and internal,) and, ultimately, to real discrimination.
- Stigma often causes us, the recipients, to get defined as our illness. We may lose a sense of our outside strengths and interests and our sense of identity.
In effect, these eight definitions function as a road-map to the rabbit-hole of psychosis which can help those dealing with distress to find things like meaningful work, relationships, and social integration. With psychosis defined as such, there are numerous solution strategies I have been able to develop that can help move people out of crisis.
Indeed, I believe a new definition like the one I have sketched out is necessary for the public to internalize. I feel if the public had a better understanding and respect for what so many people with mental health challenges experience, not only those who carry the diagnosis of schizophrenia would benefit.
Indeed, such a definition places far less blame and belief in eugenics and brain damage. In fact, often brain damage may happen because of trauma we experience being invalidated and talked down to, dis-empowered and neglected. And still even the greatest traumas give us potential for glorious learning.
Indeed, special message experiences like intuitions, dreams, and interpersonal interactions are things that everyone can relate to and can benefit from navigating in meaningful manners.