A key problem in “psychosis” is that people identify part of their experience as being a problem or the enemy, and then imagine they need to get rid of it in order to get well. This puts people at war with themselves, and the state of” war” generates more disturbing experiences that are seen as an worsening of the condition and lead to even more desperate attempts to eliminate the perceived problem.
This is not just true in psychosis, but also in other mental health problems.
A good video showing how an opposite approach, involving acceptance and even embracing of the experience, can be helpful for “panic disorder” is
Another video showing the same approach for generalized anxiety disorder is
Her story is amazing partly I think just because she is so articulate: she really knows how to bring out the moments that were the turning points, both for bad, as she descended into a hell of psychosis, self harm, and persecution and mistreatment by others, and then again for good as she turned toward recovery.
Her story is not one of being rescued by in depth therapy, but more a story of people sharing hope and helpful ideas, until Eleanor decided to take what was being offered and to make the recovery happen. One psychiatrist does play a key role, but the main thing he did was offer hope and do things like help her reduce medications when she decided that is what she wanted. This psychiatrist moved away before she accomplished much of her recovery.
Eleanor is currently working on her PhD in psychology, and she also works for an early intervention in psychosis program.
Anyway, I would like to see the showing of this video or videos like it, if there are any, on a regular basis at psychiatric hospitals and other institutions where people treat “psychosis.” I think the mental health system would have to change, and people would learn not to believe the doomsayers.
This video, showing me explaining the basics of Cognitive Therapy for Psychosis to an audience in Corvallis Oregon, is a few years old but is still a good introduction to the subject, and to my perspective on it.
I was talking to a group of people who hear voices the other day about “self compassion” and I noticed something interesting. While just about everyone in the group had problems with voices which were hostile and disparaging, and they were often influenced by these voices into feeling bad about themselves, none of them seemed to have ever tried replacing the voice with compassionate self talk aimed at themselves.
I suspect this may be important. Most approaches to helping people with such voices have something to do with either trying to get rid of the voice, such as by taking drugs till it fades away, or trying to ignore the voice or distract attention away from it, say by listening to music or the TV. One problem with such methods is that they all involve avoiding whatever issue or emotion the voice may be bringing up. And what we know about avoidance is that we can only do that for limited amounts of time: eventually, we have to deal with what we’ve been trying to sweep under the rug.
For example, let’s say a person feels like a loser because of having few friends, being on disability, and having been recently hospitalized. A hostile voice might be happy to bring up this issue, telling the person that he or she is the scum of the earth and must die or be tortured so that justice may be served, etc. Drugs may numb out the feelings around this issue, and so quiet the voice for a bit, and ignoring the voice and distraction might help the person feel free of the voice for a short while, but none of these strategies help the person reconcile with the feelings of loss that set off the voice in the first place. [continue reading…]
Here’s my first, very amateur webinar – this is using software that is just for pre-recorded webinars, if I really get into doing them it’s best to do them live with software that costs money to use.
Understanding Trauma Related Dissociation and Its Role a Wide Variety of Disorders, including Psychosis
This is a free Webinar, 50 minutes long, that outlines how one basic process, dissociation in response to trauma and stress, can lead to a wide variety of “mental disorders” including anxiety, depression, PTSD, Borderline Personality Disorder, Bipolar Disorder, and the psychotic disorders including schizophrenia. (Of course, it can also lead to the disorders that are explicitly recognized to be connected with dissociation, such as Dissociative Identity Disorder.)
This is an experimental venture on my part, so my apologies for the fact that the technical quality is not great. The Webinar is in 4 sections, due to limitations on video length at Youtube.
I’d be very interested in hearing your thoughts or your questions about this subject matter and/or about the way I present it.
In the future, I’m thinking about doing a lot more with web based education, some of which would be free and some where people could pay and earn continuing education credits. So this could be the start of something big…..
While much of what is currently written about psychosis defines it as a condition caused by defective brains and brain chemistry, Watkins correctly notes that scientific research finds that only a minority of people diagnosed with schizophrenia show brain abnormalities, and it is dogmatic thinking, not science, that leads to the obsessive search for exclusively biological causes of psychosis. Meanwhile, overlooked, is a huge collection of evidence about the psychological forces that drive some people into psychosis, and about the kinds of dynamics that sometimes bring them out of it.
Watkins writes about all the hard questions in psychosis, with great chapters exploring the roots of psychosis in experience and development, the connections between psychosis and the dreaming mind psychosis and the mind on psychedelic drugs, spiritual issues and possible positive reorganization within psychosis, and when it makes sense to use, or not use, antipsychotic medications.
He also provides a good historical overview of the recurring role of ignorance in the treatment of psychosis, for example quoting Jung about how even in his training, the main art taught to psychiatric students seemed to be “how not to listen to their patients.” Watkins explains that seeing humanity in the expressions of individuals experiencing psychosis is itself frightening, since the psychosis provides a mirror for the uncertain chaos that resides just below the surface in all of us. By sharing many stories of people who have been psychotic, then recovered and took the time to explain their experiences, Watkins shows us that these experiences are understandable if we take the time and find the courage to take a look. [continue reading…]
Portland, Oregon is having a 2 day event to highlight problems with the current mental health system and possible changes on May 13 and 14, 2011. I’ll be giving two presentations on the 14th, one on CBT for psychosis, and the other on the Open Dialogue approach. This should be accessible to a lot of people, as they are only asking for a small donation.
When people are trying to get off neuroleptic (antipsychotic) medications, they often run into a problem like the following. The medication is reduced, then some kind of scary problem emerges, and then the person finds they must go to an even higher dose of medication than they were previously on in order to bring the problem under control. The possibility of such scenarios is a reason given by many prescribers for never attempting a reduction in the first place.
(Note that scenarios like the above can occur even when people work with their prescriber to reduce doses very slowly, say 10% at a time, and waiting to get back to equilibrium before reducing again: they are even more likely if reductions are made quickly.)
I don’t believe, however, that the risk of this occurring, or even the fact that it has happened to a person in the past, should be interpreted to mean that no one should try to reduce or get off medications. Instead, I think there are ways to prepare to face the difficulties that might emerge when reducing medications, and such preparations can increase the chances that a reduction can work. Each person is unique, and decisions should be made base on that unique situation, but here are some ideas about things that might help. I’d also be interested in hearing about what ideas others may have. [continue reading…]
Psychiatrists working within our current mental health system often complain they have no choice other than to practice as they do, which usually involves, for example, prescribing neuroleptics, otherwise called “antipsychotics” for everyone who seems to be having symptoms of “psychosis.”
I recently wrote down some principles I believe a psychiatrist could follow even while working within our current system, that would achieve a better balance between the possible benefits and risks of this kind of medication. In my practice as a non-prescribing therapist I haven’t had a chance to work with any psychiatrist who follows such principles, but I would like to be able to!
For people who come in with emerging problems with psychosis, I would want the psychiatrist to:
• Not assume that people were coming to him or her for medication. They might be coming just because the psychiatrist is seen as the highest authority in mental health care, and the person doesn’t want to mess around going to less than the highest authority when facing a serious problem. Instead, check in with people, what did they come seeking?
• Make sure the person knows that the medication will not do something like correct a known “biochemical imbalance.” People are likely to be coming in having heard this from various sources, and this may be motivating any requests for medications. People should end up on medication due to having believed misinformation, even if the psychiatrist was not the source of that misinformation. [continue reading…]
Given the recent events in the Middle East, it’s an interesting time to think about revolution.
One pattern often seen in revolutions is where when the uprising first breaks out, there is tremendous relief, a huge upsurge in hope, etc.
In the best cases, things work out from there, maybe all the hopes don’t get fulfilled and they have to scale back some, but things move along.
Often though, the pattern is that after that first hopeful burst, horrible things start happening, and civil war becomes the norm, with things overall darker than before, and the state seems to have failed. It’s hard sometimes to sort out where the darkness comes from, between the excesses of the “old order” trying to stop the revolution, and the excesses of the revolutionaries trying to break free. Still, hope lives in corners, mixed in the disorder. Recovery is still possible.
It’s interesting that “psychosis” often follows the same pattern: people are hopeful at first, it seems as though something really wonderful is happening, a breakthrough. Then it turns dark, horrible experiences become common, and the “self” seems to have utterly failed, though hope still shines through, in disorderly ways, at times.
This 6 hour course presents evidence based, practical and humanistic ways to help people recover. For more information or to register, go to this link.
Working with Trauma, Dissociation, and Psychosis: CBT and Other Approaches to Understanding and Recovery - An Online Course
Free Offer: Presentation on “Understanding Psychosis as an Attempt to Solve Problems: Integrating Perspectives on Trauma, Spirituality and Creativity”
Click the link below to access this recording that explores some of the trickiest aspects of "psychosis," and also to receive notices periodically about online courses and webinars that may become available.
http://eepurl.com/cMAgI
This webinar explores the largest study that demonstrates how to offer successful therapy for people whose psychosis is linked to trauma https://www.eventbrite.com/e/empowering-the-silenced-trauma-focused-therapy-for-psychosis-tickets-1988338830968?aff=Partners
"This review illustrates that schizophrenic symptoms are not discrete, unrelated deficits, but rather an integrated whole, emerging from a fundamental reorganization of consciousness." Important observation!
Today on the MIA #podcast Prateeksha Sharma reflects on her experience of recovery from psychosis, sheds lights on the treatment harms that often go unnamed and thus unnoticed, and discusses how to claim narrative, dignity, and voice.
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