Back when I was battling with what a State Hospital labeled as schizophrenia, I had little reason to trust mental health workers. Prior to the catastrophic occurrences that rendered me a ward of the state, I had survived for seven years as a mental health professional. I knew what a lot of mental health workers said behind closed doors and in team meetings. I longed for a day in court where I could rectify everything that happened to me, but the mental health workers at the hospital simply rolled their eyes when I tried to share my story. At key points I was mocked. This is the story of how I’ve lived with mistrust for mental health workers ever since. 

Initially, as a mental health worker, I thought I was doing good work. But once incarcerated in a state hospital I realized how delusional I once had been. I had not realized how much I dehumanized mental health patients until I was one of those dehumanized patients. I saw the way the staff demeaned, mistreated and put themselves on a pedestal in front of me. And they took home good salaries for treating me this way. I initially decided not to return to work in mental health. 

My therapist of seven years had told my parents I would be in and out of hospitals the rest of my life while I was trying to escape to Canada to seek asylum. My parents believed her. Right before I was released from the longest three months of my life, my father begged me to stay in the safe hospital for another nine months rather than allow myself to be released. I had been restrained and punched in the back by staff because I was confused. I was seriously threatened by a veteran with a history of violence. I had received offers to join a gang and I was a person of interest among those connected to the local Mexican mafia. I survived dangerous and deplorable conditions. I didn’t need nine more months of this. I had devoutly followed this therapist for seven years and ignored the part of me that felt she was an ivy league snob who grossly underestimated me. Now I could see her as the mental health worker she really was, one that was there to control and suppress me. 

Control and Suppression:

Streeted to a Greyhound Bus Depot in snowy Montana, I made my way to sunny Fresno California. I did okay. I managed to find a job and establish an apartment until I ran out of meds at the end of the month. Hence my battle started with housing insecurity and underemployment. It would take years and years to return to secure professional employment with weekends off. Somehow on this recovery journey my mistrust for mental health workers never changed.

In Fresno off medication, I believed that the government sewed a tracker in my dog when the pound fixed her. I believed that the men who drove white trucks were in the mafia. I believed that all the oranges in the streets were left there to let me know that the mafia could take my life if I snitched. See, I had this unique knowledge about the reality of the drug war based on recent epiphanies I gained on my last social work assignment in Seattle Washington. I believed that my father was a high-profile crime boss on the east coast working under the umbrella of the society of friends (or the Quakers) and that he was funding this negative attention I was getting throughout Fresno to silence me and protect his fortune.

When my meager savings got low enough my aunt in the bay area offered me an arranged job at an Italian Delicatessen if I move to Antioch CA and endure a ten-mile bike commute and hour-long BART ride to work and back. Only then would my parents help me. And I had to see a shrink for 125$ an hour.

I was making 9$ an hour and the shrink made me see her two hours a week (250$) and she just could never understand why this might anger me. “Why sweat the small stuff,” she said. And she was very critical of me for giving my power away and letting the rich kids who worked at the deli bully me. “I too shop at AG Ferrari,” she said. So, this relationship didn’t exactly heal anything. I did learn to lie to her and compromise and balance my emotions.

Returning to Mental Health Work Without Blowing the Whistle:

Although it’s true I hadn’t wanted to go back into mental health, after ten months of poverty, isolation and deli work with this long commute, I changed my mind. Getting a new education was costly and I was desperate to get back control over my life. 

I returned to taking medication which enabled me to get a job in social services working with developmentally disabled individuals as the manager of satellite housing. After six months of this low wage work, I healed enough to return to mental health. The first job back in mental health I failed to attain because I had a panic attack in front of my clinical supervisor on the first day. They used me for three months and cut my per diem hours. Luckily, I landed on my feet and managed to get another per diem hire at an outpatient psychiatry program. 

I learned to hold my tongue around mental health workers. As I heard them compare the schizophrenic mind to that of a dog, I dealt with this by working harder and longer than them. I felt so afraid of falling into homelessness I blindly followed people I secretly did not like so that I could work. I saw a lot of things go on that I had used to speak out against. Now I had to accept them and prove that I would not again blow the whistle so that I could survive.

In early internships, which I maintained after the clinic hours to get the required five-hundred child and family hours necessary for California Licensure, I kept a low profile and did not disclose my history of madness to anyone. How was I to make healing relationships when I was forced to hide parts of myself that are vital to understanding my mission and purpose in life? 

I worked six years in silence. Half of this time I worked without any time off, seven days a week. In 2008, when I finally got my license, I started running a group called special messages in which I disclosed my history of madness and institutionalization to the clients so we could collaboratively share the contents of psychosis. It was at this point where other professional therapists I had largely ignored started to get my attention again. 

It wasn’t just because I was aware some of my colleagues were calling me, “crazy Tim,” behind closed doors that I left the job three years later. I knew what I was doing was unconventional and for that reason I produced extensive write-ups of my group curriculums to document what the clients and I were creating. Sure, colleagues took those write ups to the manager with concerns trying to get me fired. I really thought that the institutional mentality of the staff was unnecessary and possible to escape. In doing this I stopped facilitating the groups which were wildly popular and beautiful. I left for greener pastures. I took a pay cut and entered a county recovery project where they used recovery language.

Racing into the Arms of Recovery: 

As a Recovery Services Administrator working in the county’s pilot program merging three best practices called CHOICES, my lived experience was to be considered an asset. Even the author of the project admitted that he had once been in a cult. The organization I worked with were all peer counselors. 

But alas, I walked into a political bee’s nest and that the person who was going to get stung would eventually be me. The company that hired me was from Arizona and several people in the multicultural county were having issues with one of the owners and her openly color-blind views on race. Her attitude that race doesn’t matter, only qualifications, was not well received. I also heard enough of what she had to say to be offended and set boundaries with her. I would not promote her racial ideologies that were alienating her staff and the local professionals who worked with us.

But there were other players in the county who weren’t offended and who were willing to partner with the company owner, and they seemed to be giving her bad reports about me and my behavior in the team meeting. I worked against these negative senses of things while I was getting bullied in the team meetings, working towards a brighter outcome. The teams I was working on were often hostile and superior to my workers and I had a need to defend them and often faced a room full of people being unfair. 

It wasn’t long until the professionals in the county became very concerned about what I had to say about psychosis, enough so that one time the project director set up an ambush in which I was the target. All the professional therapists in the room were mad and wanted a client who as a gang member forcefully medicated and I pointed out that it was illegal to do so.  They all knew I was right. 

They accused me of being against medication and dangerous! 

I said, “Why would I be against medication? I take medication. I am for self-determination and choice.” 

One other professional saw this political ambush and pointed out it was unfair, and she got written up by her boss.

I left that job and the sixty-hour work weeks after a year and a half. I got demoted because the owner said it was dangerous to have me working with clients. She agreed with the recommendation of the director of the program that I was better off just reviewing charts.

I saw one of the other directors after I left. He couldn’t believe that I had found a job within Alameda County. 

I had gone back to the hospital where I had a supervisor who believed in my work and where others called me, “crazy Tim.” I didn’t tell this director that they barely let me back in the door as a per diem employee. I didn’t tell this director that they would work me a year-and-a-half before they gave me back my benefits. I just looked at his glaring eyeballs and said yes.   

Going Up the Food Chain: 

On the one hand, my recovery has brought me a life I never believed would be possible when I was incarcerated in the dank, Montana State Chronic Unit that was only heated to just above freezing at 40 degrees Fahrenheit. On the other hand, my ability to heal that original world view that mental health workers were there to control and suppress has not changed. 

As a licensed Marriage and Family Therapist I have been able to go up the food chain and study with experts to renew my license every two years. The focus of the field and my own studies has been understanding how to heal trauma, something that I believe is needed when people have experienced extraordinary experiences associated with psychosis. Indeed, using these training opportunities to help myself and others heal from trauma I hoped that I could change my relationships with my coworkers and thrive.

Fifteen years ago, I went to a twenty-four-hour CEU training in San Francisco with Bessel Van de Kirk, Ph.D. and he made fun of psychotic people three times and presumed that the audience had all been to school in Massachusetts.

A few years later, I went to an EFT Training with Dawson Church, Ph.D. He referred to people who were unable to benefit from EFT as being annoying and reversed. I was unable to benefit from the tapping and had let that fact be known. Others had told me that it was because I was too dissociated. Good Ol’ Dawson got bolder as the training wore on. “What is wrong with them,” he said, “they are unable to know when something is helpful; they should just let themselves be helped.”

In 2016, I was researching trainers from where I wanted to get my forty-hour EMDRIA training. I took a training course with Laurel Pernell Ph.D. She made fun of one of her subjects as not being smart. In fact, she failed to notice all the code-switching that indicated that he had clearly been born and bred as a mobster. As someone who experienced a year and a half of believing I was being harassed by the mob, I was outraged that she depicted him as being non-intelligent. She clearly had no kind of understanding of the lifestyle he lived or what it’s like to survive in those circles. 

A few years ago, I took an online PESI training course with Frank Anderson MD., and he made fun of people who heard voices. Now there may be some context to his comments that I am not capturing here. But by the time I had heard this it was just another microaggression put out by just another elite trainer.

Thus, in training I found elite trainers to exclude people who do not fit their “trauma” culture. This process of othering is passed down through the institutions into the mental health workers. It is passed on to the most vulnerable who must battle with it in their minds. I have found the best way to deal with it publicly is to be humble and submit to those in power even when it isn’t warranted. What becomes most important is to not internalize their sense of superiority so that it affects your own sense of self.

 I Have Survived:

So now that it’s been twenty-five years since I have been hospitalized in a state hospital, I work part-time at the hospital and part-time in private practice. At work in the hospital, I use my tenure and popularity among the clients to challenge the suppression and control of the clients and do my best to promote practices that support healing and recovery. I often feel like I am all alone in my views as I offer the sole dissenting perspective. I try to stay positive and amicable toward my coworkers even when I don’t like their views. 

I have had some coworkers I have connected with over the years particularly when I have functioned in the role of a supervisor. At times I have been able to demonstrate how my dissenting views actually do coincide with the values and ethics of the profession. It’s true that working in the psychiatric system, I must have a sense of willingness to compromise; however, I do my best to honor my sense of recovery first and foremost. It is still easy for me to feel othered in training and via associating with other professionals in networking circumstances. But I am glad to have survived what I have survived even if I haven’t healed my relationships with coworkers or changed my views about psychiatry being about control and suppression.

The post Reflections on My Mistrust for Other Mental Health Workers appeared first on Redefining "Psychosis".

When the IFS trainer suggested that that we all may have been in training spaces that weren’t safe, I needed to hear that. And then, she also extended a welcome to neurodivergent people in this work. This too was important for me to hear, as I have attracted three neurodevelopmental labels in my lifetime. On day one of this sixteen-week course, I hoped that this popular methodology, Internal Family Systems, might be the answer to addressing my own complex trauma. Being in a safe place that is open to neurodivergent people seemed like an important place to start.

I have found other trauma-focused psychotherapies, like eye movement desensitization and reprocessing (EMDR) and emotional freedom techniques (EFT) very hard to use. I struggled to feel enough to successfully work with either modality. EFT, or tapping on energy meridians, didn’t help me feel any better when I was numb and not feeling anything at all. Likewise, EMDR or using dual attention stimulus while reviewing my own early traumatic events, rendered me in a void at first, and as I worked with it more it started to feel like being inside my head during a hike. Because I don’t experience special healing from either of these modalities it is hard to use these practices on other people with promise and optimism.

I had already taken several PESI courses on IFS and thought I had a pretty good idea of IFS jargon and concepts.

IFS, created by Dick Schwartz, is an approach to understanding the human psyche that reasons that one individual has multiple parts. The impact of trauma is that it drives us away from having the unifying principle of Self that can lead our parts with the wisdom of all our experiences to heal and work together in a healthy existence. When traumatic events (known in IFS as “burdens”) exist in our past, younger “protector” parts come out and dominate our consciousness, taking on extreme roles and fighting with each other to cover up what happened. Being led by the principle of Self enables us to heal our burdens and let our protector parts to live in harmony with each other within our awareness.

The appeal of parts work for me is that it views problems as rooted in things that happen to us instead of some unfounded brain pathology that can only be reversed by adjusting neurotransmitters. Thus, instead of talking about clinical depression we talk more specifically about the part that is struggling. In IFS we get curious about not only what is wrong with a part or problem, but also how it works for us. Thus, when a part shows up that is struggling with motivation and feels negative, we curiously explore the part and as we describe it and explore its history, we find that we stop “blending” with it. In effect our Self, along with the Self-energy of the therapist, comes out and helps us understand it.

In IFS, there are three types of parts: managers; firefighters; and exiles. Managers are socially conscious and try to operate in acceptable ways to hide the effects of our pains and shame. Firefighters are more reactionary and do things that aren’t socially acceptable to ward off the pain and keep the exiles from coming out. Exiles hold the pain and the memory of distressing events. Understanding the nature of these parts becomes very important to get to the point where we can unburden the pain of exiles so that the Self can lead our parts in a healthy manner.

My Experience with The Course:

As I began this latest IFSCA course, I could sense that my experience of doing IFS was different than that of my cohorts. They were more loyal to the model. When they began using IFS, they seemed to have visual or auditory experiences that I didn’t have, which seemingly allowed them connect to their parts. Indeed, having to practice being a vulnerable client—as is often the case in these training courses—quickly became so uncomfortable that I reached out to an IFS therapist who my insurance would cover to work with on my own.

In the past, I was punished by the state for purportedly hearing voices, when I didn’t realize I might be hearing very infrequent auditory illusions. How ironic it now felt in the group to be feeling outcasted for not being able to hear the voices of my parts. I learned that I had to use thinking parts to provide the answers to the questions because my parts didn’t speak directly for me.

With more practice coupled with individual therapy, I learned that with IFS one has to be in a trance-like state that I just wasn’t able to get into. This became very frustrating and I felt myself ruminating over the fact that I was different from the others in the group. It was a familiar rabbit hole that left me spinning and affected my mood and functioning.  I became concerned that the reason I was unable to hear from my parts was because I take antipsychotic medication. I continued to try to do the best I could, but the group was not proving to be a safe place for me. It was a place where I did not fit.

Repeatedly, I was directed to wait and hear from my parts and not let my thinking parts get in the way. One trainer suggested that I showed signs of having very big trauma in my background and that I couldn’t trust myself or my peers. While a part of me felt seen, another part of me felt uncomfortable with this. I have tended to be okay with trusting myself, it is other people I simply cannot trust. Where was this trainer getting this understanding of me from?

I noticed that after being consulted this way, my functioning in the course went down. Every four weeks we had sessions devoted to asking the trainer questions. During one of these sessions, I found myself less able to be attentive to her jargonized explanations. This left me in a tailspin. I found myself feeling bad about myself. This reminded me of being diagnosed with schizophrenia and feeling pathologized to function less and less.

I remembered how I kept the faith and kept working to overcome this. Thus, I went back and watched the recordings of the sessions, did the readings, and got a better understanding of the materials. I got a grip and unblended from the part of me that was convinced that there was something wrong with me because I was incarcerated in a state hospital for three months.

Eventually, approximately two-thirds of the way through the course, I started coaching my cohorts that they had to deal with my thinking parts. Work with my therapist went a bit better because she let me use my thinking parts. Still, as I listened to the complex descriptions of IFS concepts in the training sessions, I couldn’t understand what it felt like to experience the world in this way.

For example, updating the parts was never something I could do because my parts didn’t communicate with me. I found the technique to work for others to enhance self-energy and help protector parts trust and build rapport with the Self. But when others tried to use the technique on me, I wanted to say please don’t ask me those questions because I don’t know the answers. Likewise, in a trance with the pressure on to provide answers, I could not tell if I was blended or unblended so it was hard to know what worked at un-blending from a negative state or part. Mostly I was just blank. I dissociated which is a common firefighter response. I saw others update and unblend from their parts, but I couldn’t.

Meanwhile, I could go and tell my stories about traumatic things that happened to me anytime. I don’t need permission from my protector parts to do so. See, I have practiced telling stories as a keynote speaker. More frequently I have practiced sharing my stories in supportive groups I offer to others who experience psychosis. Furthermore, I have written a memoir to try to undo the sting of all the stigma I experience. I have faced a lot of rejection and weird energies from people who hear about my mental health; and I also wish they would open their ears and listen to the stories I uncover because there are so many valuable lessons to learn from them.

Lessons Learned and Moving Forward:

One thing that I have learned from working with people who experience psychosis or what I prefer to call special messages is that therapy works best when you meet the person where they are regardless of their disabilities or differences. And because of that, I struggle as a therapist to push people into a trance-like state when I can’t deal with going there myself. I found that being in this training made me afraid of trying to go inside because so often when I do, I block and come up empty. This aversion gets in the way of me understanding my parts and how to heal the exile parts that hold the pain.

Now that the course is over, I am going to continue learning IFS with my therapist and see if I can get to the point where I can get in contact with my exile parts and relieve burdens. As a therapist, I want to be able to work with other people’s parts and use the skills I learned, but feel I still have some personal learning to do before I alter my day-to-day practice.

For me feeling different or not up to snuff has a long history. I recognize that trying to do IFS work in the course caused me to blend with this part. The lead trainer named her parts, like her anxiety, and was able to stay in Self. I, unlike her, name my parts but they linger and stick around. In the training sessions, not only did they stick around; they got reinforced and that did not feel safe.

At the end of the training, I took what I consider to be a courageous step to publicly ask if the fact that I take antipsychotic medications may deflate my ability to be in a trance like state. It is also possible that my lack of trust for professionals is so profound that I just can’t do the work in front of them. When the question stumped the trainer, I went through another tailspin feeling insecure about the fact that I had let people know that I had a history of madness.

The course suggested that we keep in contact with our cohorts and, somehow, I highly doubted anyone would want to keep in contact with me. Stumping the trainer felt very awkward to me and reinforced that it is not safe to deal with madness in public spaces.

Even though the trainer had bent over backwards to include neurodivergence and taught us to meet people where they are at, she was unable to deliver safety when there are mechanisms of oppression that are beyond her control. As is often the case, we therapists often think we are safe, when a lot of times we need to take the time to prove it. And sometimes it is impossible to make someone safe in certain contexts depending on what they’ve been through.

I do believe I can benefit from the non-pathologizing approach to healing that IFS promotes and that I can teach others like me who have been institutionalized and take medicine to unblend from warring protective parts. Even if I do not get clear communication from my parts, I know they my parts are there and that I can learn to understand them.

I think I may be able to benefit even if my parts never answer. Nonetheless, my struggles to feel safe lead to an interesting set of questions in my mind:

• Do medications make it harder to heal from trauma within these new modalities?
• Do episodes of institutionalization mixed with ongoing stigma make it that much harder to develop trust so that trauma work cannot be done?
• Does the IFS community need to do more outreach to include the mad community?

Indeed, in learning the answer to these questions I will have to practice and see what I can learn. I doubt there will be books that will give me an answer to them. Much as it was for me coming back from the schizophrenia diagnosis, I will have to push my limits and defy what doubters say to get answers to these questions.

I do believe the course was a good starting point to enable me to work on my complex trauma. However, I felt extremely comforted when I told a recovery friend about stumping the trainer with my question about madness. He complimented me for my self-advocacy and said maybe my question would help the trainers be more prepared in the future. Viewing my efforts in the positive manner that they were intended helped me recapture my dignity and respect. Indeed, my manager parts—the protector parts that are concerned about being socially accepted—felt they would be interpreted as social-suicide.

The post A Mad Perspective on IFS Training appeared first on Redefining "Psychosis".

Did you know that mental health challenges affect millions of people each year? In 2021, a staggering 57.8 million people in the United States experienced a mental health challenge. 

These numbers highlight the important impact that mental health has on our society and the urgent need for understanding, support, and practical resources to address this growing concern. 

It touches the lives of people from all walks of life. Mental health challenges know no boundaries and can affect anyone, regardless of age, gender, race, or social status. It’s complex and takes on various forms.

One such mental health challenge, which comes a great deal of stigma, discrimination, and stereotypes, is psychosis. Experiencing symptoms of psychosis can be distressing and confusing because the sufferer doesn’t know what to expect and doesn’t want to be confined to a mental institution for the rest of their life. 

It’s important to understand that psychosis is a condition that leads to a great deal of misunderstanding and mistreatment. Many people who have endured psychosis talk about having a bad time not only with the experiences but also with the way they were treated.

Remember, one in ten people worldwide experience hearing voices, and many do not find the experiences distressing or related to their mental health. Below, we’ll review psychosis symptoms, causes, prevention, related conditions, schizophrenia, and treatments. Remember, you’re not alone, and help and hope are available.

What Are the Symptoms of Psychosis?

Psychosis is a psychological condition in which a person is accused of having lost touch with reality. It is a set of experiences that shape how people think, feel, and act. These are some of the most common warning signs that a person may be experiencing psychosis.

Hallucinations and Delusions

Hallucinations are when you see, hear, smell, taste, or feel things that other people don’t. Some people believe they are having sensations that come from their mind rather than from something happening around you. People who experience hallucinations come up with a lot of interesting explanations for what is happening to them. For example, some believe they can see or hear other dimensions of reality. Some people believe there have been technological advances that enable governments or powerful people to impose these experiences. And, in fact, some of these technologies do exist. These experiences are real, even though there’s no clearly identifiable external stimulus causing them.

Delusions are when someone strongly believes in things that go against what is thought to be reality by most people. These beliefs can seem irrational or impossible, but for those who are experiencing the experiences associated with psychosis, it makes no sense to see the world in any other way. For example, a person starts to collect experiences that indicate they are being followed. As coincidences and serendipities increase and as evidence comes at them from a variety of different sources, they may become convinced they are being watched by hidden cameras; they may conclude this is happening because they have superpowers; they may feel extremely important in a way that doesn’t match how others see them.

Again, these delusions are “real” to a person with psychosis. They can significantly impact how a person thinks, acts, and interacts with others.

Disorganized Thinking and Speech

Psychosis makes the brain work very hard and leads to preoccupation with thoughts about the stimuli (hallucinations or other experiences) that so distresses the person. Then, the person is asked to carry out regular activities in life and it appears like their thoughts and speech are disorganized. This can lead to:

• Conversations that don’t make sense
• Speech that jumps around
• Trouble focusing on a topic

Thoughts may suddenly appear to be fragmented as the sufferer can’t possibly articulate all that is in their head. In this manner, it becomes challenging to articulate coherent ideas or communicate effectively. 

Lack of Motivation and Social Withdrawal

Psychosis is characterized by a noticeable loss of motivation and interest in everyday tasks. Instead, the person becomes focused more on what is immediately necessary for their survival. The following types of observed behavior may start to apply:

• Loss of interest in things they used to enjoy
• Low motivation in getting tasks started
• Trouble staying focused and concentrating

Social withdrawal is also common. This is because the person may feel alone or afraid of being judged or labeled because of their condition. This can continue even when a person has recovered from other parts of psychosis.

Causes of Psychosis

Each person who experiences psychosis is on a journey. The potential causes of this journey are different and might vary widely from person to person. Industries are built around the concept that psychosis is caused by:  

• Genetics
• Chemical imbalances
• Anatomical abnormalities in the brain

Indeed, if you look at a college textbook, you will see a lot of evidence in support of these claims like twin studies and pictures of severe brain damage. This causes many of us to forget that there are “life” factors that can either start or intensify symptoms. For example, the following:

• Substance abuse
• Suffering a traumatic experience
• Chronic stress 
• Life transitions

It is important to work with mental health professionals who are curious and open-minded about the causes of psychosis. Too many have read textbooks and see statistics instead of a person. It is important to craft different treatments for different individuals that are based on the idea that the person can recover and adapt to the challenges they are facing. 

Psychosis Prevention Strategy

Even though it may not always be possible to stop experiences that lead to psychosis from happening, there is a great deal of learning that can help a person manage. Still there may be times of overwhelm and a person needs to work hard to remain healthy and functioning. Keeping your mental state of mind in good shape is essential by using a psychosis prevention strategy.

You can do this by making healthy living choices. For example, the following can all help with overall mental health:

• Regular exercise
• Having a healthy, well-balanced diet
• Getting enough sleep
• Learning how to deal with stress

Building a solid support network and getting professional help at the first sign of trouble are important ways to prevent symptoms from worsening.

Other Conditions Linked to Psychosis

Psychosis can be a symptom of various other underlying conditions. For instance, other conditions linked to psychosis could be the following:

• Bipolar disorder
• Schizoaffective disorder
• Major depressive disorder with psychotic features

Still many other “disorders” coincide with psychosis and are similar. Sometimes a mix of neurodevelopmental disorders underlie experiences with psychosis, disorders such as:

• Autism
• Dyslexia
• ADHD
• OCD

Also, many disorders associated with trauma may likewise underlie and mix to cause experiences of psychosis, disorders such as:

• PTSD
• Personality Disorders
• Dissociative Disorders

Substance-induced psychosis may occur due to drug use, particularly stimulants or hallucinogens. Certain medical conditions, such as brain tumors or infections or dementia, can also lead to psychosis. Recognizing and diagnosing the underlying conditions is essential for effective treatment and management of psychosis.

Psychosis vs. Schizophrenia

It’s important to note the distinction between psychosis vs. schizophrenia. While psychosis refers to symptoms, schizophrenia is a specific mental disorder.

It has several signs and symptoms, one of which is psychosis. Schizophrenia often causes long-term problems with how a person thinks, feels, and sees the world. On the other hand, psychosis can happen as a short-term event.

A mental health worker must make a correct diagnosis to develop the right treatment plan and give the right kind of help.

Treatments for Psychosis

Treatments for psychosis are usually treated with varied methods tailored to each person’s needs. Antipsychotics and other medicines can help control symptoms and make them less severe.

There are other treatments, such as behavioral interventions. For example, the following:

• Cognitive-behavioral therapy
• Family therapy

These can help people learn how to deal with problems and feel better generally. Peer support groups and community tools can also help give understanding, compassion, and direction.

Psychosis Unveiled!

Experiencing symptoms of psychosis can be overwhelming, but remember that help is available. Understanding the encompassing signs, help, and support is essential to treating psychosis.

People can obtain help and resources for their recovery. Remember, you are not alone; with proper care, it is possible to regain control and lead a fulfilling life.

Taking that first step towards seeking help is an empowering act that can lead to a brighter future. Reach out, speak up, and embrace the journey of healing. You deserve support, understanding, and the opportunity to live a fulfilling life.

If you are seeking valuable resources and support for navigating psychosis, look no further than Tim Dreby’s website. Visit the website to access a wealth of information and tools tailored to individuals experiencing psychosis.

The post What to do if you think you might be experiencing psychosis appeared first on Redefining "Psychosis".

In the United States, there are some estimates that suggest that approximately 50 in 10,000 people may experience psychosis or a psychotic episode at some point in their lifetime. At the same time there are estimates that 1 in every 100 people in the U.S. alone carry a diagnosis of schizophrenia, which is suggestive of a much larger presence of psychosis. Then again, there is the estimate put out by the hearing voices network, an international movement, that 1 in 10 people hear voices worldwide. The differences in these different statistics are shocking. Why do estimates vary so widely?

It is arguable that there are political reasons for suggesting that “psychosis” is so infrequent. When psychosis is depicted as rare, it helps justify that subjecting people to long term incarceration or warehousing is appropriate treatment. It suggests that nothing else can be done for this small percentage of ill individuals. In fact, I believe that having bouts of psychosis is much more frequent and tends to be underreported because people are afraid they will be called crazy and subjugate to demeaning treatment.

I have often heard that psychosis exists on more of a continuum and that it affects people to varying degrees. Some people are influenced to a lesser degree and can sustain important roles in society, while others become totally overwhelmed and lose the ability to function due to associated distress. I think if we understand psychosis as a wide array of experiences that many more people can relate to having these experiences. Many people have these experiences and develop thoughts that aren’t so realistic. When understood in this manner there are more therapeutic strategies that start to make sense and a lot more help to be made available.

Witnessing a psychotic episode can be terrifying. It can be nerve-wracking when you don’t know what to do when a loved one needs help. Indeed, it is common for many family members to start out being overly protective and scared about the safety of their loved one. Often this period of overprotection can be followed by a sense of hopelessness, a worsening relationship, and eventually referring the family member to a system that promotes warehousing. Read on to learn more about what you can do to get your loved one the support they need to heal and sustain a full recovery.

Psychosis: What Is It?

Often people think of psychosis as a diagnosed mental disorder, but this isn’t true. In the DSM (the diagnostic statistic manual of mental disorders,) psychosis is a cluster of behavioral observations regularly seen in several mental health disorders.

I have learned to treat psychosis across diagnostic divides and tend not to believe that disorders exist as they are described in the DSM. I propose that a better definition is to identify a long list of experiences that many people may be able to relate to that so preoccupy the mind that it can seem to an outsider that the person has trouble telling the difference between what is real and what isn’t.

According to the DSM, a person dealing with psychosis may experience hallucinations and delusions. When experiencing hallucinations, a person’s brain will pick up on sensory inputs that others do not experience. These hallucinations can affect all five senses, leading the person suffering from psychosis to hear, see, smell, taste, or even feel things that no one else can observe.

Again, according to the DSM, delusions are when someone believes in something that most people would suggest is untrue. I believe they continue to experience the world in ways that cause them to think in different kinds of manners. For example, some people with delusions believe they are being followed.  For another example, a person suffering from delusions may firmly believe that someone or something outside of themselves has control over their thoughts and actions. This can lead to behaviors that can be observed and labeled psychotic because of the associated conflict and distress.

In fact, when a person experiences trauma-related dissociation a different alter or part of a person can take over the body and control their thoughts and actions. Many times, when people have their views invalidated repeatedly as they do when they are told they have a delusion, they may develop this same phenomenon of dissociation in concert with their delusions. In fact, as I have worked with people who carry psychotic labels over the years, I have found that ultimately this overlap is extremely common. Understanding this can help us understand behavior that is thought to be psychotic.

What Are the Common Causes of Psychosis?

Certain mental health disorders include episodes of psychosis as a symptom. According to the DSM-5, Schizophrenia Spectrum and Other Psychotic Disorders fit this category. Common mental disorders that can cause psychosis include:

• Brief psychotic disorder
• Delusional disorder
• Psychotic disorder due to medication
• Schizophrenia
• Schizoaffective disorder
• Schizophreniform disorder
• Schizotypal (personality) disorder
• Substance-induced psychotic disorder

Still many other disorders that are in the DSM V also can result in psychosis. For example, those with bipolar disorder and major depression can develop psychosis symptoms. Medical conditions such as Alzheimer’s can cause a person to experience psychosis. Research shows that 1 in 500 women experience postpartum psychosis after giving birth. Additionally, those who have severe head injuries and traumatic experiences can develop psychosis symptoms. Often extreme experiences with developmental disorders such as ADHD, Dyslexia, Autism and OCD can result in a person developing psychosis. Also, substance abuse can result in psychosis.

I have calculated that there are a total of thirty disorders in the DSM 5 that involve psychosis and so I have trained myself to listen to peoples’ experiences across diagnostic divides. Additionally, there are often other mental health struggles that are going on beneath a person’s psychosis that can be harshly exacerbated by receiving “treatment” associated with psychosis. Things like trauma, anxiety, depression, and substance abuse can become much worse because of experiencing what is thought to be a “psychotic” break.

People with lived experience develop very interesting thoughts about the cause of psychosis, as do professionals. Often, getting better involves diversifying one’s causation ideas. It is very positive when people with different perspectives work together to understand new facets. I believe that there are styles of causation theory. I teach that there are: political, spiritual, traumatic psychological, scientific, and artistic explanations for a person’s journey through madness. Understanding all perspectives is an important part of getting better.

Psychosis Risk Factors

Some individuals are thought to have a higher risk of developing psychosis than others. I tend to want to dispel these risk factors as I think they reflect a lot of stigma. Psychosis risk factors are thought to include:

• Family history of certain mental disorders
• Drug or alcohol abuse
• Severe mental, emotional, or physical trauma
• Brain cysts, tumors, or damage
• Genetic mutations
• Certain medical conditions, including dementia, HIV, and other infections

There is a widely publicized link between genetics and the risk of developing psychosis. While there is a large amount of funding that has been put to proving the genetic link, little definitive evidence has been produced. What we hear from experts is that so much more research is needed to possibly prove a link. When something is suggestive of a genetic link, it is amplified in the literature because so many people want to hear that psychosis is caused by genetics.

Many people with lived experience are open to the idea that they are spiritually gifted. I believe that many individuals in a psychosis crisis do have psychic abilities that complicate matters and confuse people. Perhaps it is arguable that there is a spiritual gene that might be isolated and proven to exist. I believe that many people who presume a genetic link, presume there are inferior or problematic genes and tend to have eugenic misconceptions. Unfortunately, this can result in a lot of stigma and mistreatment of people who have experienced psychosis. This is often seen on psychiatric wards when staff people think they are above the patients, and it is unfortunate.

I am partial towards understanding the role that abuse and social exclusion plays in developing psychosis. Consider the famous psychologist, Carl Jung, who fell into madness when Sigmund Freud betrayed him or the famous sociologist Emile Durkheim who fell into madness during his massive suicide study under the social pressure of people who did not think that he would not be able to complete the project. Such examples suggest that under the right conditions any body could fall into madness regardless of their role in life.

Early Psychosis Warning Signs

Early warning signs of psychosis can be challenging to detect since it is usually a gradual process that starts with seemingly small changes in behavior. To make it even more difficult to identify, early warning signs can affect nearly any area of a person’s behavior, from thought processes and speech patterns to emotional and social changes.

While there are a huge number of early warning signs of psychosis, some of the most common may include:

• Belief that their environment has changed
• Change in language structure or speech patterns
• Difficulty focusing or thinking clearly
• Withdrawing or isolating from social situations
• Extreme, unwarranted aggression
• Decline in self-care and personal hygiene
• New or worsening sleep disturbances
• Showing a decrease in emotions
• Acting suspicious or paranoid

I have heard of many stories of people who heard voices as kids at certain points and how they never had problems until they told others about their experience. Often speaking about voice experiences cause voices to become critical and threatening causing them to get referred to treatment. Unfortunately, what many people with lived experience report is that many forms of “treatment” cause things to get worse. Treatments like psychiatric incarceration, involuntary medication, seclusion, and restraints often take intolerable situations and make them worse. This is why I advocate for the public to get a better understanding about what psychosis is and learn basic interventions so that the more traumatic treatments become less necessary.

How Can You Help a Loved One With Psychosis?

It can be difficult to know and understand what you can do to provide psychosis help to a loved one, especially if they are in a psychotic episode. If you’re trying to offer good support and care to a loved one dealing with psychosis, here are some suggestions:

Don’t fight with them: People struggling to grasp reality will perceive things others are not experiencing. Your first reaction may be to get angry and argue with them about what’s real. Instead, stay calm and discuss with them what they’re experiencing.

Ask them how you can help them: If your loved one seems to be in distress during a psychotic episode, consider gently asking them what you can do to help. While this may not always work, in some cases they may be able to direct you in a way that is specific to their needs.

Discuss the importance of seeking help: Your loved one may hesitate to seek treatment for their psychosis. As I stated before, a great deal of mental health treatment can be perceived as negative and indeed have negative outcomes. Thus, it is important that you don’t advocate for those measures.  Learn about recovery-oriented help that does not involve a future of being warehoused. Ask yourself if the suggested course of action is likely to lead your loved one down a path of recovery and healing or trauma and abuse.  Then it makes sense to advocate for them to trust the help that is available to them. Additionally, it can really be helpful if you are willing to work with them to find the right treatment.

What if They Become a Danger to Themselves?

Many people benefit from medication and other treatments that help them stay in touch with reality. After receiving proper medical and mental health attention, it’s not uncommon to see improvement in psychosis-related symptoms. Of course, it helps when you can help to assemble a team of trusted professionals that respect the self-determination of your loved one and believe in their recovery. However, symptoms can still occur despite appropriate intervention. This can get your loved one down and even lead them to become a danger to themselves or others.

Thus, it becomes important for your loved one to learn about how they want to be treated and how to advocate for the type of treatment they need at a particular time. A good resource to help them develop these skills is wellness recovery action planning. WRAP groups will teach your loved one to develop a crisis plan. Learning to plan for crisis ahead of time and to collaborate with others to learn about the best resources that are available to them is very valuable.

Thus, if psychosis does cause your loved one to become a danger to themselves or others, lean on the crisis plan they have developed to get them to where they have determined would be most fitting for them. Call 911 only when all else has failed as that is truly a last resort. Having police called can become traumatic for many people.

What Psychosis Treatment Options Are Available?

Psychosis has been around for a long time and was once blended with religion and social order in earlier epochs. Before there was oppression from the state, psychosis might have caused social status to elevate. It is only when there is a great deal of oppression and a medicalized view of psychosis that treatment starts to be a negative thing. Now, it can be hard to find treatment for psychosis that doesn’t involve warehousing and suffering in the United States.

In some situations, anti-psychotic medication can help control the symptoms. Still even while on medication it often takes a lot of hard work to get to the point where voices, other hallucinations, or “delusions” disappear.  Additionally, when there is miscommunication between the psychiatrist and the patient, or violence during incarceration, there is the problem of overmedication. When there is too much medication there is often sedation which adds to the negative symptoms of schizophrenia. When used properly, I believe medication can function as a tool for some people. Even so, some people may be able to taper off their medication at some point.

I have said a lot about treatment that is negative. If your loved one becomes a threat to themselves or others, temporary inpatient treatment may be a resource you must use.  Still, I discourage people from thinking that long term psychiatric incarceration is a reasonable option. Too often, long- term incarceration just confines people and fails to address any issues. Many long-term facilities just train your loved ones to accept warehousing. That said, there may be times when long term treatment beats other warehousing circumstances or homelessness.

Many people don’t believe therapy is helpful when people are in psychosis. To counter this argument, cognitive behavioral therapy for psychosis has been set up and is thought to be a best practice and can be used to help build the skills and knowledge necessary to cope with psychosis.

I believe that individual, family, and group therapy can all be beneficial. However, it’s important to remember that not everyone responds to therapy treatments the same way, and different styles may need to be tested to find the most effective styles for your loved one.

I believe that hearing voices network groups are a great potential resource for people who experience psychosis. From fifteen years of running these groups in an outpatient program, I have learned to identify four areas of treatment off which I base my work.

First, learning to tell your story and articulate the experiences associated with your internal process in groups or with another individual helps a person be more mindful and aware that other people have similar experiences and that there are other explanations for what is going on with you that exist. This can take a while because many people are taught through hospitalization that it is not safe to talk about their experiences with anyone.

Two, collaborating with others and learning about new explanations for these experiences can help one become more flexible in how they make meaning of their experiences. This can help people realize when they are getting tricked and how to avoid getting tricked into negative self-fulfilling prophesies when they get stigmatized.

Three, behaving against your negative symptoms or emotions and working toward social rehabilitation is likewise very important. To do this it is important to learn about aspects of treatment you have found traumatic and learn to accept limits to which you can share your internal experiences with others outside of groups and practice social skills toward social functioning in the right contexts. For many people these contexts need to be work related, but not for everyone.

Four, as people start to improve, they start to recognize the existence of stigma. I believe it becomes important to work against internalized stigma through checking your thinking using cognitive therapy. I believe that stigma and being treated badly makes people with psychosis think poorly about themselves. I consider rational thinking and cognitive therapy to be a tool, much like medication is a tool, that might help.

Choose a Specialized Psychotherapist for Psychosis Help

If your loved one is suffering from psychosis, they may be very afraid of coming for help or even interacting with other people for fear of being invalidated and mistreated. Still, there is a lot of hope for your loved one and it is important to highlight the positive things that your loved one does do. If you are looking for individual therapy I can help.

I am a psychotherapist in California with over 25 years of experience. I offer treatment for psychosis across diagnostic categories. I also offer treatment for trauma, anxiety, depression, auditory hallucinations, and substance abuse. If you know someone needing therapeutic support, contact Tim here.

The post How to Deal with Psychosis, Help Loved Ones Deal With It appeared first on Redefining "Psychosis".

Psychosis is the name given to a wide range of mental ailments categorized by periods in which someone loses touch with reality. These episodes are difficult to process because they’re so convincing. Someone in the middle of a psychotic episode is unable to differentiate what they are experiencing from consensus reality.

Did you know that somewhere around 3% of Americans will experience a psychotic episode in their lifetime? That’s around 10 million people! Still when one considers that one in every ten people hears voices worldwide, this 3% estimate seems conservative. 

Psychosis is much more common than many people think or would like to believe. As with other taboo DSM classifications of yesteryear. like homosexuality or drapetomania, schizophrenia is so badly stigmatized that related experiences go widely underreported.  

If you’re curious to learn more or have ever asked yourself, “What is psychosis?” You’re in the right place. Read on to find out more!

What is Psychosis?

Psychosis is the word used to describe a mental health problem that causes people to perceive things differently from how they are. The two main examples of psychosis are categorized by episodes of hallucination and delusion. Often, these are experienced at the same time. 

Hallucinations are defined by sensing things that don’t exist. This includes sights, sounds, feels, and smells. Hearing voices is a common hallucination reported by and observed in people suffering from psychosis. Delusions are when someone believes things that aren’t true, something that seems baseless and illogical.

At times delusions and hallucinations make sufferers act in peculiar manners as they react to things without a basis in reality. Paranoid thoughts involving friends and family are common examples of delusion. Beliefs of intricate plots being drawn against them and unfounded suspicions are good examples.

Psychosis Treatments

Treatments for the many forms of psychosis need an individually tailored approach depending on the needs of the patient. Antipsychotic medication may help relieve some experiences that trigger psychosis, but there’s no magic pill. If pharmaceutical aid is proven effective for the patient, they have to deal with negative side effects. Long term use of antipsychotics is often imposed while health risks are not considered.

Psychological therapy is a proven treatment for helping a patient overcome their challenges. Speaking with hopeful professionals who are knowledgeable in specific strategies is helpful. Speaking to professionals who simply refer the person to the hospital is not and say they are trained to work with such conditions is not.

Cognitive behavior therapy (CBT) is thought to be helpful with people dealing with schizophrenia. I believe CBT helps reduce internalized stigma and is a valuable tool at times. Family sessions have also proven to be effective in reducing the need for extended stays in the hospital. Teaching family members to care for and understand the plight of their loved ones allows for significant aid from the comfort of home.

Reducing reliance on unfamiliar places and people helps to lower the stress of the patient in general, but limiting the stress too much also reduces the individuals’ ability to function. If the person in question continues to have severe psychotic episodes, having a structure they can adhere to like a job or a program where they volunteer to work with others often helps maintain and build on functioning.

Psychosis treatments aren’t guaranteed to be effective. The nature of the condition is difficult to understand and there is so much stigma, discrimination, and abuse that people in a break endure, that there remain people who fail to thrive. Many attempts and different approaches are often necessary to see a positive effect.

Causes of Psychosis

Psychosis isn’t recognized as a mental health condition in and of itself. It’s seen in people who are struggling with a diagnosed mental health condition in conjunction with other symptoms specific to it.

Psychosis is a common symptom of schizophrenia, a condition that causes a wide range of debilitating mental effects.

The question of ‘What is psychosis?’ often leads people to explore other conditions where psychosis is a foundational symptom. In the DSMV, there are 30 different diagnoses with features of psychosis in them. This helps further the understanding of psychosis in a general sense.

Schizophrenia is a brain disorder that disrupts healthy thought patterns due to delusions. Traditionally. When someone has a psychotic break, they are often thought to have schizophrenia. However, bipolar disorders that cause feelings of intense despair or mania can also trigger a psychotic episode. 

Causes of psychosis are specific to the individual but are sometimes thought to be a response to traumatic experiences. Changes in the physical makeup of brain structure can make us perceive the world in unexpected ways.

Delusion and hallucination are relatively commonplace after sustaining serious brain trauma. Tumors and the abnormal growth of brain tissue are often observed in people suffering from symptoms of psychosis.

I believe psychosis results from a collection of experiences that trigger thought patterns. Some of these experiences like intuitions, dreams, or reads on interpersonal energy are common to everybody. 

Signs of Psychosis

Signs of psychosis are relatively simple to spot in someone suffering from a severe psychotic episode. Anyone who insists on an alternate unobservable version of reality is most likely having a psychotic break.

We’re quite in tune with a standard shared version of reality, and when someone deviates, it will usually be obvious.

Someone interacting with people, sights, sounds, and voices that don’t exist is a strong sign they’re suffering from psychosis. If they’re experiencing fear and paranoia without an obvious cause, these are also strong indications of psychosis.

Indications of psychosis can be subtle and difficult to diagnose in some people. Someone who seems outwardly calm and collected might be suffering considerable internal turmoil. Losing focus and freezing up may indicate they’re dealing with their psychosis inwardly.

Not everyone exhibits wild and sudden changes in demeanor or emotion. Some people suffer for years without ever being able to draw a line between their delusions and reality. If you suspect someone to be suffering from psychosis, you can contact a professional and ask their opinion on how best to proceed.

Help for Psychosis

Fortunately for sufferers of psychosis and mental issues that cause it to be a regular occurrence in their lives, help exists. A wide array of medical aid is available in the form of therapy, prescription medicine, peer support, employment support and other professional therapeutic aid.

Before help for psychosis can be found and implemented to the best effect, a consultation must be made to tackle the issue. It’s not as simple as prescribing a blanket medication or therapy, as every individual has different needs.

If you enjoyed this article, “What is psychosis?,” don’t hesitate to reach out. We’d love to hear from you.

The post What Is Psychosis? appeared first on Redefining "Psychosis".

I am a white male from families that mostly owned property or had social power. I have to say one of the most meaningful projects of my life has been to overcome my narcissistic background.

I once had a shrink that told me that my “paranoia” was like reverse narcissism. I really wasn’t as bad as I thought I was.

At the time, I was working twelve-hour days of physical labor, (four hours of it was a sweaty bike commute.)  I was bringing home 900$ a month and paying $955 dollars a month in rent. I was coming back from a psychiatric hospitalization and battling housing insecurity with some financial help. I had many internalized parts that judged myself in narcissistic manners. These parts were reinforced by the attitudes of the few people I was in contact with at the time including the shrink.

The problem was that just about everyone I knew actually judged me worse than I judged myself. Within five minutes of talking to me they presumed I was delusional. To me that meant I was schizophrenic and that I would spend the rest of my life in hospitals. To many it meant I was no longer friend material.

Now over twenty years later, I feel like I am fighting narcissism and slander in most communities with which I come into contact. The only community that I don’t feel that way about is the community that subjects themselves to psychiatric treatment in the hospital where I work. In other communities I feel ostracized.

One might think a person like me could find social comfort via affiliating with communities that stand in resistance to narcissistic abuse. What I find is that the power structure of some of these communities often excludes me. Sometimes I feel excluded for good reasons, and sometimes I feel excluded for bad ones.

I tend to view power in society as narcissistic and unjust. Ultimately, I choose to think all these styles of narcissism I have endured are here to help me overcome my own sense of narcissism. I have learned to lean on a higher power to ease my desperate moments. I remember that the privilege I was raised in was the result of abuse of others. I choose to continue to learn ways that narcissism is wrong.

Today I intend to identify seven styles of narcissism that have tended to lead to abuse in my journey. In many people’s eyes, these styles vanish with the use of a label that explains all that I have gone through as being a schizophrenic medical condition.

I write imagining that the styles of narcissism I identify are such that others might relate to in a variety of ways. Each style is something that can turn chronically normal caring people into judgmental and exploitive narcissists.

I come from a culture that has used genocide and slavery to advance its power so it is number one. It’s arguable that this gives our citizens a natural tendency to think they are better than others. We always hear about American casualties in armed conflicts.

It strikes me that this is important now that narcistic abuse and gaslighting is starting to be a focus of psychotherapy practice. I hope to use aspects of my personal journey to help challenge narcissistic judgements and decrease the things that divide us.

Style Number 1:  Exploitation Resulting from Unrealized Sexual Abuse:

Somehow, I developed a tendency to be hypervigilant regarding sexual intentions of others and to dissociate when things get uncomfortable. Since an early age, I remember having distressing feelings that I do not understand. I believe that in my case this has resulted in complex trauma or interpersonal struggles with others.

My teacher in kindergarten observed that I didn’t do well socially.

Back when I took baths with my sister I would play with my penis and ignore my mom’s nagging that I needed to stop. One time, exasperated that I would not listen to her, she sketched me with my hand in my crotch.  This was effective in getting me to stop but also resulted in shame.

I shunned all things associated with masturbation at an early age. I used to explain this to other kids on the playground, unaware that there was anything unusual about this.

Latency was a very serious thing. I remember vowing to my best friend in second grade that I would never to have a girlfriend.

In the next year or so I was coerced into taking a bath with a family friend’s daughter and when I was groped. I dissociated and ended up eating a moth ball necessitating poison control to be called. This was a detail I never remembered until I was writing my memoir in my mid-forties. I showered in my shorts for a year after the incident with the family friend without ever understanding why.

During my first year at sleep away camp at age eleven, I was terrified by the expectation that we would be okay with skinny dipping.

In sixth grade I refused to dance with girls and repeated things my mother told me about sixth graders not being old enough to dance with each other.

Being different in this way led to a lot of teasing and shame. Not only is the act of sexual abuse narcissistic, but the social response to people who are easily shamed is also.

I now believe that I was sexually abused by a family friend at age three. Not remembering this made latency and the trouble I got into with my mother a very serious thing.

My father had an affair and eventually divorced my mother when I was fifteen. My mother was very hurt and rebelled by having polyamorous relations with other men. Thus, when I was sixteen and reaching a late puberty, I had a hard time forgiving my mother for this and developed lasting resentments. My failure to have empathy for my mother was rather extreme.

As Pete Walker suggests in his book Complex Trauma: from Surviving to Thriving, with early abuse “the superego morphs into a totalitarian critic that trumps the development of a healthy ego.” (26). In my experience, having a strong sense of conscientiousness can result in bullying or the failure to thrive as a social being.

I repeatedly struggled to have empathy for others when they engage in corruption.

Also, one summer during my teens, I believe I witnessed a brother rape his sister. I remember that they were skinny dipping. I have other vague and foggy memories of the deed. They are not attached to my other memories of the evening. I do know that the sister ended up having dissociative identity disorder. I remember running in absolute terror and feeling like a terrible coward.

In short, child sexual abuse may lead to complex trauma in relationships with others. Other kids always seemed to target and believe they were better than me and this reinforced my shame. This happened in a host of settings. I later developed mental health symptoms and food addictions.

Style Number 2: Being Underestimated and Misunderstood with A Neurodevelopmental “Disorder”

Diagnoses such as autism, dyslexia, attention deficit or obsessive compulsive are now being considered to be developmental trauma. I was not diagnosed with attention deficit and dyslexia until I was in graduate school. While it is possible for many with the right interventions to maintain their school performance, I never received extra support or understood why I struggled so much.

In simple terms, these kinds of learning challenges mean that some areas of the IQ may be high, while others are low. Or perhaps its easier to understand that some areas are more utilized and higher while others remain less utilized and fail to develop. Fluctuations in abilities as such make learning more challenging.

In contrast, people tend to associate neurodevelopmental struggles with a resource room, or ultimately segregated special education classes. In its most extreme form, segregated severely emotionally disturbed schools, with point systems may seem to prep smart students more for prison than it preps them for acquiring job related skills. These kinds of consequences and associations to these consequences can make a neurodivergent child be treated like they are less than.

Indicators of these kinds or struggles that I experienced were speech impediments, anxiety related to school attendance, getting teased, tendency to befriend only older or young playmates, and poor spelling. I nearly wasn’t allowed entrance into the school where my parents taught because I didn’t use the scissors like everyone else.

Some teachers or parents who see these emerging patterns of behavior may become critical and fail to connect with the neurodivergent student. Or they may not understand the struggle and set unfair expectations rife with microaggressions and high expectations. Thus, being misunderstood or not properly trained by the teacher may set up the sense that other kids are better.

In my case, I was extremely slow in accomplishing tasks, but I worked to compensate and brought home good grades. My father presumed my slowness was laziness and tried to force me to work harder. When I couldn’t sleep at night for a year, he intervened by taking a working vacation in which we worked physically for sixteen-hour days. I did sleep. It was a solution.

When you get older, people do intellectual assessments of you based on the college you attend, interpersonal skills, the company you keep and your job. As the reader will see, I haven’t lived my life to pass these intellectual assessment tests. Many people narcissistically judge misfits, underestimate, or ostracize them.

In high school, I spent dozens of hours perfecting a fifteen-page story and got a B. My college essay that I incessantly rewrote nearly got me kicked out of the school convincing the school psychologist that I really was suicidal. I poured my heart into my Poetry notebook which only earned me a B because it was too depressing. I wrote a twenty-five-page essay on Tibetan Buddhism with 60 references that went unrecognized.

For a variety of reasons that will become clearer, I chose not to go to a college in which the same thing would happen to me all over again. I did the work without being in community. It is arguable that this further amplified my neurodevelopmental differences.

Style Number 3: Facing Class Superiority with a Complicated Class Identity

My first experience of class came from comparing things like toys, houses, violence and vacations to those of my peers. I developed awareness of the stark contrast between rich and poor in the early years of my life. I noticed many who are well-to-do develop notions that they are better than other people and they fail to realize that other people may be smarter or stronger than them.

When I was a child, I seemed to have a raw deal. My parents had private school teacher salaries which are not all that impressive and they could not afford to keep up with the Joneses. Though they bought a house in one of the wealthiest Philadelphia suburbs, I did not understand it was a wealthy district. The house we lived in was old and taken care of by my father who was a do-it-yourselfer. Therefore, I grew up with a sense of depravity when I compared myself to my private school friends.

In contrast, in the summer we went into an impoverished rural community where we owned cottages and property. I compared what I had to what the other kids had and I found myself embarrassingly lucky.

I would notice that local kids would act very virtuous in front of me when my family hired their parents. That part of my family had been lumbar barons and the town had been built around the lumbar company. Thus, we were on remnants of a very unjust system.

One time, I challenged this fake niceness I was noticing and I found my virtuous friend to be capable of atrocious behavior that went beyond that which I was comfortable. Thus, I realized that many of my peers in that rural town had to fake it in front of me because their lives depended on this.

Of course, there was always an occasional kid who would urinate on me when I was three or try to fight me when I was thirteen. I was not embittered by these experiences. I could always understand how these acting out kids felt because I knew what it was like to have a raw deal in comparison to the suburban kids with whom I grew up.

At one point in my preadolescence, we rented out a property to a welfare family. The kids had fancy dirt bikes. For me, dirt bikes were a no-no. They were just too expensive for me to have one allotted to me. It was confusing. My father explained that in his experience growing up, scholarship students often had better things than he had. It was confusing but it was reality.

The welfare kids would give you the shirts off their backs because they liked giving. I could use their dirt bikes as much as I wanted. Then, my father exclaimed that they worked a lot harder than me. It was hard not to feel they were better than me at all turns. Plus, they knew how to have wild and unruly fun, unfettered by adult intervention. I liked them a lot and wanted to be like them.

Meanwhile, back in junior high, my cohorts were having a field day on me perhaps in part because I was not allowed to wear name brand clothes. I didn’t like being teased by spoiled kids and I fought back by acting out in odd manners. That was a problem for the teachers who witnessed this. I was sent to a shrink.

When the shrink met with my parents because I said they would not buy me name brand clothes, I learned that it was my fault I was not wearing the name brand clothes. The only good part about being blamed for something that was not in my control was that was I got to go shopping. The thing was I still learned that I was better off when I bought cheaper imitation brands. I stopped fighting and tried to get along for a spell.

The issue of income disparities and the superiority of the fortunate is complicated. The norms of rich people exclude people who don’t fit in. The norms of poor people seemed to me to be more open, even though in my case, the rural poor were forced to deal with me. I did not understand the violence that often comes with poverty due to the reality of the U.S. black market.

Ultimately, disparities in income have a tendency to make some people think they are better than you. The haves hate the have-nots is how many people understand this. False notions of superiority get spread throughout the culture based on this.

And yet the realities of crime are a great equalizer. Crime may have been what afforded those welfare kids with fancy dirt bikes. When crime, drugs, and corruption enter into the picture, things get a wee bit complicated.

Style Number 4: Judging those who Fail to Regulate Addictions

Around the time I was exposed to the reality of substance abuse, I refused to be influenced by peer pressure like everyone else. I did not feel ready to use and I didn’t like the way I felt drinking alcohol. My father drank in a way that often made me uncomfortable and I didn’t want to be like him when I was drunk. The result was that my social struggles were exacerbated. I did not associate my need to relax with socializing and with alcohol like everyone else did. I secretly became obsessed with eating.

It was the summer of 1988 and I was in a work camp in Orangewalk, Belize. My peers did notice my obsession with getting enough food and often made fun of me about how much I ate. Unlike them I was working many physical jobs all day under the Caribbean sun. They were sleeping after drinking ten or twelve beers the night before. I would go out with them but retire as soon as I could so I could work. Thus, when they saw me craving food, they made fun of me.

The next year I did not fight the temptation to drink and socialize when I was buried in school work, I fought the temptation to eat. I did this twice a day for lunch and dinner. Meanwhile with my undiagnosed learning disabilities I worked late into each and every evening trying to keep up and perform at the level I was capable of performing.

I lost my position as a starter for the varsity soccer team because my speed went down. I just didn’t have the gumption to chase the ball the way I used to. I still felt that I had to get a control of my appetite. I planned and organized social service events for the school community during the lunch hour. I started lifting weights and running long distances after soccer was over. I continued to sleep four hours a night to complete all my homework. And I started counting calories. By the summer I was admitted to the psychiatric hospital at 6’1”, 103 lbs.

The following year I was in and out of the psychiatric hospital and barely completed the year to earn my high school diploma. I moved in with a friend to get away from my parents. All the service work I had done the year before was credited to my colleague. I took to writing, but my best efforts failed to deliver the results I wanted in terms of grades or awards. I became invisible and my classmates shunned me. I skipped graduation night for a lifeguard course so I could move to a Summer Camp. I left the suburbs and my life at a private school and never looked back.

My peers thought I was bulimic because they always saw me eating cookies for lunch. In my opinion they were so wrong about me because they believed the gossip that emerged from my parents. I resisted their efforts to fatten me up in the first hospitalization they sent me to by vomiting in the hospital trash cans.

As I mentioned earlier, I increased my writing efforts as an outlet for my pain and my grades decreased.

I would want nothing to do with the school or my peers by the time I graduated. I followed a twenty-five-year-old old girlfriend to a local commuter college to rebel. I blamed the school and my peers just like they appeared to blame me.

What I failed to realize was that I became addicted to hunger, like many addicts get addicted to their substance of choice. It is expected that people my age start using substances and regulating themselves so they can still perform. I failed to do this. I know what they all concluded about me. It is what they conclude about addicts who fail to keep up their school work. I was weak. I was not worth their time.

It is not until I have lived many years and looked back that I realized the sense of narcissism in the private school community got expounded by my public display of addiction.

Style Number 5: Impact of Racial Abuse

As a white person, I cannot do justice to the narcissism associated with race in this country. I have not lived it the way people of color do.

I leave inner-city communities of color and can still look like I belong in the suburbs. I do not face micro-aggressive eyeballs everywhere I turn and people who fear that I will become violent.  In fact, I know the white world pretty well having grown up in it. I may experience a pinch of imposter’s syndrome when I try to connect in suburban contexts, but it does not take away the fact that I grew up there.

I immersed myself in a black and brown inner-city community in college. I worked at a summer camp at the Camden New Jersey YMCA in which I was the only white person. I contrasted the facilities with those in which I grew up. A lot of those kids at the YMCA had middle class families that could afford the tuition and yet they had to accept the roach filled facilities.

As middle-class white kids we were taken out to nature and had other activities to enjoy.

Then, I worked at a Korean run deli with neighborhood coworkers for three years including two summers. Since that time, I have maintained ties with communities of color through years of working in social work. I have worked my current job for twenty years at a majority African American community.

My first apartment was roach infested and I had to carefully and respectfully connect with neighborhood people to get it. I used to make the managers dinner at the Deli to even be considered for the apartment. I needed to let my coworker con me into driving him to his connects house to cop. I needed to be friendly with the owners of the drug complex across the street from my complex. Then, when I proved to others that I was a safe resource, I saw how exploitive the police were.

Especially, I learned about how the vice squad were the real bad guys. I never went to a single college party with drugs in it and yet the vice squad harassed me on one occasion telling me, “You can’t hustle a hustler.”

Yes, you can when you have no hustle.

When the university career office suggested for me a career in law enforcement, it made me cackle and feel my intelligence was being insulted.

Bearing witness to the decisions that the youth who lived on the block were faced with also had an impact. They had to work to help their family out as opposed to me who was only worried about myself. My perspective on white America did change and I was angry with people who weren’t dealing with roach infestation. Seeing one of my younger coworkers leave the job to sell crack made me really sad because I knew the danger and the challenges that he would be facing. One day I would face the same danger.

Thirty years later, I still learns lessons about the impact of race on a regular basis and I still am aware that I am racist and am liable to offend others from time to time with my cultural manners.

Europeans invaded this country and brought with them three centuries of slavery and genocide. The concept of manifest destiny caused native Americans to be killed and segregated on reservations. Three centuries of slavery was horrifically narcissistic and degrading. Then, Jim Crow laws were historically so tilted against black and brown communities, it kept them segregated and lynched for a century. And still with zoning, gerrymandering, employment bias, immigration and drug laws definitely in effect, there is a disproportionate representation of black and brown people in jails and the prison system. Skin color is often associated with stereotypes and incarceration and fills many people overtly narcissistic with implicit bias

When I came in off the streets to a mental institute and was observed on an evaluation unit, they determined that I was schizotypal personality for making the same kinds of interpretations of power in the Rorschach that I am making in this blog post. I was not influenced by the cultures I had been exposed to: the rural poor, the suburban mainstream and urban people of color; I was clinically odd. I was started on antipsychotic medication.

Style Number 6: Extending Unequal Pay for Unskilled Labor

I grew up in the throes of the postindustrial revolution when the service economy started to set up very high degree of income disparity via making many jobs so low pay that people who worked them could no longer afford the American dream.

Service work makes sense if it is carried out by young, housed individuals who are looking for a little income as they move through school. It may teach people a work ethic and may motivate them to get skills in school that will enable them to get better salaried work.

As I grew up, there were some people from wealthy families who never had to learn how challenging service work can be. I had witnessed a lot of people take it for granted. There are people who start work negotiating good salaries that can sustain families without understanding how hard it is for people in that sector of the economy.

Working these jobs, a student can also meet and get to know people who work in this sector of the economy who don’t have it so good. Many may learn and accept that such people fall into the temptation to make fast money, yet do they see the consequences of doing this? Or perhaps they opt to use their parents’ money to get around this kind of work altogether. Some may think the work is easy and for people who aren’t as smart as they.

When I reached an independent age in which I had to balance rent with the rest of my needs, I really stared to learn how little that kind of work is respected. Additionally, when I befriended people who are in those situations I started to understand and respect the injustice.

I began service work in high school and college and it was always a means to get extra income that helped sustain me. In college I used it to pay my expenses, but I did not depend on it to sustain my rent or tuition. I had parental support for that.

When I started living independently, I always worked an extra service job to make sure my expenses were covered.

It wasn’t until I was forced back into the service economy due to my mental condition, when I really understood how difficult it was to sustain rent and independent living on so low of a salary.

Not being able to afford a car for help with transit and working forty hours a week earned me nine hundred dollars a month when my rent was nine hundred and fifty dollars a month.

I had to transport myself from an affordable location into my low paying job in a wealthy district which took four hours a day. I was doing everything in my power to survive and I couldn’t do it until I found a better salary back in social work ten months later. I never worked so hard in my life.

I found doing unskilled service work for such low pay was far more demanding than working two jobs and going to grad school which I did for almost three years. At least back then, I could afford to drive. Everyday I see people work these jobs and I do not know how they can afford to survive without family support.

I feel that people who do not understand how challenging unskilled work can be can be can easily undervalue it and treat people who struggle with it in narcissistic manners.

The shrink who made 125$ an hour presumed that because I was only making 9$ an hour that I really wasn’t working that hard. Certainly not as hard as she. She denied any level of financial exploitation from her business.

Style Number 7: Challenges that Await the Formerly Incarcerated

I was a ward of the state for three months in a state hospital where I obtained a diagnosis of schizophrenia. After the law could hold me no longer, I was streeted at a Greyhound bus depot with the remaining three thousand dollars I had in a bank account and a months-worth of medication.

I was afraid of again being followed by police and possibly by other people as I was when I was trying to cross the Canadian boarder to break a story of corruption.

My best friend had threatened me that he had the power to do me much harm if I ever betrayed him. I had been setting up services in a notorious section 8 housing authority project. There were many newspaper articles written about the project in the paper. Nobody knew that I was the off-the-record source responsible for a few of them.

My psychiatrist in the hospital refused to meet with me in spite of my requests. She moved me to the chronic unit which was a cold and dank facility. When I got very sick the staff refused to give me aspirin because she had failed to order it for me. When I was finally getting better after a severe fever, she came to see me.

“Once we had someone come here who said the FBI was following him,” she said, “and they really were following him. He hadn’t done very much but it was true they were following him.”

I did not trust her enough to ascertain that she was talking about me even though that’s what I still figure. I did trust her enough to return to taking medication because she didn’t believe the aids report that I had been sexually inappropriate the night I had begged for aspirin.

The first night I arrived in the state hospital, my roommate told me that the mafia was following me.

The girl on the unit who had a crush on me told me her father was the head of the Mexican Mafia in Montana.

Even though I should have known better, I often yelled at my parents accusing them of being mafia.

I only got beat up once. It was only by staff. They told my parents I had gotten violent when I had only tried to support another inmate who I believed to be an FBI undercover agent. He had wanted to play his guitar and I stood with him and suggested he should be allowed to do so.

I only got recruited to join one gang and I was able to refuse without any repercussions.

But nobody told me what would happen to me on the streets when I had this much exposure and knowledge about the underworld.

I did not have a parole or probation officer to drug test me or require me to get a job.

When I arrived in Fresno CA and bought a bike and paid for the rest of the month at an extended stay studio, I didn’t realize that I would be able to find a job while medicated. When I got a job, I got an apartment. It just so happened that when my meds ran out, I was unexpectedly cut from the low wage job and unable to find work. The only job I could find was a professional job as a social worker. But I was afraid that I could ruin my career. I was experiencing a great deal of harassment. I believed I was being followed again. When my bike was stolen, I believed I was being targeted.

Finally, I turned to family support. My father told me there was nothing he could do for me. But my aunt arranged for me to move close to her and she could get me a job at an Italian Delicatessen. Then she arranged family support as long as I kept that job.

I tried so hard to find work outside that Italian Deli for ten months until I was successful. The bike/train commute was really challenging.

Not everyone understands what it is like to work with young rich kids when you are in this kind of situation. I considered myself formerly incarcerated and it was hard to cool out. I finally got a car and started back on medication once I qualified for benefits.

On the bike ride to work, I would come across a man I knew from the section 8 housing complex where I worked in Seattle WA. One day he had come up to me and told me that he killed someone. I had looked at him like I was really not impressed at the time.

On the train platform he had a homemade sign that said CIA and he carried with him handcuffs.

I ignored him and worked my day.

Most days I experienced similar things that were equally bizarre and distressing. I still believe that these are tests that formerly incarcerated people are given. These kinds of oppressions are hard to measure as they are different depending on the situation.

When I finally did get a car, the police tailed me all the way to my shrink’s office which was a forty-five-minute drive. There was nobody to tell. No one who cared about anything I shared. I had to shut up and serve rich folk. I think these are examples of tests that formerly incarcerated people must endure to survive.

And everybody just presumed I was a spoiled loser who was a tax on my parents. Most of their friends, my mother told me, said they were just enabling me and I belonged in a hospital. Some of my friends just said I got into drugs.

That is the kind of narcissism formerly incarcerated people must face, I think. Many are presumed to be guilty regardless of whether they were set up or not.

False Medicalized Notions of “Psychosis”

The word schizophrenia which is based on Kraeplinian ideas about brain damage and an unfounded genetic mental illness concept, covers up lifetimes of narcissistic abuse. Quite often this concept tends to justify warehousing people and depriving them meaningful lives.

I have identified seven styles of narcissistic abuse that have been part of my life. Some of these styles are abuse I endured personally and some have been things I have seen afflict myself and others. I am aware there can be quite a variety of narcissistic behavior including physical violence of which I have not endured all that much.

Many of the styles of narcissistic abuse I have talked about are spread throughout the culture and can be quite normalized. For some, it can be easier to throw a person overboard than it is to acknowledge your own superior sense of narcissism. I do believe that often times people with privilege make the mistake of not acknowledging it.

I am aware that my view of power being a corruption of the human spirit is impacted by some of the trauma I have experienced. But I think an awful lot of people undermine the value of other people. When labels like schizophrenia or bipolar are involved, it is easier to presume that a person cannot get better than it is to give them a chance to do so. I believe that if given chances, that many more people could break through their challenges and fill their lives with meaning. But many people who endure these challenges are deemed untouchable.

Many articles I have read about how to deal with narcissism suggest setting boundaries with the narcissist, exposing the abuse by extending the concept of gaslighting that accompanies it, and halting the internalization of the messages made. Many ultimately suggest cutting off the narcissist because their methods will not change.

I think the schizophrenic who does this often is seem as having low insight into their illness. There is even a fancy word for this called agnosia. Agnosia provokes the ire of many a loved one who wants to help. Agnosia was not something I was able to overcome until I had reestablished safety and economic security. I had to work as a therapist for 6 years until I overcame it.

Unfortunately, a schizophrenic like me cannot necessarily escape from narcissistic abuse. It is hard to interact with others without seeing narcissism that can threaten my sense of self.  The best I can do is expose aspects of it in order to avoid internalizing the abuse and thinking ill of myself.

Ultimately, I feel very burdened about the amount of narcissism I view in the world that doesn’t accept me or make space for my contributions. Not all of us get to have our contributions highlighted or honored. We can continue observing and undermining narcissism so that it stops with us. Maybe that truly is as good as it gets.

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According our country’s cultural delusions, social institutions take care of people and deliver social justice based on a persons’ merits. Institutions for education, law, health, religion, athletic achievement, arts, recreation, work, transportation, housing, and social entitlements are often thought to be entities that people can trust to learn from and get the support they need to thrive in society.

Yet, there violence in the streets. Many come out of jail worse than they were when they went in. Help proffered in our involuntary psychiatric units leads to a revolving door and distain for therapy.  Board and care homes and halfway houses may subject individuals to a sense of poverty. Many of our institutions become the source of pain and trauma. Some institutions work for some people. Some people get targeted, punished and hurt and become marginalized.

Intersecting generalizations about race, socioeconomic status, gender, sexual orientation, gender identity, citizenship, mental and physical health interfere with a person’s capability to self- actualize. Some people are raised to fight and fend for themselves by any means necessary and there are institutions built for them; while others are insulated from these challenges and have wealth and sometimes luxuries to lean on; and there are institutions built for them.

Cliques and societies are formed in every institution that push out people who don’t belong. Some peoples’ skills are celebrated while others are ignored and undermined. Sometimes based on a stigma, a slander or a gossip, skills or abilities get lost.

While often abuse is thought to start in the family system, much of our lives are spent outside the family in institutions that are supposed to guide us in the right direction. How, then, can some of us become mired in mental anguish? Institutional abuse is important to consider when people are suffering.

The Importance of Doing an Institutional Analysis: 

Assessing a persons’ attitude towards the institution is important towards knowing if that institution has functioned to abuse the person. Institutions can do harm in many different kinds of ways. It doesn’t only depend on what the institution is meant to do.

Consider people who thrive in an institution. If they have dealt with an institution that is positive about them like earning a spot on a travel sports team, has it led to better performance and has the selection turned out to be a good outlet for their skills and esteem?

There is a lot that can go wrong on a sports team. When a person doesn’t thrive and optimize their skill it is important to know what happened. Perhaps they went elsewhere and found another outlet or discipline to perform. This happens when we assess people’s passions and interests.

Many clinicians tend to do an institutional analysis in this manner without thinking about it. When dealing with institutional trauma, it becomes important to help a person utilize contexts and times they have thrived in institutions in order to look at the times when they haven’t.

When there is a positive experience, it is important to extract resources from those institutions. If they have a negative outlook on an institution, it is important to learn about the institutions that they did feel good about. If they did have some good experiences in which they thrived, it is important to understand what went wrong.

Often, one doesn’t get this kind of information on the first psychosocial experience. A clinician needs to remember institutional issues and return to them and excavate them later in session.

It is also important to consider resources that often aren’t addressed. Have they had success with a peer group? Have they any attachment to counterculture? In some contexts, it is important to consider institutions that are not given legitimacy like jobs working for black market industries. It is important not to judge the institution, but rather to explore it for resources.

Mental Health Institutions:

Not always do institutions with negative stigmas do people a disservice. Even when the purpose of the institution appears to be to ruin the person’s life, there are often opportunities for good learning experiences that help a person avoid complete defeat.

Thus, if they have come to contact with an institution that is thought to be negative such as a county jail or a county mental health facility, the question becomes what have they learned about themselves from the experience? In the case of mental health institutions labeling a person with a diagnosis with a poor prognosis: do they agree with the negative prediction? What happens to their social performance when they leave?

In my experience with public mental health institutions, compliance may result in a worse outcome. In twenty-five years of working in them, I have tended to see that many programs are built for social control and to maximize financial gains.

Often the way things are set up is so top down that the individual’s needs get lost in the process. Cookie cutter concepts of evidence-based practice often fail to promoting health and healing and personal growth. Some people just get worse and worse over time so that labels like schizophrenia get to be thought of as illnesses of progressive decline.

It is clearly arguable that understanding any person involves understanding how they fit in to the institutions in which they associate. It is not enough to simply learn about the list of institutions that have impacted them. It is important to learn about how they dealt with socialization in the facility in order to learn what they learned from their experience.

Thus, a clinician needs to be patient and not make too many generalizations. After all the secret stories and heaps of bullshit that might need to be excavated. A great question to ask is about people who worked in those contexts that didn’t fit the mold. Part of my reason for writing this is to encourage more people to work in these contexts who learn to counter the negative missions of many institutions.

Assessing the Impact of Abuse Within the Institution:

Often, institutional abuse is covered up and needs to be drawn out to even get seen. The victim may not even have the power to have anyone believe a word they say and that is frustrating!

To help a person heal from institutional trauma, a clinician must learn to see the person they support in a different manner than the institution that damages them sees them. That means acknowledging than an injustice is happening becomes a first step. Too many clinicians working in an institution aren’t inclined to do that. Many workers accept the status quo and impose increased trauma on an individual especially when the person is negative about the institution as they are going through it.

Acknowledging the harm is the first step. Often this is simply a listening skill that needs to develop and a sense of justice is necessary. Sometimes a clinician can suspect this is going on and ask questions that can draw out stories and abuse.

Then, a clinician can develop an alternative narrative for how things might be if the institution was being fair to them. It’s true a clinician can’t change the institution, but they can articulate and advocate for what is needed for a particular client without being able to deliver it. This is essential to building an alliance and mitigating the damage being done. It is a direct route to healing.

It becomes essential to look at what is happening through the client’s eyes.

Understanding Your Institution’s True Mission:

Each institution has a mission and people it is trying to serve. For example, if the county mental hospital is there to prevent homeless people from committing suicide it can be important to acknowledge that that is what the institution is trying to do. This might help the person who has been damaged by the institution realize why they did not fit in and get the help that they needed.

Puzzling through a county’s mentality in treating people also involves considering the bottom line which is the way the institution makes money and survives. This involves understanding the counties finances and the need of the contracting agencies to make money.

In a federal prob the county where I work has been deemed to be criminal in its services. A lot of money goes to emergency hospitalization services and not a lot is set up for treatment outside the hospital.

Abuse might involve more than just suspension of a persons’ bill of rights. It might be an institution is built to control violence and impose involuntary medication and this might have nothing to do with a person’s needs.

It might involve exposure to substandard facility hygiene and this might or might not be what the person is used to. Some might see an unhygienic unit as an insult while others may recognize it as like many other unkept situations they are exposed to.

A therapist is keen to understand the mission of their institution. Believe me it is not in the institutions mission statement! It is more likely to be seen in the metamessages that the institution puts out. It requires real-life interpretation and perhaps some Marxist financial analysis.

What was wounding about the true mission of the institution when it didn’t suit the person you are seeing in the therapy room?

Examples of Differing Institutional Missions:

In my life I have had a lot of conflict with the missions of the institutions that most powerfully affected me. I share them now to demonstrate the kind of race and class bias inherent in institutions. Indeed, if I were your patient, understanding how the mission of three of the institutions I have been subjected to is important to understanding my trauma.

When I was admitted to a state hospital during a break, it seemed like the institution was there to prepare me for living in permanent poverty. The presumption was that I would not be able to work and that I would therefore have to adjust to board and care poverty. It was built into the institution as a mechanism to fill the local businesses, according to my observation.

Enduring that mission, being treated like a piece of cattle in the field, was very hurtful to me when I transitioned back into professional work. It is important to understand the impact that being treated in such a manner has on a person.

In contrast when I attended a private prep school, ten years prior, I was taught that my classmates and I could be anything we wanted to be if we just did what they said and got transferred to an elite university. What mattered was the prestige of the university.

When I decided that I didn’t trust that institution and figured that prestige was some bullshit, four years later I graduated from a local commuter campus in the inner city. The message I got as a freshman, that most people I went to school with weren’t going to graduate, demonstrates that the mission of that particular institution was very different than the mission than my private prep school.

The help I got from the career center suggested I should be a cop. I don’t think many of my prep school graduates became cops. Believe me, it’s not the only time I was invited to join a gang that may exacerbate social violence. I received several offer in the state mental hospital.

In my case, I could see the contrast in the different institutional missions and I always knew that I didn’t fit the mold. I didn’t trust the mission of the prestige prep college. That is something you would definitely want to explore.

Luckily when I was discharged to the streets from the State hospital, I had three thousand dollars to start my life over and prove that I could work in spite of my “break.” There is a lot to explore and many stories to be told. I am in favor of letting the stories be told while assessing the re-traumatization factor. Too many clinicians are afraid to know or counter the mission of their appointed institution. We need more therapists who stand against the mold in the institutions. They do matter and can help.

The Importance of Having Faith and Extracting Resources:

It is true work on institutional trauma takes time and is best done when the clinician has a strong sense of the persons resources. There are times when the person needs to rant and rail against the way they are or have been treated. A clinician who does not believe the resources that might exist or who starts to extoll the virtues of the institution really can set the person into a traumatic response.

Thus, I think clinicians need to have faith in a person’s inner resources. I can be hard to teach this especially when the clinician is not native to the persons culture or contexts. It takes a long time to learn these multicultural skills. Setting up systems in which students and young workers are responsible for knowing things they just don’t get is not a good way to train or heal institutional trauma.

Keeping pay at entry-level salaries, hiring people who don’t have a background outside a degree, and having young managers who are eager to advance and lack cultural understanding is not a good way for organizations to address institutional trauma.

I believe clinicians who have humanistic views of various kinds of people who don’t judge people about external behaviors have a better chance of extracting a person’s resources and helping them love themselves again. Conversely being fearful and condemning of a person who has behaved in problematic manners is a good way to have the person clam up about their resources. When a clinician maintains that kind of stance, it can become a self-fulfilling prophesy that exacerbates institutional trauma

The post Why Clinicians Need to Address Institutional Trauma: appeared first on Redefining "Psychosis".

In my experience, being singled out and excluded from the discourse because I don’t fit in is what causes me most pain. It is taking me a long time to realize exactly how and why this happens to me repeatedly.

For me it is not a simple process. It seems to do with people who seek to manage me. My managers get internalized in my mind. I have had managers in my family, managers throughout my education, mangers in the mental health system, managers at work, managers amongst my peers, and most recently I have encountered managers in the recovery movement. Fundamentally, the needs of managers are about power and control. They define what is appropriate from what is not.

As a result, I opt to avoid power and control as much as I can.

I am not jealous that managers have the power and control. It’s just that the hurt that come from their use of it keeps smarting and preoccupying my neurodivergent mind.

It’s arguable that being excluded and politically marginalized is the very action that made me experience “psychosis” in the first place. And yet casting people out of the group is so often a cultural norm in the modern world. It can seem like if you don’t cast out a few misfits out you are likely to be seen as someone who fails to take care of yourself.

Throughout my life I have felt cast out. To get back in I have had to learn to work with managers who have tended to wrangle and control my behavior. I have never felt good enough to get noticed or acknowledged. And then, there is a part of me that is so angry about the whole process, that when I do get acknowledged, I have to fight not to want to spit at the manager in the face.

But this ultimately isn’t the story of what happens when I am cast of the ship, it is the story of trying to live a good life while the factions and politics that surround me seem to demonize and marginalize me. It’s about going to my managers and advocating for better treatment. It’s about assertively teaching them that they are wrong about me.

I’ve gone to great lengths to keep politics and factions out of my recovery. But what I’ve noticed is that others don’t. Therefore, after years of letting people play politics, and use factions against me, I am writing today to envision a different outcome. Indeed, this post is about knowing and accepting that these things will happen. It is ultimately about letting it happen and then confronting those who have done this with assertive self-advocacy.

We All Have Trigger Words:

In dealing with experiences associated with psychosis, there are as many triggers. Even when I am out of emergency and able to function optimally, when I am not attentive to my work I may get struck with flashbacks. In fact, it can happen so frequently that I don’t notice that it is happening. I just feel dissociated and depressed. It is when I take care of myself later when I realize that the political hits I have taken actually hurt. It takes time to allow myself to feel and understand them.

It can feel like every managed group with which I associate slashes me. Just persisting and working through the politics and factions is a good thing. For me, there is the medical model unit where I work, and the family of origins relations are constantly surfacing. But the worst experience for me is when people in the recovery movement do it. I had so hoped it wouldn’t happen there, but it has yet again.

For many of us in the mad movement, the words normals use to define associated experiences are triggers. The word psychosis is one itself. I call it the “p” word and put it in quotes as often as I can. I do this because it is so misunderstood and misused that it triggers cultural delusions that are eugenic and ridiculous. And sure enough, it is a word that even if you use quotes around it, might trigger a manager to correct you. I have been corrected and told that madness is really a much better word to use than the “p” word.

There are a lot of trigger words in the “psychosis” community! There is the “d” word for delusions, the “h” word for hallucinations, the “s” word for schizophrenia. The ‘p” can stand for either psychosis or paranoia. All these word trigger misunderstanding and cultural delusions about the “psychosis” experience. A medicalized perspective is most commonly used.

We all have trigger words and we all do our best to deal with them. In some cases, we might use one to reclaim it or redefine it or craftily address a cultural delusion.

Case in point, one time I used the “d” word in the title of a post: “How to help when you think someone may be delusional.” It’s true I used the “d” word a number of times without quotes. I used it a lot and then I started to add quotes around it to accent the point. Some readers got it and responded that they too were triggered by the “d” word.

I had been fishing for mainstream people to read the article and come away from the post using quotes around the “d” word. However, it provoked the ire of a highly regarded speaker who confronted me that using the word delusional was stigmatizing. When I responded to his issue by identifying myself as a fellow survivor and accenting my intention, he was unimpressed leaving bitter and what seemed to me to be superior words.

A few weeks later, a local manager who I have helped and from whom I would like to get support for my work, proposed that we pay this international speaker to come and do a local training. At this point I learned the speaker uses the “p” word without quotes in a similar manner. As a result, my hurt and frustration have been thus compounded.

In this case it is because I have a training that has been well received in several contexts that my managers ignore. Additionally, in my mind paranoia is just as misused as delusional and psychosis and schizophrenic! Is it possible that he was really just trying to hurt and alienate me from his movement? Sometimes I feel like everybody I have known who are his colleagues have done the same thing. It is a small community. I suspect that people talk. Is it the “p” word starting up yet again, or is it a legitimate perspective?

Playing Politics and Creating Factions!

At some point we all have to get over our peeves and entitlements and move on with our lives. I think we can learn to do this. But we have to see what is happening and heal. We have to avoid joining in and slandering the person who has triggered us. It is best to collect our thoughts, practice using them, and consider addressing the person who is marginalizing us. Sometimes we have to make this a long-term project and repeatedly look for openings in which we can assert ourselves. Ultimately, when we are successful a sense of healing may ensue. Maybe we finally get the inclusion.

However, when we hurt, we may factionalize and fight over trigger words and who belongs in the tent. It starts to be about who has more friends, support and power. Maybe we want to follow the person with the higher degree, or the one who went to the more prestigious college. The number of factions in the mental health recovery movement are truly incredulous.

In the “psychosis” community alone, do we split up the voice hearers from those who are targeted individuals? Do we split up the people who learn to benefit from medication from those who reject it entirely? Do we then advocate for more socially acceptable remedies like cannabis? Do we look to kick out the people who don’t fit in and create norms that exclude? Do we separate those who have been on the streets from those who have chosen to live with their parents? Do we divide positive manic camp from the depressed, schizophrenic camp? Do we separate those who abuse substances from those who have been incarcerated and are on probation? Do we gaslight those we don’t like or who ask us challenging questions?

The answer to this question for many is to factionalize. “If black people want to form a group, for example, they can, “I have heard it said by the man’s colleagues. Is it not our responsibility to incorporate their cultural needs into the larger group? Indeed, that perspective is complicated.

It starts to be about how we manage who gets in our tent and who gets cast out. Every four years the nation gets into wars of rhetoric that get everyone divided. Right now, many of us are wondering if there will be a civil war based on mainstream propaganda and cultural delusions about white supremacy.

Understanding the Origins of the Trigger:

Indeed, this kind of issue takes me back to kindergarten which I had to repeat because I used the scissors backwards. Indeed, I would have been denied entrance into what has become in mind, the vile private school I attended; however, my parents both worked there.

I may have graduated cum laude fifteen years later, but they still tried to kick me out again my senior year. Even though my father, a top administrator, had left his position the teachers were divided about me. Some would argue that my spelling was atrocious. Some accused me of lying about how much time I spent doing homework. My mother was the reading teacher and yet I evaded her radar. Some may have been shocked about how low my PSAT scores were.

Maybe I just hadn’t eaten all day and just could not concentrate! I don’t remember.

I slept at tops four hours a night. I continued to achieve mostly A’s, work around the clock, organize community services, and play sports after school; but I stopped eating and landed in the hospital to avoid dying from anorexia.

I spent much of my 12^th grade year in and out of the hospital. I moved in with a friend and my room was converted to a study. My mother first called me an “asshole” and then I became a writer.

My first college essay was so good the school psychologist evaluated it and said I was on the verge of killing myself. This nearly got me re-hospitalized. I continued to re-write the essay and sent it out to spite the school, the psychologist and her husband, my English teacher. I got into some good colleges. I also got excluded from ones who didn’t approve. Meanwhile, I was starting to think college would be about more of the same bullshit. I hooked up with a twenty-five-year-old photojournalist and moved to attend school in an affordable inner-city.

It didn’t seem like I made these choices. They all just kind of fell into place. When the school lied and published that I was going to an expensive school in the yearbook, I vowed never to return. It didn’t take long for me to find myself alone in a roach infested apartment in the inner-city on all the holidays from work. I wrote.

A True Outcast:

I really don’t think anyone knows what it’s like to be outcasted until you’ve been homeless, jobless, and endlessly working for your survival while others project horrible generalizations upon you so they don’t have to feel guilty.

When I was in high school and college, I was exercising the privilege of telling the people who raised me to fuck off. Oh, how that privilege washes away when you go to low-wage, entry-level work to get your life back on track after losing everything.

I am talking about my recovery from psychosis. It was a privileged recovery albeit with white skin and family money, but there was a long-term state hospital, homelessness and a constant threat of being forced back into that lifestyle.

Mustering Up the Self-Advocacy:

Talking like this makes me repeatedly lose cultural capital among people who manage me. I have the sense that I am easy to marginalize politically. I feel like I have a different background and experience, so I am easy to disregard, slander and doubt. Many blame the victim even when they think they know better. They fall into becoming like a pack of dogs chasing a puppy in a dog park.

There comes a time when I must notice that not all managers are evil. There comes a time when I must find those few weak links in the chain and make appeals.

I think approaching the managers in a negative manner is not only hard to do, it is not always wise. Managers are renown for threatening us not to do that. Thus, it is a good thing I have internalized them in my head.

When I address a manager, I need to prepare myself. I will be asked for examples that illustrate the points I am making.

Because elements in my past have been traumatic, carrying in them underpinnings of sexual abuse and neglect, I tend to lose my ability to think when pressed for examples. When I am asked for examples or overtly mistreated, it can be hard to directly address it. When I don’t address it, people do have a way of talking and targeting.

Thus, even when the manager may be reasonable when pressed, I start out afraid. Understanding the patterns of abuse that repeat themselves takes me back to a misty October day around my third birthday. It is a memory I endlessly cannot access. But through writing I have accessed others that are significant.

Maybe it was that unremembered day, or maybe it was something else.

All I know is that I just was not able to live up to private school expectations when I was so hurt. Some days I remember nothing accept repeating patterns of marginalization.

Thus, hounded like dogs sniffing assholes, I need to remember that my body holds the trauma. Many do say it is all my fault because I am too nice. Maybe I deserve all the shit I’ve been put through because I am soft. But I am still on my way. Still, I am getting closer.

Writing so helps me prepare and honor what I’ve been through. All this work is there to help me assert myself. I must practice and run my concerns through my head and ask to have my needs met. I have to be like Tom Petty and tell them that I won’t back down.

Yes, the “D” word is bad, but so are the “P” words. Also rooting out difficult people and discarding them doesn’t fix everything when there is generational genocide and good old American inequality to muster through.

It really helps that I have reached a point where the person to whom I am asserting myself can no longer hurt me. And the manager I am dealing with is a lot more than just a comment on Facebook who may not have accurately read my post.

It helps that I have achieved a stable life that will persist regardless of what they do to me. When I was threatened with homelessness and underemployment. I just couldn’t do it, but now I can. Other people can project their stuff onto me and spread slander and refuse to say sorry, but they can’t put me out on the streets again. At least for a little while.

All the times I have been hurt, gaslit, rendered speechless, red faced and marginalized will be gone. I will assert my truth and ask the questions I need to know. I will pitch my work to my manager and ask for help and maybe it just won’t be as bad as I think.

One time recently I have done this and gotten the answer that I’ve always told myself to be true, but that was so hidden from the public. Successes can build on successes and can help me try again with the hopes that I might just might be granted that which I need. And if I don’t, I know what to do. I will return again and again steady and clear voiced and assert myself until I find my own dignity. Maybe when I realize that I can do this, the “they” will change their blaming mentality.

And I don’t need an ultimate confirmation that I or my work has value. Maybe I just need to assert myself in a new manner, Maybe I can learn something that can help me be successful.

When I can do this, the factions, the politics, the stigma will clear from out of my head and all unjust managers and control will fade into the background and I will feel a sense of relief. Maybe this will happen some day! And when it is my turn to cast someone out of the lifeboat, I just won’t do it no matter what “they” say.

The post Overcoming Factions, and Politics in My Recovery from Psychosis appeared first on Redefining "Psychosis".

Fawning, saying yes sir, or shining it on is such an important skill in enduring life, especially during a break from reality. It is a skill I struggled with during times of mental health crisis prior to my break. Indeed, I have had to get pretty good at this fawning skill to survive.

Prior to the break I was prone to tangential rage and resentments against people who rejected, humiliated or abandoned me. It felt like everyone I knew, would eventually betray me.

In fact, this is a repeated pattern in my social relationships. Other people would see me alone and bullied and take some interest in me and I would reciprocate. Eventually I would disappoint them or they would get what they needed from me and there would be a falling out. At times of mental breakdown this pattern would become evident to me. And I would get down on myself and the world.

It is my understanding that fawning is a symptom of complex trauma. People learn to fawn due to childhood neglect or abuse. They don’t feel safe so they fawn and fail to confront people who are abusing them. In their reality there is no point in asserting themselves. There is no use.

As a therapist I am learning to encourage people to stop fawning with me and trust me with their true process. Being able to know a person’s authentic process and feelings toward me is indeed a privilege that I am eager to promote.

But in many ways, I am not ready to throw the act of fawning under the bus. Indeed, I went through a lot to learn how to fawn.

It depends on your station in life whether it is not safe to let people know exactly where you are coming from. I believe much of the world is oppressed by privileged people. When you are supposed to be oppressed, I’ve come to feel it is wise and honorable to fawn a little.

Becoming a Targeted Individual:

In the years leading up to my two-year break from reality, I shared my realities of being targeted and undermined with a therapist in my twenties. She taught me I was paranoid. There was no concept such as complex trauma or Asperger’s at play. It was an extensive cocktail of medications. I trusted the psychology degree behind the cocktails and worked my way through a Master’s Degree in Counseling Psychology.

The mentality of blame the victim in psychology is such a powerful force. When I tried to ignore the patterns of abuse and built relationships anyway, it was far easier for the one person who had the ability to see what was going on for me, to blame it on an illness. She would one day tell my parents that I would be in and out of institutions for the rest of my life. For a long while, this did direct their support of me.

Deference to this power of psychology was the skill that made me a successful social worker prior to my break. Prior to my Master’s degree, I often respected my superiors and turned to them for direction. But along with education came the responsibility to think about what I was doing and to help rather than just cover my ass.

I moved out west where I didn’t know anyone and started work in a Section 8 Housing project in Seattle Washington. I started to resist standard business practice of blaming the victim and making the money. Indeed, I started going the extra mile.

As people were being hurt and even killed, I started talking to reporters. I worked extra hours and I made good relationships. It’s true I felt more appreciated by the people with whom I worked. When the company offered me free tickets to a concert so I would stop my vigilante patterns, I turned around and invited all the residents to the music festival. Unfortunately, this led to into a state of consciousness in which I became a real targeted individual.

I had a friend with a nefarious past who threatened me. It proved to be a very credible threat. When I admitted I was scared for my life and told him what I was doing. I tried to run to Canada and got stopped and manhandled by police. I got a three-month, hospitalization rather than a promotion for work that challenged the system to be better.

Learning to Fawn:

Earlier in my journey the therapist who had taught me I was paranoid, had already tried to institutionalize me. She’d told my parents that even though I had a 3.9 GPA I was not really college material. She urged them to put me on social security. They never told me this and I resisted her efforts to institutionalize me by working customer service jobs where I had to practice my fawning abilities. It was either that, or a repressive social program. It was embarrassing because I was really depressed, but some people cared enough to support me. Then I got back at it graduated, and went to graduate school.

Ten years later, learning to fawn again as an inmate in a state hospital was a new low. I believe the purpose of the incarceration was to teach me there was no use in even trying to take care of myself. I documented clear signs of abuse and requested to meet with my psychiatrist. It took the psychiatrist two months to actually meet with me. She said one time they had a patient who was being investigated by the FBI. When he was hospitalized for believing he was being followed he really was being investigated. Then, she told me everyone who observed me said I was an entitled person. I agreed to take my medication again.

First, I was locked on a unit for two weeks. When I finally gained grounds, I did everything I could to be industrious and work to feel better. They let me work in an automotive shop and I started to heal. Just as I was getting stable, exercising and strengthening my injured back, they moved me to the chronic unit. It is true I didn’t exactly conceal my distain for my family and the mafia. Those elements were revealed to me chronically throughout the hospital. The chronic unit was old and barely heated during the Montana winter. Massive icicles grew from the crack in the window above my cot. We dressed for the forty-degree temperature inside the dingy barracks.

Self-advocacy was pointless. When I finally took medication and surrendered to them, I did get released.

Fawning to Return to Professional Work:

However, I did not believe that outside the institution that self-advocacy was pointless. I took a greyhound bus to Fresno California with the small nest egg I had saved for myself. First, I got a job. Then I got an apartment.

This would have worked but I ran out of medication and experienced many signs of government/mafia surveillance. The day I got hired, my nefarious friend called me and let me know he knew I got the job. It wasn’t until I withdrew off my medication that I couldn’t control my rage about this.

I tried to find work anywhere. Finally, I got a job at a foster care agency, but did not have the funds for a car. My family only agreed to help if I move into a very challenging situation that my aunt set up for me in the bay area. My nefarious friend agreed that this was what I needed to do.

So, I had a two-hour bike commute and a job at an upscale Italian Delicatessen arranged for me. My grand delusion was that my family was an Irish Mafia family that had set me up for the situation I encountered in Seattle.

At the Italian Deli, I learned the learned helplessness toward the government/mafia that I needed to survive. Eventually I was able to break back into the land of social work and psychotherapy. This included a great deal of fawning towards customers, my family, employers, and mafia triggers.

This fawning skill seemed like an answer to many of my problems and I was able to suppress my experiences with being a targeted individual

Fawning to Survive Psychosis:

When a person experiences a break from reality they must learn not to react as if their tactical reality is really happening. This takes some doing and work. Especially for someone who ends up being a targeted individual, emotional triggers must be controlled.

Thus, even when the person who is in a break is right about the fact that corruption is rampant in our society, they must learn to act as if there is no such thing here in America. We don’t have indentured servants or enslaved people anymore. No, we are the land o the free.

So, on my daily ten-mile bike ride I would see signs of being followed and harassed. Once I encountered a resident who I knew from the section 8 housing complex in Seattle. He walked around with a pair of handcuffs at the train station. He sat across from me on the train. I pretended that I noticed nothing. In front of the demanding customers all that mattered was that I fawn exceptional customer service.

Targeted individuals know their apartment is broken into and their employment mail is violated. They know the people standing outside their apartment with gang tattoos on their shoulders are gang members.

They must learn to fawn for the sake of people who live in consensus reality. In spite of where they have been and what they know, they must act as if they fit in. I think it is imperative to be able to do so to survive at any job or any social setting. One must avoid any action that is triggered by one’s history of being targeted.

One time the police entered my apartment and trashed it, spreading kitty litter over my rug. The apartment complex management told me that my uncle had done this. Nobody cared or believed me that this happened. It was excellent customer service that was required to get rehired into professional work.

It is like code-switching in the African American community, one must fully understand that there is no understanding of your culture and speak as if the culture of the oppressor is the only culture out there at the workplace.

Fawning is a great skill that can help you fake it until you make it.

Fawning for Trauma Experts:

In training to work with trauma, I have attended workshops of Bessel Van der Kirk, Dawson Church and Laura Pernell. In each of these workshops I learned important things, but I did not feel particularly safe and had to do a lot of fawning with people. EMDR and EFT particularly didn’t work for me because I was to dissociated in those settings to work through my issues. I was not sipping the tea.

Bessel van de Kirk made several jokes about psychotic people in his workshop. Dawson Church was clearly angry at people like me who were reversed and for whom tapping did not help. It is very hard to be at ease when the training turns into such a hostile environment and the assumption is made that all the healers in the room are above their traumas.

Let me tell you, after being rejected endlessly for not fawning, it is a real trip to have a group of therapists in a trauma training notice that you are dissociated and fawning and dismiss you as being damaged goods. Suddenly your survival skill is a sign that something is gravely wrong with you. Suddenly if you don’t stop fawning, you will not be successful at fitting in with the clique that surrounds you. I fawned, but I withdrew and didn’t try to deal with anyone,

Teaching the Fawning Skill:

I have actively taught the fawning skill to participants in profession group therapy that accepts and explores psychosis. It is a much-needed skill that is imposed on others in institutional circumstances. But learning when to use it and when not to is a challenge.

Indeed, as a young social worker with a private high school education, the affects of which I learned to hide, I was accustomed to see others fawn at me. In the system, the power differential between the staff and the client often encourages this kind of behavior.

When I was a young social worker, I didn’t know I needed to undermine the fawning responses and make deeper connections with people. So, as I have openly taught this skill, there is always a sense of irony that has historically has made the patrons of my groups chuckle.

This is why I often argue that it can be imperative for providers who work with psychosis to work with the symptoms and normalize them without judging or reacting to them. This creates more of a level playing field so that the person in a break can have their ways respected. Then, it becomes easier to ask them code-switch back into chronically normal mainstream culture. This can give someone the social support they need to fawn for a living.

The alternative for many is to accept institutional neglect and poverty.

Overcoming the Fawning Skill?

Indeed, many people judge and take advantage of those who fawn in certain environments. People who vie for power will test another person in power. If the person in power submits and does not challenge their bully they will be demoted. I have experienced this professionally a number of times.

Indeed, this reality has cost me professionally. I have lost jobs and respect and have dealt with slander campaigns when I have tolerated bullying. It is really hard for me to know when its time to put up my dukes verses when it is time to simply survive in a humble manner. I have chosen to work in contexts in which I am not in power.

Indeed, teaching psychologists not to blame the victim and send people to an institution is not a safe thing to do. Fawning and undermining is indeed the only way to provide freedom to inmates of the institutions.

As I have started a private practice and work with a few people in the tech field, I have learned that fawning is not appreciated and does not lead to success in the corridors of power. It has made me aware that it sure is hard to know when it’s truly safe and necessary to forego fawning.

While in therapeutic service to another person, I feel safe to forgo this kind of skill. Many find me authentic and appreciate my help. I usually reflect on things when I write notes and in my off hours before I take action.

But dealing with people who do not understand their role in institutionalizing others it is not appropriate to forego fawning! I constantly have to watch my back and follow rules and pray that I don’t get made and sacrificed.

The sense that you are going to get in trouble for what you do constantly lives withing the survivors of our societies impoverished institutions. I am not really sure I want to give up this skill amid the waters in which I tread. Indeed, I consider it an emotional regulation skill in many contexts, acting opposite to the behavior you feel.

In another sense, a great deal of emotional intelligence goes with the fawning response. Taking medication has helped me enormously with my EQ and ability to fawn and reconnect with consensus reality in a meaningful way.

Sure, I want to go from surviving to thriving. Sure, when I work with others as a helper, I am able to be authentic and I do not fawn. But until the mental health system shifts from a social control model, to an integrated healing and wellness one, I may well have to keep resorting to those fawning skills. So, when I am training in a room full of therapist whom I perceive as trauma sharks, I will not feel denigrated for having to be alert and fawn.

The post The Neurodivergence of Fawning for Mental Health appeared first on Redefining "Psychosis".

It’s been nearly twenty years since I came out of a two-year break from reality. I am no longer faced with the prospect of homeless and unable to find work. I have a career, a marriage and a sense of stability. But in other ways I am just starting to realize how fragmented and dissociated I remain.

It’s taken a lot of work to learn to be successful and mad in a mad world. But there are still some things to heal that have been around for a long time for me. Things like feeling joy and relaxations have always alluded me. I am still developing self-compassion given the issues with which I have dealt.

Join me today as I use internal family systems theory to help me have more compassion for myself. I will examine the interplay between my manager parts and the exile parts who need to work together with better collaboration.

Preoccupied with Slander Campaigns:

I still struggle with the sense that other people have engaged in slander campaigns against me and my work. Since the release of my memoir five years ago, my efforts to promote the book and the rest of my work redefining psychosis, have failed to create the impact for which I yearn.

It’s true my book never had a release party. Turns out local people with big names on the national stage, took the free copy of the book and did not write reviews. In fact, a few started treating me with micro aggression, leading me to believe there might be a wider slander conspiracy much like what I have witnessed at work. One person did write me a review but left a shaming comment in the middle of it.

Likewise, although I am very committed to my work, I repeatedly get passed up for promotions. I have a different perspective and expertise than my colleagues and I am often undermined.

It’s true my book won awards. It’s also true that mostly the reviews I got from workshop trainings I have conducted have suggested I did well with most opportunities I have been given. Still, I have not become a sought-out speaker. And my writing platform remains relatively small.

In quiet moments, I often have the idea of a slander campaign come up. Perhaps it is a younger part of me that has been hungry and desperate in the face of financial challenges during my break. But ideas of a slander campaign go back a lot farther, back to grade school bullying and alienation from my peers that started in fourth grade. I weigh these thoughts with the fear that my presentation skills might be a bit lacking.

Presentation Skills:

It’s true when I was in high school, my classmates used to count the number of ums that I made during my speeches. Even though I am passionate about what I am saying, my success often depends on the energy in the room that lifts me above the anxiety.

For example, I recently had a zoom interview about my book. My interviewer, Peg Morrison, actually took the time to read my book and ask me thoughtful questions in front of her NAMI network. She wrote, “If you’ve ever wondered how Holden Caulfield turned out, you’ll want to meet our guest Timothy Dreby (pen name Clyde Dee). I was given the questions ahead of time to reflect on and prepare my responses

To prepare for the interview, I took two hours off work so I could come home and ground myself in the questions. About twenty minutes from home, I found myself in a traffic standstill. The stand still took a great deal of time and I wasn’t even sure if I would make it home on time for the interview. My wife called me and read me the interview questions over the phone.

Since the interview is on YouTube, I have been able to view it and assess the extent to which my own performance might be part of the problem.

Critical Eyes:

One aspect of enduring a break from reality is learning to live with vigilant eyes. When I was in psychosis, I picked up a great deal from serendipitous occurrences. Discharged from a state hospital, I took a Greyhound to a different state. Not only was I jobless and in need of survival funds, I was convinced I was enduring a black list conspiracy after I outed covered up murder in a section 8 housing authority.

One aspect of these observations were my interpersonal interactions with others. It seemed like I had the ability to discern their subconscious intentions so as that I knew their personal thoughts. I was always vigilantly assessing for safety, sincerity, and intentions.

I was especially vigilant to sense a persons’ connection to secret societies that may be involved in persecuting me. Maybe the secret society was my family conspiring with the treatment team at the State Hospital. Or maybe it was a black-market organization conspiring with a law enforcement agency. Or at times it was the management at the only job I could find, a job at an Italian Delicatessen that my auntie arranged for me, conspiring with my young co-workers who delighted in taunting the mad thirty-year-old with vigilant eyes.

For the last thirteen years, I have engaged in redefining psychosis. I started by doing this in professional groups. I did so in a manner I could justify interventions that are radically different. In doing so I have suggested that interpersonal perceptions of others are a source of special messages for a person in a break from reality. (Of course there are other sources like dreams, intuition, hearing voices, media, visons etcetera get added into the mix.)

It’s clearly arguable that many of those acute perceptions may come from a scientific assessment of energy waves that come off a body. For example, as I have learned through learning emotional freedom techniques, a host of energy waves that reflect a person’s spirit may be more readable with a set of vigilant eyes. There are also many other non-verbal cues that are hard to explain when someone is intensely vigilant. Voice tone, emphasis, body gestures, and posture are all intensely notable when a person has vigilant eyes.

When I was eventually able to use medication and come out of my crisis, I was able to withstand having vigilant eyes without involuntarily reacting to what I experienced. It enabled me to fake it and improve my working income and come back from a choppy year of underemployment in which I only earned thirteen thousand dollars.

As I started to feel safer and perceive less danger, people stopped responding to me with ridicule and threats and I eventually returned to being able to utilize my Master’s training and maintain positions in social work and psychotherapy. But I am not sure I ever lost my vigilant eyes.

Viewing my Performance:

I have intensely critical managers in my head who take one look at my performance in this interview and think that I should not be the one up on the podium leading the discussion. This is part of me thinks it is smart, entitled to judge, and doesn’t acknowledges that it internalizes social Darwinism. It still says that that a kid with my set of disabilities should not be allowed to bring home straight A’s even if he was up all night doing his homework. This was a remark I internalized from my father. While he might have meant it as a compliment, it was an example of a patronizing attitude that has really impacted me.

One might think this manager part of me has enough life experience to know social Darwinism and eugenic concepts are false. It has seen me locked up for three months in abject State Hospital poverty with a diagnosis of schizophrenia. It has seen me in the streets in yet another strange land trying to work my way up from nothing. It saw me fail to get jobs at McDonalds and hundreds of other franchises. It’s seen me struggling to ride my bike to sixty-hour weeks of physical labor for thirteen thousand dollars a year. It has seen upstanding citizens on the streets run the other way because of the rage in my eyes. It endured the support that criticized and cut me every step of the way. I kept trying and things did get better so one would think the manager knows better.

But when I watch the video of my interview, the manager also can see that I have just sat in traffic and am tired, slow, internal, and stressed. It views the slowness of my responses with distain. The manager in me tells me I am full of myself and not giving the host enough pleasantries. It continues to be embarrassed and ashamed to be me.

How this Manager-Part Developed:

I think an aspect of this managing part of me mistrusts other people with power but also distains and internalizes their views. I have a rich history of being vigilant when I assess teachers, therapists, trauma experts, or others in power.

Both of my parents were teachers who knew that I was struggling even though I was always one of the better students in my class. I got left back in kindergarten and I was almost not admitted because of the way I used scissors in the interview.

Early writing efforts often went unnoticed and did not result in top grades. The teacher who graded my poetry notebook told my mother my work was too depressing and only gave me a B.

When I took to writing and wrote my college essay, my parents were called into school and I was nearly sent back to the hospital because the school psychologist suggested I might be suicidal. I wrote about running a half marathon at Outward Bound and was very proud of my work. It’s true that I was, as I always have been, very self-disclosing in my writing. This particular essay I had rewrote incessantly. In fact, I continued to rewrite it. I sent it out to colleges anyway.

Even though I was shamed in front of my whole class who gossiped as I was called before the school tribunal, I sent that essay out and then I didn’t go to the schools that accepted me. Shortly thereafter I got so angry at the school, I let my weight drop and I was put back in the hospital for a second time for anorexia.

I felt intensely betrayed by anyone who had tried to teach me when the school erroneously published that I was headed off to an upper crust college. Really, I was moving in with my twenty-five-year-old girlfriend to attend a commuter college in Camden New Jersey. I raged at the whole community of teachers who failed to see any value in my writing when it came time for awards.

In college I continued to be vigilant of teachers who graded my performance. When a professor finally gave me a hundred on a take-home-exam and said he hadn’t done so in ten years, I was outraged. My other efforts were just as good as this one. On this particular essay I was just regurgitating his opinion after talking with him. My other efforts were better and more heart felt. When an English Professor wanted to put my essay up for an award, I again was outraged and never got back to him. I didn’t care about a stupid reward!

In graduate school I was working full-time and, hitting classes after a full work day. My relationship with most professors remained on a similar trajectory. I thought most of my teachers knew nothing about the things I was working through during my day job. Several made fun of me for asking too many questions.

After I graduated with my masters, I moved to the west coast without knowing anyone. I met a really nice Thai Buddhist girlfriend. We attended political speeches with regard to the WTO protests together. Later she told me that when she heard how hard I criticized the speakers and author’s we talked about she felt self-conscious and wondered what I thought of her. She was right, everybody I heard speak about a political issue I was way too hard on.

I guess the manager-part feels justified because of the way it was rejected. It is still internalizing the authorities who never reached out and helped it. Many of my teachers were managed by my father. Perhaps they looked at my dyslexic spelling, disliked my father, and downgraded my work.

Compassion:

I do feel bad for the little boy who used the scissors in an unconventional manner. He never deserved to be managed and criticized by a judgmental, prep school community. I do want to protect him from the managers who are now a select few of his peers in the recovery movement.

Indeed, while others were learning to socialize in college while they built skills, I was the anorectic-white-boy working at a mom-and-pop deli mart in Camden New Jersey with a Glock under the grill and a shotgun over the trash can. I think leaders in the recovery movement may not understand why I don’t have college social skills.

But to a larger extent, managers who guard public opinion rest in cliques and decide what and who they are going to support. Yet, I need to respect their role in creating community is also important. They are smart and better than me at some things. They too need to be acknowledged. It really is important for me not to bite back at them.

My father, who was often driven to rage by my slow pace, did need to help me work faster at some points. He committed his life to leading the prep school environment trying to make it a fair and just place to get a superior education. It was not his fault that I was dissociated and depressed. I believe I had some childhood trauma that made me that way. He wasn’t used to dealing with kids who failed to thrive.

His father dumped all the family assets onto him to manage in the summers. There was no rest for the wicked for my father. He worked and worked and all he had to show for it was a modest private school salary and a slow dissociated kid. All he had was control over those family resources and relationships. They would go to the kids who respected him and didn’t bite back and bring the inner-city manners up in family gatherings.

Indeed, for every manager that I have worked with there is a similar story of someone who wasn’t seen and their work not acknowledged who just has to bite back a little. So, as I work with that kid that I want to protect, I need to teach him to understand the manager and use this understanding to assert and advocate. I need to show the managers that they need to look at what the neurodivergent mind has to say even if the associated behavior is a little different.

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