Troubled by Individual and Collective Psychosis? Maybe Compassion and Dialogue Could Help!


As we view what many of us perceive to be the wreckage of our political system in the USA, it’s interesting to reflect on what this means in terms of “hearing voices” and “extreme states.”

Last month I attended the Hearing Voices Congress in Paris. A common emphasis in many workshops was on the importance of actually listening to the voices in a friendly way, with an eye to getting to know the emotions and the wants and needs behind the voices, while also getting better at not being taken in by what the voices might literally be saying when that happens to be a lie or something really destructive.

I also heard talk about how it can be really scary to listen to voices, because of the fear that they will gain too much influence and might get us believing things that aren’t true and taking destructive actions. So it’s understandable that we often feel like it’s the wrong idea to listen, even though listening in the right way is key to healing.

It seems to me that the same dynamics apply to a divided nation. We need to learn to listen and respond in a caring way to the disturbed and disturbing voices within the population—to really engage with them, while also not believing any lies or distortions or letting destructive forces take over. Here in the US, unfortunately, we have done too little of this deeper kind of listening, while there has been way too much of the shallower listening to and believing in lies and destructive actions.

I do agree with those who have framed what we are going through as something like a “collective psychosis.”

So, since we are all “in psychosis” now, maybe it’s even more important to think about how to work through psychosis to some kind of “other side?”

Some of the most promising approaches involve some combination of love or compassion and dialogue.  I recently had the opportunity to hear Charlie Heriot-Maitland speak about how to combine compassion-focused therapy with voice dialogue methods to best reach people troubled by disturbing voices, within an individual or group therapy context.

I have been very impressed with his approach, which seems to get right to the heart of what must happen for healing.  He emphasizes first helping people center themselves in a strong and compassionate place, and then doing outreach to the most disturbing voices, in a way that overcomes polarization by exploring the concerns of extreme voices while also not letting them run the show.

If you want to learn more about this approach, you can view this recorded webinar featuring Charlie, on the science and application of the compassion for voices approach:

Charlie of course is focusing on how to help individual voice hearers, not whole nations.  But I think some of the same principles apply to national healing: we need to organize first around principles like compassion, wisdom, and strength, within ourselves and our support groups, and then reach out and dialogue with extreme and even overtly destructive voices, individuals and groups.  This dialogue can help us find and even ally with what is good in these voices, and reduce the current polarization, while we also hopefully get better at finding ways to resist letting bad ideas “run the show.”

This isn’t easy, on either the individual or collective level.  But it does seem to be heading in the right direction, and just getting started in the right direction can sometimes be a very big thing!


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


  1. Ron

    You said: “…we need to organize first around principles like compassion, wisdom, and strength, within ourselves and our support groups, and then reach out and dialogue with extreme and even overtly destructive voices, individuals and groups. This dialogue can help us find and even ally with what is good in these voices, and [REDUCE THE CURRENT POLARIZATION] (emphasis added)…”

    I disagree with the thrust of this blog. There will be NO reduction in “polarization,” nor should there be, UNTIL the current political upheaval in this country is resolved through major systemic changes in the both the economic and political system.

    “Polarization” has historically always preceded major social change and right now should be viewed as a very GOOD thing. We should not fear this or try to make it go away, but instead seize upon the new opportunities this opens up for us to change minds and organize forces for future battles.

    In my neighborhood (in Massachusetts) I have witnessed friends who have in the past leaned toward the Republican Party who have become outraged (and even talk about feeling traumatized) by the presidential campaign and the election of Trump. Some of these people are already building alliances with people on Facebook and elsewhere to prepare for upcoming political battles. I am amazed at the kinds of advanced discussions I can now have with these people.

    It is a waste of time to focus on trying win over hardcore right wing supporters of Trump and his ilk, or to approach this recent “polarization” by promoting more “love.” Organizing against reactionary ideas and policies and fighting for a major transformation of the status quo (in the most powerful imperialist country on the planet) is a true act of “love” for ALL of humanity. This will involve both activities of persuasion AND confrontation.

    Back in the 60’s there was the strategic approach of “unite the advanced to win over the intermediate and neutralize the backward.” Will some very backward people be won over and change their thinking and behavior through major political upheaval? Yes, of course this will happen, but it should not be the focus or major concern related to our political tasks at this time.

    A significant leap has taken place in the direction of fascism in this country. We must not fear the resulting “polarization” but seize upon the opportunities it opens up for us to advance all forms of human rights struggles. I have said it before and I will repeat it again; a profit based economic system and its related political structures stands as a major impediment to future advance of all human society. “Dare to struggle, Dare to Win!”

    Respectfully, Richard

    • I am not “in psychosis.” And I believe that such language mystifies and confuses the issues.

      Nor is this a Republican-Democratic thing; Democrats are more dangerous in my view because they do and get away with the same shit Republicans do, but liberals won’t confront them. I think the fact that Trump is not as adept at obfuscation makes him easier to fight, as the sides will be drawn very clearly, and when he steps over the line we need to take on his shit while there is still some disarray in the Republican ranks. But equally important and urgent is for Democrats to study the Machiavellian and corrupt ways by which the nomination was stolen from Sanders, and make sure another such Clintonian figure is never nominated again. But already the Democrats are going back to business-as-usual.

      I think the analogy of “disturbing voices” is faulty, and, if it analogizes the “disturbing” voices in society to those of Trump voters, somewhat condescending as well. It’s hard to know if this is what is meant.

      Some of these people are already building alliances with people on Facebook

      Facebook, sigh. Didn’t someone just say something recently about using the master’s tools?

  2. “So, since we are all ‘in psychosis’ now, maybe it’s even more important to think about how to work through psychosis to some kind of ‘other side?'”

    Brilliant, Ron. I like your multi-dimensional thinking, here. Seems to me this is an opportunity to, once and for all, get what this means, as per everyone’s lived experience, in the moment and self-responsibly.

  3. Interesting title. To my way thinking, “collective psychosis” has a long history. Religious, political, and secular fanaticism have thrived throughout the ages. “Individual psychosis” however only became a problem with the advance of institutional psychiatry (i.e. forced mental health treatment), and the witch hunts that accompany it. If the problem is intolerance, perhaps the best solution would be to “treat” the former by ceasing to “treat” the latter. Were one to equate “sanity” with “wisdom”, it certainly, given greed and ignorance, has never represented any kind of behavioral “norm”.

  4. Hi Ron,

    This is a very interesting article.

    I think the collective psychosis probably drives everyone mad, but a lot of people are able to hide their terror. This might be why so many people consume anti depressants – because “depression” might be an acceptable way to feel unhappy.

    I’ve tried to change myself and that’s worked to a certain extent – but so far I’ve always been able to provide for my basic material requirements. From the way people talk this isn’t necessarily guaranteed in the Future.

  5. HI Ron,

    Thanks so much for including the video on the application of the compassion for voices approach. The 5 minute video of compassion for voices is something we have watched a lot, and this lecture from Dr. Charile Heriot -Maitland was very helpful to me as a support person. I like how he talked about developing one’s ‘soothing system’ and how important it is -it may me feel so hopeful about how the environment we are trying to maintain in our home may be allowing our loved one to eventually work through things. I liked his humbleness, and how much he believes in the brain’s ability to heal itself. There was even some very simple practical suggestions (a breathing app which has a visual to help someone slow down their breathing) that we thought might be useful to show our loved one.

    I wonder if there is any way that Dr. Heriot-Maitland and Robert Whitaker could add this (the 5 minute video and the lecture) to the ‘education’section of MIA so more people would realize it was out there?

  6. It strikes me the election is more of an example of a collective delusion, than a collective psychosis. Everyone on mainstream TV news coverage was absolutely positive that Donald Trump would never win. I’m not a big TV watcher, instead I prefer reading and researching on my own. And I will say that on the morning of the election I found it interesting that the mainstream media was all calling for Hillary to win, but many on the alternative news sites (and other ‘intellectuals,’ especially those who discuss economic issues) were predicting a Trump victory. I was curious who would end up being the more accurate source of information, turned out not to be the mainstream media.

  7. Hi Ron – I agree that listening with compassion is one of the keys to helping someone. And I agree that we are all in this together – not just the USA but the entire human species.

    I think of the words, “seek first to understand, then to be understood.”

    I also want to share a bit of my own experience. I have helped hundreds of very depressed and often self-harming and suicidal teenagers over the past 15+ years. And I have been very depressed on and off, and once close to suicide, myself. My depression is directly and stongly correlated with the amout of emotional support I am getting and the amount of freedom I have to leave emotionally toxic environments.

    I can attest to the importance of listening with empathy and showing acceptance, caring and understanding.

    I have seen and felt how much this helps. I have limited experience with those who hear voices, but I have a lot of experience with very depressed young people.

    There is btw, a very clear and very direct link between emotional abuse and teen depression, according to my experience. I co-edited a book called “Letters from the Unloved” which helps show how emotional abuse leads to depression, self-harm and suicidal thoughts/feelings. Anyone can easily google that title and find the free pdf copy.

    So far almost no one in the mainstream has taking the book’s powerful message seriously. I believe it is simply too confronting and too challenging to the status quo in terms of how teenagers are seen by most of society.

    In anycase, thank you for your article and thanks for reading this comment.

  8. Just a note to say I tried to edit my typos but the time expired while I was editing my comment! I felt pressured to edit quickly and this actually caused me to make mistakes while editing, thus taking longer, so if this is a setting that can be changed I strongly recommend it.


    • Hi Stevehein — thanks for the feedback. It’s a balance between giving people enough time to make quick edits for spelling, but not allowing people to edit their comment hours or days later since that can sometimes lead to confusion for people who have already responded to the person’s post. I just went in and increased the time limit, though, since I agree it was too short, especially for editing longer comments. Hope that helps!

  9. I think the problem is in having a dialogue like the one being called for, people are enabling abusers. They are acting like the problem is within themselves. It is a “Recovery” oriented approach.

    So rather than organizing and acting to obtain justice, people are seceding, talking a cop-out approach. It is based on the standard lie, that you can restore your social and civil standing without having to engage in political and legal action. So instead, people collaborate with abusers, and with an entirely parasitic industry, Psychotherapy.


    Move from talk to action! Please Join:


    Here’s the text:

    Here’s Murphy’s self-congratulations:

    ““This is a landmark moment. The federal government’s course in addressing mental health and illness in America is being fundamentally changed. Congress has finally come together in a bipartisan effort to bring serious mental illness out of the shadows. Now federal agencies will be moving from feel-good programs for behavioral wellness to ones that emphasize evidence-based care for those at highest risk and those with symptoms of serious mental illness. We’ve achieved long-sought reforms by creating an Assistant Secretary for Mental Health and Substance Use to elevate, integrate and coordinate programs; investing in services for the most difficult to treat cases; expanding the mental health workforce, and so much more.“It couldn’t be more fitting that we’ve reached this bipartisan agreement between the House and Senate at the close of Thanksgiving week.”