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What is “psychosis” and who decides who is “psychotic”?

The Merrian-Webster online dictionary defines psychosis as “fundamental derangement of the mind (as in schizophrenia) characterized by defective or lost contact with reality especially as evidenced by delusions, hallucinations, and disorganized speech and behavior.” The notion that we can distinguish out people who have a defective contact with reality, suggests that there must be others of us who have unflawed contact with reality from which we can judge. But “in reality” we are all imperfect, and have various imperfect degrees of contact with reality, some of us more in contact with some aspects of reality, others more in contact with other aspects. It follows that any attempts to make black and white distinctions as to who is “psychotic” and who is not, are a bit presumptuous. Without being so presumptuous, we may still be able to distinguish when a particular person is having problems due to his or her failure to be in touch with some aspect of reality, while staying open to the possibility that this same person may be more in touch with some aspect of reality than are the people attempting to help him or her. This less black and white version of “psychosis” is probably more realistic, and is more conducive to recovery, since it recognizes that we are all human with imperfect notions of “reality.”

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