In spring 1997 I went on an adventure and moved to London. Days working at a restaurant, nights at the hostel in Earl’s Court, with South Africans and Aussies, the backpacking thing. I had had a psychosis six months earlier, and it had left me feeling a bit brain-dead. Depressed. I thought it was the meds I was on, so I quit them.
Slowly life returned. Things took a turn when I met an Australian guy I fell in love with. A bit dangerous for me, opening up to so much emotion. Euphoria set in, and a few weeks later I crashed with a psychosis. I spent a month at the Maudsley Hospital in Camberwell.
Through this admission, I was offered to be on a trial, where part of the participants were given therapy and a control group was not. Fortunately, I was in the group that received therapy.
My therapist was a nice guy in his late 40s, fun and energetic. I liked him. In one session, I brought up my experiences of psychosis, and he suggested I write about it. To my next session I brought a text, which pretty well explained what I found problematic in how psychotic patients are treated within psychiatric hospitals and mental health care.
I wrote:
“In one session with my therapist, I remember saying that I would like to discuss my experiences in the ‘other world’, and my therapist then asked: what do I want to achieve with this?
I didn’t want to admit it then, but I can admit now that of course I wanted to convince my therapist that my views, which probably differ from the mainstream, are correct and acceptable.
And of course, it feels like… well, he’s a psychologist with many years of training and I’m just a nutter. Do I think I can come up with something he doesn’t already know? But, on the other hand, I do have an insider’s view of some aspects of psychosis that he lacks.
And I have to say that, in my opinion, a person suffering from psychosis does not get the right kind of treatment at all. When you become psychotic, you cross the line into a completely different world, which can be (in addition to being wonderful) alien, confusing, and scary. And the doctors and nurses around don’t seem to know how to give you anything, any kind of help or guidance. You feel like you’ve been left all alone to survive.
Why is this? They should know something about this, they should be there and help you, that’s their job. But all they do is give pills and try to talk about normal things, thinking that it will bring you back to the normal world, not realizing that their talk is completely irrelevant, that that is of no use. Because you are not in the normal world now.
If only I had had someone who could have told me what was going on, what this journey entailed, what I would face. If someone had told me what it all meant, it would have made the experience so much easier. I would have needed someone to offer me some sort of explanation for my experiences, but no one could. All I saw around me were uncomprehending, worried, scared faces. No wonder people with psychosis feel they are alone against the world.
I don’t know why it is like this. Is it perhaps that a person who has not experienced such a trip himself just cannot understand it? Or are people unable and unwilling to acquire information on the subject? Do they feel that if they gained knowledge, they would encourage people to…take these trips?
The course of psychosis would be completely different if the patient received the right kind of support and guidance during the journey. It’s tiring that during the trip everyone just wants to drag you down. People get out of psychosis on their own in time, so why does it have to be forced?
It has happened to me that when it has been done by force, I have crashed to the ground, disintegrating, instead of being able to land in a controlled manner. The sad thing is that when this happens, a person probably loses all the valuable knowledge and experience that can be gained on such a trip. I sometimes think that the reason why I have had so many psychoses is that when I came back and “cured” I threw away everything I had learned. Like my doctor, I dismissed my visions during the trip as the product of a sick mind. So I was pulled back, again and again, until I came back with the knowledge I was meant to come back with.
My psychologist lists all the positive things that psychosis brought me and says that my life is not ruined even though I have a bipolar diagnosis. Well, I know that. But perhaps many bipolar sufferers find it difficult to cope with these experiences. I’m not surprised: the message they get is that these experiences are pathological, sick, and disturbed. That they invented everything, and developed an inner world to hide in, because, as my psychologist explained to me, they are not strong enough to withstand reality, to survive the pressures of everyday life.
Of course, it’s thoughtful that someone tries to convince me that I don’t have to feel inferior even though I have a diagnosis, but I feel that this is missing the point. If a person is given the right support and guidance along the way, psychosis can be a useful experience. I’ve read that more and more therapists are becoming aware of this, but this view has not yet spread very widely. If the therapist doesn’t believe in some mystical, inexplicable, “the other world”, I don’t see how he can help his patients who live in that world. I mean, if I had to learn how to survive in Antarctica, I would rather consult a person who has been there than a person who tries to convince me that the whole place doesn’t exist.
One might think that since it is difficult for those experiencing psychoses to stay in normal reality, the therapist’s skeptical feet-on-the-ground attitude would be necessary and the most useful approach, but in my experience this is not the case. For him to be able to understand people who live in another world, the therapist needs information about this world, preferably personal experiences of the journey, and not just external fragmented information about symptoms.”
***
I certainly had some apprehension towards how mental health staff treated patients, although I had liked my time at Maudsley hospital, and been helped by some very empathetic nurses. But I had started to question whether a psychosis was nothing more than pathology. Maybe writing that letter gave me the first push towards it.
Years later I came across the work of researchers, psychologists and psychiatrists who had done groundbreaking work in understanding the psychotic process. Not only did it help me to solve my own challenges, but more than that it inspired me to work for a change in psychiatric care.
Attitudes change slowly, and the notion that a psychosis could be a process with deeper meaning is not exactly embraced by mainstream psychiatry. But based on what I have seen, I firmly believe that by deepening our understanding of what it is that actually happens in a psychosis, we are way better equipped to help people who are going though one.