It was once suggested to me in a sociology class that sometimes we should be skeptical of advances in society. “Sometimes for the truth,” the professor with a nose ring exclaimed, “it is wiser to go back in time. Sometimes the wisdom in ancient societies can teach us a lot.”
Nowhere, in my opinion, is there a field where this sentiment more applicable, than the fields of psychiatry and behavioral health. And within those fields, this is most true, in the treatment of “schizophrenia” and other psychotic disorders.
In the laboratory, “schizophrenia” is being better defined as more of a syndrome than a mental illness. Meanwhile, I find that when people are artfully prompted to share their stories of madness that details of their experience often correlate with mood, post-traumatic-stress, anxieties, neuro-developmental realities, substance abuse and dissociation experiences. In a sense, these experiences that are thought of as disorders seem to be like layers that go beneath any given madness.
Meanwhile locally in the bay area sprawling homeless encampments are adding cruel and unusual psycho-social stress and trauma that complicate recovery and exacerbate experiences associated with “schizophrenia.” In addition, many subjected to such hard circumstances develop mental health problems simply from suffering on the fringes.
It’s true, many argue, that substance abuse or sex work may provide income for many facing homelessness. There are many generalizations to be made about people on the streets. Meanwhile treatment exists in the revolving doors of the psychiatric ER and the county jail. Many sufferers end up tortured in solitary and suicide watch. Many others get forcibly medicated. Many of those who do have bad reactions to injected psychotropics find that this and restraints further traumatize them. Meanwhile, distressing experiences continue and worsen with coercion, abuse and being treated like traffic on the streets.
Now, attaining a bed in a shelter is a 24/7 job. Furthermore, it can take some years on waiting lists and displacement to find some form of housing. Locally, working a service job is not enough to solve the problem of housing. I hear many who stay in shelters and on the streets are working service jobs in addition to surviving on the streets. They may do this without having a sense of an end in sight.
Nineteen years ago, I experienced two years of psychosis that felt like it would never go away. While housing and service work were difficult to maintain, I am sure that the stress I experienced did not compare to the stress of homelessness that many are currently facing in the city where I work. Even so I can assure the reader that being surrounded by alternate realities and the way many people address the extreme-state lifestyle I led, made survival difficult.
Now, I have a recovery. I have worked providing treatment for “schizophrenia” for the past fifteen years. It is a costly endeavor, but treatment outside of homeless encampments and the hospital does exist.
Because of my own experience, I have stubbornly refused to believe the text books that say this problem does not go away. I have ranted and railed against the standard of care that forces people into the hospital for what is often referred to as a “tune up.” I have remained faithful to my lived experience, the Yale Harding Study, and the statistics that suggest that most people do experience recovery and healing over time despite the “treatment” that operates with a disregard for human rights.
Now thanks to epigenetic advances, two new “disorders” have been created in the DSMV that account for my mental health struggles: autistic spectrum disorder; and complex post-traumatic stress disorder. I think these new “advancements” help me understand my madness along with understanding of counter-cultural reality that many people I work with refer to as “the underworld.”
Now, I am going to argue that understanding elements behind a madness is like going retro, kind of like disco was in the clubs of San Francisco back at the turn of the century. I think that if these elements are understood as layers of personal realities beneath madness instead of epigenetic disorders, they bear the potential of moving the field of treating “psychosis” back in the direction that it used to be before the Prozac revolution and before industrial times when institutionalization and electric shock was the norm.
I know there are articles that exist that could support what I am saying. Still, I prefer to write without the mystique of a scientific platform. Perhaps the reason for this is that I have learned through cracking open thousands of stories over the years that causation for “psychosis,” or what I prefer to call a message crisis, varies a great deal. Generalizations do no justice to reality!
Indeed, I had a rough road receiving treatment during the era of Prozac and psychopharmacology. I had to learn to stop listening to the therapist who was constantly telling me to try new medication or to try to be a more normal person. Although she was very credentialed, she encouraged me not to research trauma treatment because she was an expert. As a man with an eating disorder, a personality disorder, ADD, and dyslexia, I would only be more difficult to deal with if I knew what I was talking about.
During my “psychosis,” I learned to pay a second therapist lip service while she took my financial support. This was done to satisfy my parents who seemed to feel that my continued suffering was more socially appropriate, rather than admit that my three-month hospitalization was inhumane. While the therapist was making 250$ a week off me, I biked twenty miles a day on top of working a forty-hour-week to stay housed. I struggled, but I worked through my “psychosis” at the only job I could find, an upscale Italian Deli. (I believed the mob was following me.)
Since this relationship, I have devoted my career to creating alternative treatment so that others do not have to go through the ridiculous invalidation and abuse I went through when I was struggling with psychosis. Instead of listening to these therapists, I got back on my feet and I have used my training and personal experience to infiltrate a psychiatric unit as a credentialed paid worker and created my own treatment and process of self-understanding.
In writing my way through this, I have developed my own little “schizophrenia” therapy platform. In developing this I have learned to use eclectic therapy concepts that are based on understanding that many of us who struggle with message crisis also have assorted mixes of trauma, social skill, mood, and substance abuse challenges. Learning how to take care of myself and others with these techniques has given me a stable life that I can tolerate.
Much as my sociology professor suggested back in the nineties, I think we need to look backwards to some of society’s older ways of managing mental health particularly when it comes to developing treatment for issues related to “psychosis.”
Indeed, as is commonly known in survivor circles, recovery rates from “schizophrenia” are higher in many traditional third world societies. Traditional societies are more prone to support shamanic endeavors and are less influenced by the bay area’s cost of living and shocking distinctions in disparities.
Consider what people like me must face in contrast to someone in a traditional society when they involuntarily descend into a “psychosis.” In our society, we face institutionalization, over-medication, and all the social issues related to decline in wages in postindustrial service economies (the construction of the drug war, and the prison industry to name a few.)
Even when western society was industrial and so brutal as to institutionalize people with psychosis, they used to define psychological problems as being related to trauma instead of chemical imbalances. Psychiatrists were trained to do therapy in addition to prescribing medication. Psychoanalysts performed extensive treatment for the wealthy and many avoided institutions.
It wasn’t until the postindustrial, x-generation when the economy shifted, that we began to see the rise of this notion of medication for mental health problems. With post-industrial society came the closing of mental institutions, homelessness, the prison industry, the explosion of free-base cocaine in the inner-city, and the Prozac revolution in the corridors of our institutions.
I am writing this account because I think respect for atypical, neuro-divergent brains, trauma sensitivity, understanding of black-market subcultures are required ingredients to helping people find the meaning and purpose needed to counter experiences associated with “psychosis.” I think that a better social definition is needed for “psychosis.” I think it is just as they are slowly proving in the laboratory, it is a syndrome.
The experiences that lead people to alternative realities need to be explored like different cultures so that they can be less judged. When those of us who have privilege in this society think of those homelessness images and realities, it is liable to increase our judgment of the experiences associated with special messages. This serves to make sufferers more impacted by psycho-social stress.
I happen to be a psychiatric survivor who continues to use psychiatric medication to improve my functioning. I am not against this when the situation requires it. I don’t think brain chemical fix disorders but rather aid in functioning. They have helped me accomplish things I wanted to accomplish. But I have also learned how to manage issues associated with “psychosis” by leading group therapy during which I disclose my own history.
In group I reflect on the content of “psychosis” in a structured way and on solutions that have enabled me to live in both worlds. I like the ideas of the hearing voices network movement; but because I work primarily with individuals of color, I wonder if it is more apt to call groups like the ones I run shamanic healing zones to honor Non-European Cultures. When it comes down to it, I believe that issues of trauma (which require safety, resilience, enhancing pain tolerance and justice to bring about healing) and neuro-developmental realities (that require acceptance, perseverance and accommodation,) and counter-cultural realities (which need to be better understood, less stigmatized, and less incarcerated by the public) must guide our treatment of the “schizophrenia” syndrome.