Reconstructing a Culture of Psychosis Across Diagnostic Divides

Perhaps one of the greatest ways to oppress a people is to convince them that they don’t exist.

In America, this is what many people who have experienced psychosis face in standard treatment.  In the absence of a sense of a supportive and functioning self-support community, many who have experienced psychosis don’t feel we belong to a rich, interesting, and meaningful culture.

Consider all the categories that the DSM V has that includes the phenomenon of psychosis. I have collected a rough list below:

Schizophrenia Spectrum and other psychotic disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Delusional Disorder
Shared Psychotic Disorder
 Attenuated psychosis syndrome 
Psychotic Disorder NOS
Schizotypal personality disorder
Psychotic Disorder due to a medical condition (many)
Schizoaffective Disorder
Bipolar with psychotic features
Depression with psychotic features
Disassociative Identity Disorder
All Substance Induced Psychotic Disorders (ten different types)
Dementia of the Alzheimer’s type with early onset with delusions
Dementia of the Alzheimer’s type with late onset with delusions
Vascular Dementia with Delusions
Postpartum psychosis

Above, the construction of tall differentiated towers of illness, often grow taller and more isolated in the current system of care. Most provider-folks who use these words to bill would not want to be faced with the limited life they envision for their clients.

The concept of illness is so embedded in our system of care that we don’t often consider that we are treating peoples as though they are not just irreparably sick or ill, but uniquely so.  We don’t think that when we go to work we are systematically attacking a history, and imposing eugenic concepts. And people in America are so quick to attach eugenics with people who enter psychosis, that many of us deemed ill learn to believe that we deserve no companionship.

Divided by labels, many of us who experience psychosis turn inward and our fight against the world intensifies. Indeed, the poverty, neglect, and deprivation of institutional living can be quite extraordinary. It can result in tremendous trauma and damage.

Still, the bulk of treatment, money and current policy is focused on incarceration, forced medication and facilitating marginalization into socially controlled environments.  All this for the sake of suppressing rather than accepting associated experiences. I am writing to contend that ultimately suppression alone is a treatment concept that just doesn’t work!

Some fight against psychiatric oppression by differentiating some individuals into a spiritual emergence narrative. This well may be true! However, I believe that this spiritual emergence narrative is true for all who experience psychosis. Perhaps some of us just need training.

That is precisely why those, like me, who are afflicted with negative experiences need to learn to work together with those who experience what might seem like overly positive experiences. I have found that this is a much better way to support those suffering. At least treating it as a culture teaches us to be curious about ourselves. Treatment needs to refer sufferers to a group that is full of peers who have learned a bit about their culture of psychosis, accepted it, and resumed their place in society, penetrating cultural enclaves and utilizing multi-cultural skills.

Contrast this vision, to the most common intervention, those famous five words: “Did you take your medication?”

Thus, I contend that in America’s history, those who have experienced psychosis join many marginalized groups who are treated as though they are a threat to the status quo.

I ask: does dividing psychosis up into a variety of medical illnesses translate into denying sufferers a voice in clinical settings? Does it function as a legitimized form political abuse? Is it any different than a counterintelligence campaign aimed at squashing a grass-roots social movement? Are we torturing our spiritual healers instead of giving them meaningful work?

In twenty years work as a provider in mental health I have seen providers, even highly trained ones, believe that letting a person talk about delusions or hallucinations will only reinforce them. Thus, groups without the influence of the Hearing Voices Movement are often run according to the norms of the provider culture. There is no consideration for the wisdom that lies within something that sounds different.

Sadly, no treatment has ever been made that encourages co-exploration of what is inside the rabbit-hole. Treatment successes may sashay around with the Normals bearing painful and unspoken secrets. The privileged may end up insulated and hermetic in a back room; the abandoned, enduring impoverished circumstances on the street; and the majority, going from the hospital to oppressive institutional circumstances, with stints on the street or in jail.

Instead, of learning to work together, we are taught and perhaps programmed to turn our hate on each other and fight like screaming crabs in a pot of boiling water.

In our distant history, message receivers have played important roles in society.  It is arguable that before the foundations of the modern world, we were spiritual healers in our community.

Many of us face great genocidal dilemmas internally and have faced enormous apocalyptic tragedies, evil, and spiritual guidance.  In this era of environmental petulance, spiritual warfare, immigration exodus, racist drug laws, heightening class divide, and massive denial about who really rules the government, isn’t it time to create a sub culture that can stand on its own two feet and get past the medicalized oppression that has it marginalized and going from the streets to the institutions for so many years?