Understanding Extreme States: An Interview with Paris Williams


In this interview, a practicing therapist weighs our contemporary understanding of “schizophrenia” and explores alternative models beyond the “medicate your brain disease” approach. I, the interviewer Matt Stevenson, am a psychiatric survivor who first encountered Paris Williams while searching years ago for hopeful alternative conceptualizations of “schizophrenia.” At that time Paris responded kindly to my requests for reassurance that extreme states could be healed. Today I’m following in his footsteps of raising awareness about alternatives; with this interview I’m engaging him in our common goal.

Paris is the author of Rethinking Madness — in my view the most hopeful and encouraging book available about extreme states — and a therapist currently practicing in New Zealand. Before becoming a healer, Paris had to work through his own extreme states of mind based on past trauma, a process which shaped his understanding of and response to mainstream psychiatry’s narratives about “schizophrenia.”

In this interview we will explore often-contentious topics including the non-validity of the biological model, the link between parenting problems and psychosis, and how best to help psychotic people who are fighting both emotional conflicts and a psychiatric system drugging them into silence. Please read on and enjoy.

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Matt: Hi Paris. Thank you for speaking with me today. You and I have spoken several times before, on and off the ISPS listserv. You know that I’m a person with lived experience of psychosis, and that I’m trying to help others experiencing psychosis to have a more hopeful view of recovery from so-called “schizophrenia.”

First, can you tell me a little bit about your background and training? Where did you go to school, what sort of therapist are you, what sort of setting do you work in? What led you to get involved in the field?

Paris: Yes. Right now I’m a full time therapist working in New Zealand. About how I got to where I am now: I had a breakdown and/or breakthrough myself in my late 20s (I’m 44 now). I was studying physics and was a professional hang gliding instructor at the time, and I was wanting to answer all the big questions of life through physics. I was getting into mindfulness meditation as a way to deepen my curiosity about my inner world, but had no interest in formal psychology.

Then I had this powerful crisis, coming from a lot of trauma as a child. To give a little insight into how difficult my childhood was, I was diagnosed as having Borderline Personality Disorder at the age of seven (yes, seven, even though you’re only meant to be diagnosed at age 18), and was sent to a foster home that was meant to fix me. That got added to earlier trauma and my early years became a hell of a nightmare. I worked through it, but ended up with a lot of deep pain that I had to resolve.

I got introduced to psychotic experiences very young — my uncle was hospitalized several times for “psychosis,” and my mom has experienced what would generally be considered delusions and hallucinations for nearly all of my life, though thankfully she managed to stay out of the psychiatric system. Her family had deep, deep trauma: her father raped her when she was only seven, then ran off; then her stepfather was physically abusive with her and her siblings; and at age 12, my mother discovered her mother’s dead body after she committed suicide. So the way that I generally make sense of it is that she probably organized her experience in a way that helped her tolerate it, developing beliefs that she is a powerful alien from a much more benevolent world. It was bizarre, but it worked for her to cope and not be totally overwhelmed by her past trauma.

So from a young age I understood how these strange beliefs might be helpful for people. My mom wasn’t hurting anyone and her strange belief system helped her to survive. I saw the potential wisdom aspect of what was called psychosis. Organizing extreme experience in bizarre ways can help one to cope and make the intolerable tolerable.

When I had my breakdown in my late 20s, I just knew it came from all that childhood experience. I actually thought I had dealt with the trauma, but it blew up in my face. But I managed to work through it and stayed out of the system. Just by the skin of my teeth; it was pretty intense. If I had seen a mainstream professional I would have been given a psychotic diagnosis. But I worked through it and came out healthier and stronger on the other side.

After this experience, I started thinking there must be many people who go through these experiences and go to see a professional. And then they’re told these terrible things — you’ve got a brain disease, you’re never going to recover. I felt with my experience I had to do something about it — there’s certainly a lot of healthier ways that people can work out these problems rather than going into the psychiatric system. So that was my impetus toward becoming a psychologist myself.

Matt: Wow, those are some overwhelmingly intense experiences for any young child to go through. I can’t believe you were diagnosed as “borderline” at age seven! What psychiatrist would make that diagnosis for a child of that age? Okay, so after having a breakdown yourself as a young adult, you wanted to help others; that’s similar to my story. How did you move forward with these goals?

Paris: Now I practice full time therapy in New Zealand; I’ve been here three years. I moved here after marrying a Kiwi woman. I originally wanted to work quite a bit here with people experiencing extreme states, but I just got spanked badly. What I mean is I got blacklisted from the local hospital while trying to support one of my psychotic clients. And so I’ve actually pulled away from that population right now, because the system here is so oppressive; it’s even worse than what I experienced in the US.

Matt: Thanks for this background. It’s interesting and sad to hear about New Zealand’s situation vis-a-vis psychosis. You’re a talented therapist and someone who I think could do a lot of good work helping psychotic people. Can you share more about the situation in New Zealand, and also about this case that deterred you?

Paris: Here in New Zealand, simply not taking the drugs for a psychotic breakdown is enough for them to make you take them. There is very little genuine informed consent. They have a mental health act that’s a direct violation of the United Nations treaty.

I had a young male client who had a breakdown, whose parents took him into the hospital, so I went to see him there and worked with him in the hospital. First the staff wouldn’t even let me in to see him. Then they finally let me in; then I was too forthcoming with my criticisms of the drugging and the biological treatment approach. We had a meeting with the psychiatrist, his family and the client, and I pushed the psychiatrist to acknowledge that some people recover from psychotic breakdowns. The psychiatrist finally conceded it might be true but then said, right in front of the client, “Some people might recover but he’s not one of them.”

I saw my client a bit longer but then they started ramping up those doses, and then they kicked me out of the hospital. And then I went to my psychologist board and said, “Ethically, we’re supposed to take action when harm is coming to our clients.” But the people on our board said to me, “You have to understand that in New Zealand the psychiatrists run the show and there is no recourse.” Then I went to a lawyer and the lawyer said, “There’s nothing you can do.”

One thing led to another and I decided to withdraw from working with psychotic clients. It appeared to me that because I was willing to openly challenge the psychiatrists’ treatments of my clients, that out of spite, some of them were treating them even more harmfully than they would have otherwise, such as ramping up their dosages to ridiculous levels. So I felt that by continuing to engage with psychotic clients, at this time and place, I would be making things worse for them by causing a backlash from the system which would get them even more heavily drugged. I didn’t want to continue with that.

So right now, I’m still doing the advocacy in terms of supporting a recovery model of psychosis, and providing assessments that people can use with their psychiatrists and other prescribers to encourage tapering down with medications. But that’s pretty much it for the moment.

Matt: Wow, I’m sorry to hear this. This situation of forced drugging is something I’d expect to hear about in Iran or North Korea, not in a supposedly civilized country like New Zealand.

Paris: Yes, it is pretty extreme. The good news is we came here because one of my wife’s family members had a psychotic breakdown and was in the system here on heavy forced medication; and we came here to try to help her. I was really lucky that her psychiatrist had heard of me and was familiar with my work and was unusually open-minded. Her psychiatrist wasn’t happy about it but agreed to take her off her medication. And she really blossomed off drugs and got much better. This psychiatrist now is starting to question her own practice as a psychiatrist, and this family member is doing great, so that’s the positive thing.

Matt: That’s good to hear. Okay Paris, let me move on to some other questions. How much experience overall do you have working with schizophrenic clients? Before you moved to New Zealand, I remember you were practicing for a few years in California. Were you able to work with psychotic people there?

Paris: Well even in New Zealand, I actually have had a bit of experience. I found a doctor who was willing to work with me outside the box a little bit. This doctor helped one person taper off and get his family engaged as support. This young man fully recovered and got off all the meds. And then in the US before I came here I was always dancing on the edge, but I worked with several psychotic people. My experience has been that when you create a very safe space, where the psychotic person knows that they can share whatever’s going on, knows that they won’t get forced treatment they don’t want, that most people are able to work through whatever’s going on and get through it. I’ve had a lot of really good success stories with psychotic people.

I see these experiences on a continuum, so it’s hard to put an exact number on how many psychotic people I’ve worked with. But I’ve had really good results with a number of clients both in the U.S. and New Zealand, in that they’ve come off all the drugs and would be considered fully recovered by any standard. I’ve helped quite a few other people make significant positive gains in many ways, including reducing or coming off the drugs and developing strategies for riding through extreme states without losing control of their behavior or ending up in the hospital. And I have helped a lot of people make significant peace with ongoing distressing anomalous experiences.

Aside from the difficulty of supporting people in working through such difficult conditions, I have found that much if not most of my support efforts involve trying to undo the harm caused by the mainstream mental health care system. I’ve found this part of the work to be very discouraging to say the least.

I also see psychosis as extreme responses to trauma for the most part. That’s what I’m working with now; I work a lot with sexual abuse survivors. I’m more and more interested in trauma, developmental trauma as well as acute trauma. I really see these different expressions, e.g. personality disorders or psychosis etc, as sort of extreme responses to existential threat. It might be a literal threat, a bodily threat, or a deeper kind of existential threat to the “self,” such as what is often the case with child abuse, neglect or other developmental trauma — whatever makes the person feel terrified and overwhelmed.

Matt: Yes, I understand this. As I was telling you in another conversation we had, Vamik Volkan and Bert Karon wrote about how experiences of extreme, unremitting terror were at the root of what is called “schizophrenia.” Volkan wrote about how in a successful psychotherapy, one must create the conditions for the person to face their terror and past trauma — to come to terms with it, to dissolve and mature the childlike part of the personality which is trapped in fear, which he called “the infantile psychotic self.” I encourage you to read his book, The Infantile Psychotic Self, which contains several great case studies of full recovery from a long-term schizophrenic state.

Okay, now let me move on to something else. Give me your honest opinion on the idea commonly believed in our “developed” nations that people experiencing delusions, hallucinations, and apathy have a brain disease called schizophrenia. Do you think this is valid? How do you talk to clients and families who have heard of this idea and might be scared of it? If schizophrenia is not a brain disease, how can people think about psychotic experience?

Paris: No, basically I don’t believe that there’s a brain disease causing schizophrenia. It’s not all black or white — certainly there’s cases where physical issues like heavy metal poisoning or other kinds of documented neurological conditions and brain injury can cause severe psychospiritual distress. But most psychotic experience that gets called psychotic disorders in the DSM or ICD isn’t a brain disease.

I see psychotic experiences such as delusions and hallucinations as adaptations, not as diseases. If you locate anomalies in the brain within some people who become psychotic, it may just be evidence of significant trauma in their past lives. Again, I don’t see these brain changes as disease so much as adaptation; as an organism trying to adapt to a very difficult situation. That’s from lots of years of reading the research as well as working with psychotic people clinically.

Also, I’ve seen that psychotic clients can get well and not need the drugs. Did the brain disease suddenly go away and they’re perfectly well? It doesn’t make sense then, the brain disease theory. It doesn’t fit what I’ve seen. Why would the brain disease suddenly go away when they had enough psychological help? And also, the psychiatric research on “still-to-be-discovered brain diseases” is so weak; it’s very unconvincing, not real science.

The problem is, once you get a diagnosis like “schizophrenia” you get put on drugs. You probably don’t have a brain disease when you get diagnosed, but pretty soon you will have a real brain disease if you stay on the drugs long enough — in that your brain gets altered and damaged by the psychiatric drugs, as Whitaker’s book Anatomy of an Epidemic so clearly documents. So there is a disease associated with a schizophrenia diagnosis, it’s just not the disease that’s usually talked about.

I have this vicious cycle I’ve written about in my book Rethinking Madness: people have severe distress, we think we need to prescribe drugs to fix their brain problem, but then the drugs in fact lead to a real problem with their brain. Then they have more problems, then we think they need more drugs, and we don’t realize the drugs might be harming them in the long term… it keeps reinforcing the story that people have chronic life-long brain diseases. But for the vast majority of those people it’s a self-fulfilling prophecy due to the treatment they have been receiving. It’s iatrogenic.

Matt: Yep, I agree with pretty much everything you said. It’s a crime that antipsychotics are used in the amount and length they are in most countries, given the lack of evidence of their long-term benefit and safety. It’s all about profits for the drug companies and about elevating psychiatrists as doctors treating supposedly brain-based illnesses, not about what’s really going on with the psychotic clients or what might be most likely to help.

Okay, talk to me more about the role of drugs. Do you ever refer schizophrenic clients to prescribers? Or do you try to discourage drug use? Do you see any place for these antipsychotic drugs?

Paris: First of all I see drugs as drugs. Illicit drugs and psych drugs are just compounds affecting our neurotransmitters in different ways. They don’t treat a specific disease, unlike insulin for diabetes. What I’ve seen, academically in the research and clinically in my practice, is that at best you get short-term relief at the expense of long-term harm. At the worst, you don’t even get short-term relief, and you get short-term and long-term harm.

Usually I think it’s best to not use antipsychotic drugs at all for a psychotic breakdown, or if they are used, to keep it short term and then taper off. As an example, I’m working with a psychotic client right now who’s been able to taper off — since moving here I’ve only worked with four people with psychosis, including the one I mentioned earlier who got in trouble with the system. The other three all came off their drugs; they had each been started on antipsychotic drugs, and they later got off and started doing really well.

One man had been in the system on a strong antipsychotic drug for 15 years; I worked with him and his mom. We worked with a really open-minded doctor. We did a really slow taper, and he got much better. Another young man had serious sleeping problems which led him to have psychotic manic-type experiences; it snowballed and he ended up in a pretty extreme place. When I supported him I was at first trying to be alternative, meaning to help him manage his sleep with no drugs at all, but it wasn’t working. Then his doctors wanted him to go on antipsychotics permanently; he’d had two psychotic breaks and was going into his third one when I really began to work with him.

We first tried just basic relaxation and sleep-hygiene methods to help him sleep, which worked okay, but weren’t quite enough given how extreme his condition was. So he tried a benzo for a few nights, then a low-dose antipsychotic for a few more nights, just to help with sleep. Then after 5 or 6 nights using the drugs like this, he was able to stop using them, and has since fully recovered from the episode and came off all the drugs. We continued to do a little work with his past experiences and he’s been back at work full time and doing really well ever since.

Here’s what I think worked well with this last drug use situation: A) Taking the drugs was the client’s full choice; there was no coercion to use them, and B) There wasn’t any suggestion that they were medications curing any brain problem; they were just tranquilizers that helped him sleep.

So in that case I saw drugs as helpful. The problem is they’re very rarely used like that, i.e. as a last resort strategy, with full informed consent, for a short period of time. If used that way they could be helpful for some people. But otherwise, outside of those rare exceptions I think they’re pretty much a negative influence.

Matt: Okay. And why specifically, in your opinion, are these drugs usually a negative influence? Can you give some details?

Paris: A couple reasons why they’re a negative influence: 1) They’re neurotoxins — if the person didn’t have neurological anomalies prior to that, they will afterwards, as the drugs create a neurologically unnatural state (see Grace Jackson’s research). And 2) Psychologically, what the drugs are doing is harmful.

Let me explain. With so much of what we call mental disorders, a person has developed a conflict against their own experience, a tug of war with their own emotions, but with the drugs we’re exacerbating things by making it harder to work with that experience constructively. The drug temporarily reduces intrapsychic conflict by dulling down negative feelings, and they also induce a temporary placebo effect. But if the psychotic person didn’t address the root problems at all — whatever difficult feelings, past trauma, lack of love, etc, that is related to their breakdown — then these issues reemerge and come back even stronger. Psychologically, the drugs have essentially just exacerbated the idea that there’s something wrong with you and you have to keep taking the drug to manage it.

So now the person in this example has even more fear of their problematic emotions and conflicts. And then the drugs also impair the person’s natural ability to navigate through their emotions and meet their needs. They can’t be open to their feelings, which are messengers about what is wrong. It reminds me of the phrase, “Don’t shoot the messenger,” which is what drugs do.

As a therapist, I want to help people make peace with and develop a more open and curious attitude toward their experiences and feelings. And I want to help them get their needs met and develop a more satisfying life. Not always, but generally, I find that psychiatric drugs interfere with meeting those goals. Generally speaking, if a person can not use drugs at all, that’s best.

Matt: Thanks for sharing that. I know it’s not easy to speak out in this way in our drug-happy climate, in a world where most doctors believe delusions and hallucinations represent a brain disease requiring drugs. I experienced what you’re talking about and it was one of the reasons I decided to self-taper myself off antipsychotic drugs; something I did against my psychiatrist’s advice, having to deceive him and exit the psychiatric system. I often wonder how outcomes for psychotic people would be if there were no drugs.

Okay, moving on: What are some sources (books, videos, websites) you would recommend to people who have been diagnosed schizophrenic and want to learn a more hopeful approach to psychosis?

Paris: On my website RethinkingMadness.com I have a resources page. As far as mental health professionals go, I’d really push reading Anatomy of an Epidemic. I just think it’s so important to really understand the whole problem — there’s a really significant problem in the fabric of our society with mental disorders, but we make it so much worse by how we treat it in our society. It’s like, “First let’s stop making it worse, then we can address the real problems”… like problems in parenting, intergenerational trauma, poverty, and so on.

When you look honestly at the broader research, the World Health Organization studies, etc, it’s pretty clear that the Western mental health field is making things worse, generally speaking. Obviously every case is different, but we’re not getting any indicator that we’re making things better with our first-world system of treating severe distress.

One of the things I find very helpful is a mindfulness and somatic therapy approach; and my personal favorite approach to therapy of early trauma is called Hakomi. What I really like about it is it integrates mindfulness, psychodynamic, existential/humanistic and somatic therapies, and puts them all together.

So much of the trauma that shows up in psychosis is actually preverbal experience contained in the body. For the majority of people who develop psychosis, they’ve probably had trauma in the early years of life. How do you actually address it if they can’t remember or talk to you about it? This is why somatic experiential approaches like Hakomi are so helpful. The trauma is still held in the body or unconscious physical being of the organism. And the somatic approach allows you to address it on that level.

Ron Kurtz, Moshe Feldenkrais, Alexander Lowen, Wilhelm Reich, and Peter Levine were developers of this approach. They all asked, “How do we support someone who’s had trauma that either predates or extends beyond their verbal capacity?” Their thesis is that the trauma is still held in their body in some way — in the sensations, in the lens through which they make sense of the world — but they’re not core beliefs you can put into words. They’re core beliefs that go beyond just visual memories and thoughts, but are held even more deeply within the body and the entire organism, showing up in physical sensations, tensions, postures, gestures and impulses, many of which the person is not ordinarily conscious of.

The principal is that you immerse a person into the actual experience — I’ll give an exampleWhen someone’s struggling with overwhelming anxiety, one thing you can do is to direct them into experiencing and identifying where specifically the fear is in their body, and into mapping out and making an image of the sensation. Then you immerse them more deeply into this experience and notice whatever emotions, impulses, thoughts, meaning or any other experiences that naturally emerge. So, like this, you follow an organic process of peeling back the layers of their experience until you arrive at the core material. Then you support the person in transforming the limiting core belief at this very deep level in a whole organism way. Sometimes, repressed or forgotten memories emerge at this point, and you can work with these directly.

If it’s preverbal, that’s where it gets really interesting, and involves more direct physical work with the body. With powerful negative emotions we can get stuck for years and years if we don’t feel and resolve the traumatic feelings. My work is very much from a trauma perspective; it’s very holistic, holding the broad view that one’s entire organism is perpetually striving to survive and thrive.

Matt: It’s interesting to hear about this Hakomi approach. I know about Lowen and Reich, and read their books Bioenergetics and Character Analysis, as well as Levine’s Waking the Tiger.

Okay, let’s move to another controversial question relating to so-called “schizophrenia.” What do you think are the most common causal factors in someone experiencing a psychotic breakdown? The NIMH says the cause of schizophrenia is unknown. Do you agree that we don’t know what causes the experiences that get labeled schizophrenia?

Paris: I have a two-part answer. The first part: So much of what is diagnosed as psychosis shouldn’t be. Essentially, if someone is having a belief or a perception that doesn’t seem to be lined up with consensus reality or with the mainstream accepted standards, then they’re called psychotic. That’s a real problem — where do you draw the line? For example, all the members of one religion may seem really psychotic compared to another religion. You might have another group of people with strange beliefs; i.e. aliens coming from outer space to take over the world at a certain future date. It’s hard to draw the line between what’s crazy and what’s not.

The next question is: Are their strange beliefs causing harm to themselves or others? If not, no problem. If it’s not interfering with their ability to live a decent life, it’s not a problem; it shouldn’t be filed under or called a disorder.

What I’m calling psychosis, meaning psychosis that becomes a real problem, isn’t simply having an anomalous belief or perception. Instead, the person’s basic lens or paradigm or set of cognitive constructs breaks down. During our development, we build up a particular set of constructs to make sense of a world that is stable — but with someone who becomes psychotic, their whole worldview breaks down quite rapidly in different ways. It can become very rigid or totally collapse.

What I think causes this type of breakdown is usually the person being exposed to raw existential terror in some form. In my book Rethinking Madness, I had four different chapters on theories connecting death anxiety to psychosis. When we actually experience our fear in its raw primal form, it can be very destabilizing.

I think our development is like a skyscraper and the first foundation is getting the experience that the world is safe enough and I belong here and I’m accepted here. As long as we get that, we establish a greater and greater distinction between ourselves and others (more differentiated object relations). Then these needs connected to being autonomous on one hand and having intimate relationships on the other hand develop as we get a more complex sense of ourselves. So if someone has a good first few years of their life in terms of having security and love from caretakers, if they get that deep in the fiber of their being, then if some terrible trauma happens later in life they’re less likely to develop psychosis due to having a stronger foundation (they might develop PTSD or mood problems instead).

Having a psychotic break is like having the carpet underneath one’s feet getting totally ripped out — and people who’ve had a difficult early first few years of life are most vulnerable to that. With someone who’s had a lot of early trauma, the normal stresses of life as a young or middle-aged adult might be enough to break them down.

If I look at my own life, the first one to two years were actually really secure; but then all hell broke loose for me. When I had my breakdown in my late 20s, I had enough resilience at the very bottom that I had the strength to work through it alone. But other people might need more support to work through it.

It’s complicated, but if we were to generalize, it’s the undermining of our sense of self at the deepest layers that can lead to psychosis, and early trauma can make us much more vulnerable.

Matt: You give long answers, Paris! But a lot of good food for thought. Okay, I have one more very controversial question: Through neglect and/or abuse, can parents contribute to their children developing problems that get diagnosed as “schizophrenia”? If so, do you think it can be advantageous to acknowledge this in a way that doesn’t blame parents?

You know what I think about this. I hate it when certain NAMI parents and many of our American research institutions state, “We now know that bad parenting does not cause schizophrenia.” That’s not only incredibly simplistic, it almost borders on lying when we look at how strongly correlated trauma of all kinds is with psychosis. Not all trauma is from parents, but a lot of early trauma is. Okay, let’s hear your view on this.

Paris: Yes, the research is pretty clear, especially from the Adverse Childhood Experiences studies, that there are really high correlations (which look more like causal links) between the severity of adverse childhood experiences and the likelihood of developing psychosis.

The one study in my recent paper about Psychosis and the Family — about the number of adverse childhood experiences correlating with chances of having a psychotic break — concludes that when you have five different kinds of adverse childhood experiences (like sexual abuse, physical abuse, bullying, verbal abuse, etc) you’re 193 times more likely to have a psychotic breakdown than someone who had 0 or 1. When you compare the strength of these trauma factors in affecting psychosis risk to the tiny genetic correlations that have been discovered so far (which were ironically on the front page of the New York Times), suggesting that having certain genes might raise your risk from 1 to 1.2 percent, it’s pretty clear how important trauma is.

Where do these adverse experiences come from? Most of them come from our family and early environment including parents. Not all of them — some can come from war, poverty, other factors. Intergenerational trauma is important. How do we name the elephant in the room? Yes, problematic parenting leads to significant problems later in life. We don’t want to just come out and say that, but it’s so, so clear it’s true.

Also, we don’t want to get locked up in blaming the parent. Often the parents were abused themselves, or are in poverty, in a difficult situation where they’re doing the best they can, and it’s impossible for them to do a good job given the situation they’re in. It’s painful to see how you try to talk about parents and psychosis and you get labeled a mother blamer. Things are much more complicated.

Matt: Yes, I agree. Identifying a parent as a possible causal agent in triggering a psychotic breakdown isn’t the same as saying that parent is a bad person. My own father beat me for years and my mother didn’t protect me and didn’t know how to talk to me about my fear of my father. They didn’t do these things because they were evil people; they had been neglected and abused by their own parents. I have no hesitation in saying that my parents contributed to my having severe emotional problems, including psychotic experience. They did.

I think things are much better if we face and acknowledge the harm that poor parenting can do; because then we have a chance to change it for the better, especially for parents to change their relationship with their child for the better. Taking the approach of some NAMI groups, “Bad parenting does not cause schizophrenia,” is both meaningless but at the same time a stonewall that precludes a careful examination of what is really going on in the relationship between parents and a child who becomes psychotic.

Okay, we’ve been talking a long time and both need to go. Thank you very much for your time, Paris. I’m sure that what you shared here will be very helpful to people looking for a humanistic, psychological, hopeful approach to psychosis and “schizophrenia.” I’ll talk to you soon.


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.

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Matt Stevenson
Matt Stevenson is a American man with lived experience of extreme states. After recovering from challenges associated with multiple "severe" psychiatric diagnoses, he now works a normal job and is no longer involved with the mental health system. Via the psychiatric survivor underground, Matt speaks to suffering people about alternative ways of conceptualizing their distress, as well as about about paths to recovery outside the mainstream system. Any correspondence can be sent to [email protected].
Paris Williams, PhD
Rethinking Madness: With the rare perspective of someone who has experienced extreme states from both sides — as a psychologist/researcher and as someone with lived experience — Paris draws from multiple perspectives to explore what it means to be “mad” in a "mad" society.


    • Hi Matt:
      Thought to quote the entire comment I made on ISPS Listserv to your posting on this interview article with Paris for a wider readership here:

      ” Reading this, (your excerpts from the interview posted in ISPS) I found it to be a very inspiring testimony to human resiliency. 

       In spite of all kinds of traumas and adverse life circumstances, how do  some human beings overcome and make successful adaptations to their “painful life experiences” and  become productive and successful living beings?  A great question! 

      So much attention is being paid to the role of negative life experiences, but less  as to what makes many overcome such adverse experiences in life or even inspire them to achieve. This is  not to glorify in anyway such adverse life experiences! Then,  there are many who are adversely affected by these “experiences”  impairing their “adaptation to present living circumstances” and their “functioning.”  Why?
      Or is it a value judgement or  does it  make any “existential difference,” as we all go through phases of living and dying in different ways?   Who can say which one is better than others. We all in different ways process information as to what makes sense and how best to adapt to our individual life circumstances, and how we value in our own ways what “service product” is “helpful” or not at a given time of our life.   

      I think, adverse life experiences  (a causative analysis of the past)  and adaptation and resiliency  both need more understanding and attention.

      In an existential time dimension, the focus on the “present reality of experience” may be more important than the “speculative past” (which is nor Real anymore unless we make them so) in many ways.  From an existential perspective, it is the Present Reality of the Moment that we are consciously aware of.  

      I also think that the unusual gift of language and ability to articulate complex life experiences that Paris and Matt, and some others share, which  many others with “lived experiences” may not have had, or  the opportunity to express,  contribute to ours (“collaborative” team of  mental health consumers and providers, and the community at large) evolving  enrichment and  better understanding  of  the dynamics of people with  “lived and atypical experiences” and how best to move forward towards an  “egalitarian society.”

      Finally, where is this “ability comes from” and how is it stimulated, this is also something to consider in the understanding of “adaptation” and “resiliency.”  


  1. Paris offers a perspective that fits with my own experience. We need to provide opportunities to explore our relationships with experiences whose roots are pre-verbal and overwhelming. We also need to promote prevention by enabling access to adequate food, shelter, education, healthcare, empathetic compassion-focused learning and relationships. Alternatives to violence and human rights preservation may allow us to grow evolving communities, but we will need to unite in direct action despite powerful frightened and frightening opposition.

  2. Thank you for speaking the hard truth, Matt and Paris. “It’s iatrogenic,” not genetic illnesses that the DSM describes, iatrogenic illnesses that result from use of the psychiatric drugs. I know this is too embarrassing for the psychiatric industry to confess to, but it does seem to be what the medical evidence is actually coming in showing.

    And here is medical evidence that today’s “schizophrenia” drugs, the neuroleptics / antipsychotics can cause both the negative and positive symptoms of “schizophrenia.” The negative symptoms can result from NIDS:

    “Neuroleptic induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of schizophrenia—emotional blunting, apathy, hypobulia, difficulty in thinking, difficulty or total inability in concentrating, attention deficits, and desocialization. This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to ‘improve’ what they perceive to be negative symptoms of schizophrenia, rather than antipsychotic side effects.”

    And the positive symptoms of “schizophrenia” can result from anticholinergic intoxication syndrome, also known as anticholinergic toxidrome. These are the central symptoms of neuroleptic induced anticholinergic intoxication syndrome, from the drugs.com drug interaction checker (Geodon/Zyprexa, professional):

    “Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    The only difference between the central symptoms of anticholinergic toxidrome poisoning and the positive symptoms of “schizophrenia” is “inactivity” vs. “hyperactivity.” And since neither NIDS nor neuroleptic induced anticholinergic toxidrome is listed as a possible cause of “psychosis” in the DSM billing codes, these neuroleptic induced illnesses, that are indistinguishable to the doctors from the negative and positive symptoms of “schizophrenia,” get misdiagnosed as one or more of the billable DSM disorders.

    And thank you both for bringing up the even harder truth to discuss, that child abuse is being ignored and covered up for profit on an enormous scale by today’s DSM bio-bio-bio believers. The fact that “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012),” makes this quite clear.

    “So much of what is diagnosed as psychosis shouldn’t be,” also a very true statement, I had a dream query misdiagnosed as “psychotic.” And maybe dreams are “psychosis,” but when the psychiatric industry stoops so low as to claim dreams are “psychosis,” since everyone dreams, that means everyone is “psychotic.” Which makes the “psychosis” diagnosis absurd.

    I do so hope the psychiatric industry gets out of the business of profiteering off of denying and covering up child abuse soon, since of course this is technically illegal.

  3. The place for people to ground their experiences is with political and legal activism undertaken with a network of comrades.

    Though a psychotherapist may have similar sentiments, they are still not that band of comrades. A therapist is a therapist because he or she believes that the problem and the solution lie within your own head. As such we must avoid these people like the plague they are.


  4. Gee Matt — it’s a shame that to engage you in conversation one apparently must agree to not blanch every time you use psychiatric hate speech terms like “psychotic” and “schizophrenic.”

    Since “schizophrenia” is an invalid catch-all category of thought and behavior there is no percentage in trying to redefine what “it” “really” is, as there is no “it.”

    I don’t know why you refuse to address this basic reality, and act as though “we all know” what is meant by such bogus terms (or their bogus replacements).

    • An interesting interview. That said, let me just weight in with the thought that it very much matters what words we use, and insofar as any of us use words like “schizophrenic” and “psychotic”, we are thereby implying their legitimacy and in the process we are upholding psychiatry. And while this issue may look minor, it is not. As Black feminist Audre Lorde so poignantly put it, “The master’s tools will never dismantle the master’s house.”

      All the best.

  5. Thank you for this insightful interview with Paris Williams, one of my mentors. Paris actually was there for our family as a kind support 2 1/2 years ago when our 19 year old son went through a 2 week extreme state with 24/7 home respite, a dialogic, family approach and minimal meds (just for sleep for a few nights). Our son has not had another extreme experience and is thriving.

    I want to suggest that we, as a community, remain open and humble about all the possible and unknown causes of ‘psychosis.’ Trauma and developmental problems certainly are big factors in later emotional pain and upheaval. I would also argue that living in this stressful world, the experience of being bullied, PTSD of all kinds, not fitting in socially, maybe being on the “Spectrum” (which I believe is probably related to more and more expectant mothers taking pharmaceuticals or being exposed to other toxins), economic or health related adversity etc. also impact children and can lead to mental health crises. Humility is something mental health professionals have often lacked. I hope we don’t make this same mistake by assuming parenting problems are the prime cause of emotional difficulties. Parents almost always are doing the best that they can. In some cases, they may not have contributed at all to their child’s emotional difficulties. In most situations, parents are trying to help when their kids have emotional struggles and need our support.

    Pain and existential mysteries are also part of living so intense emotional transformations are a natural part of healing and growing. So much contributes to each person’s path and challenges. Thus, even though this interview with Paris shows how parental trauma and pain can contribute to mental health difficulties in children, we should not simply assume that this is the primary cause of emotional pain in children.

    Thank you Matt and Paris for this great interview. More than anything, I value that you have reminded us that emotional suffering has meaning and is related to life experience.

    • I don’t believe that either man is saying that the primary cause of emotional pain in children is caused by parents. I can’t speak for them however. But I would emphasize that even well-intentioned parents can cause problem for their children, and they will probably never even realize it. Sometimes parents and children are not necessarily good fits personality wise. And neither may ever realize this.

      It might be interesting to look at something called the Minnesota Longitudinal Study of Risk and Adaption that was done by Alan Sroufe and his associates beginning in 1975. They followed 180 children from right before their births to the age of 28. They did home visits and the children and their behaviors were evaluated fifteen times during this time period. They found that the key issue was the nature of the parent-child relationship, how parents felt about and interacted with their kids, this is what determined whether kids would have problems in later years. “..the combination of vulnerable infants and inflexible caregivers made for clingy, uptight kids. Insensitive, pushy, and intrusive behavior on the part of the parents at six months predicted hyperactivity and attention problems in kindergarten and beyond.” “By far the most important predictor of how well his subjects coped with life’s inevitable disappointments was the level of security established with their primary caregiver during the first two years of life. Sroufe thought that the resilience in adulthood could be predicted by how lovable mothers rated their kids at age two.”

      There’s also something called “disorganized attachment” that often happens between new mothers and their newborns. There’s no course or class that can educate parents on how to deal with their children but if mother and child can’t “attach” properly difficulties will likely happen for the child later in life. This is an area of study that is fairly new and many people aren’t aware of how all this is supposed to happen.

      I guess that what I’m trying to say is that even well intentioned parents can sometimes cause difficulties through no fault of their own. Coming into this world and growing up to be a well-adjusted adult is not an easy thing and the process can be fraught with numerous problems and issues that may not be readily apparent at the time. The study mentioned above might be helpful in explaining what I’m not doing a very good job at explaining. I would say that parenting is a much deeper subject than we ever really imagined. Difficulties can happen through no fault of either the parent or the child. But the resulting problems can lead to things like being labeled as “mentally ill”.

      • I would like to comment on some of the research you referenced above. I hope to continue to challenge some assumptions that tend to blame parents, usually the mother, for difficulties with development. I am a therapist, parent and a peer and I’ve spent my entire adult life coming to this perspective. Humility is the best approach when we offer support to those in crisis and their families.

        The studies that look at how mental health crises relate to adversity and difficulties with attachment show correlations between the two. It’s very clear that adversity and later mental health conditions are correlated. However, when children fail to feel safe and secure in their attachments and lives, the reasons (causes) are less clear. Many other factors beyond maternal personality and the elements mentioned in the ACE study may be involved.

        I have 4 children, one on the spectrum. As someone who has had many years of psychodynamic therapy, including much reflection on the problems with my relationships with my parents growing up, self help, education etc etc, I don’t believe that I caused my son’s developmental/spectrum issues anymore than I caused his siblings’ personalities. (Perhaps the medication I was prescribed for severe morning sickness for 5 months caused his autism though!)

        Secure attachment is critically important for all children. Nurturing and safety are vital. But not all kids who have mental health crises have parental caused attachment problems. Kids who are vulnerable can be born with sensitivities that are magnified as they struggle in a difficult world. Parents may have done everything in their power to help (often have) and still have young adult children who find growing up and living in the world overwhelming.

        Just because mother and child had difficulties when these kids were infants does not mean that the problems were “caused” by mothers…these children may have been born with very different nervous systems and developmental challenges. In addition, poverty, racism, health crises, bullying and other complex forms of adversity may exist. To later blame individual mental health crises on attachment to mothers is presumptuous and even harmful. In any case, as a parent (and a peer and professional) I have come to believe that it’s not helpful to hold to one theory.

        People (parents) know when they are being judged and I feel it a bit here. Studies that show correlational relationships do not explain the complex dance of life. Furthermore, even though there is truth in some of these theories – that parental difficulties can cause trauma and developmental problems in children – jumping to these assumptions is probably neither fully accurate nor that helpful for individuals and families in crisis.

        Again, I could not agree more that early relationships and family experiences are a part of what leads people to have emotional problems and/or more well adjusted lives. BUT, there are many, many other factors affecting people beyond maternal attachment and the 10 challenges listed in the ACE study. My question is how to keep an open, humble perspective as a therapist, support individuals in crisis with humanistic, non-medical model approaches and bring people together in dialogue. This is what I have found most helpful.

  6. Very thought-provoking interview, tons of food for thought, here.

    For me, the issue of family influence on attaching to delusions later in life came directly from accepting what I was raised to believe without question. Also, by taking on the fear that my parents felt about life, from their own perceptions which were formed based on *their* life experience. Their fears, worries, and delusions became my fears, worries, and delusions, until I was ultimately able to separate from their world view and come into my own, based solely on my experience and not on anyone else’s. When I individuated from all of that, and how others lived their lives and walked their paths, and focused purely on what felt right, true, and real to me, I was able to ground in my own reality and create the life I most wanted to live, and the issue of whether or not my experience was “real” to others became a non-issue for me, completely irrelevant.

    The psych drugs contributed enormously to feelings of paranoia, attached to stories of persecution. Having gone through the mental health system, however, this seemed somewhat reasonable, given the aggressive marginalization that occurs in there. “Persecution” is not so off-base, given the level of prejudice and blatant discrimination that occurs in the mental health field. But it is traumatic, and combined with the drugs, it became exaggerated and I carried it most everywhere for a while.

    In the end, distinguishing my own self from the family culture, ditching the psych drugs, and completely defecting from the system is what ultimately healed any doubts I had regarding my reality. Once I became aligned with my life, owned it on my terms, and felt good about it, all the fear-based and negative thoughts began to subside, and the reality I most enjoy materialized before me. And that was the end of what anyone would call “psychosis.”

  7. Thanks Matt and Paris for a discussion that I found to be extremely interesting and important. Sadly, from my experience getting articles published for the general public, more complex, interesting and important articles often receive less editor interest and reader views than more simplistic sensational stuff. Hopefully, that doesn’t also happen on MIA. Thanks again — Bruce

  8. I appreciate all of the discussion here. My primary perspective is that “dialogue,” (as in Open Dialogue or Need Adapted Treatment) between family members and the person experiencing distress can help tremendously. “Polyphony” and not necessarily full agreement on everything can help people hear each other and work things through. My hope is that professional supports join this process humbly and not with preconceived (or prematurely conceived) formulations and theories about what causes what in the family.

    Having been a part of these dialogues in my own family has been eye opening. People (parents, kids, siblings etc) in the same family can understand and experience the same things very differently. Yes, no doubt, attachment issues, unhealthy communication patterns, unresolved parental pain and issues, overt abuse and unhealed trauma as well as personality differences may all cause harm to children in the family.

    However, I would again caution us not to fall back on our professional theories and preconceived ideas. Yes, early attachment is critical and usually happens between mother (as opposed to father) and child. Developmental (neurological) problems such as autism are on the rise and can negatively affect these early developmental experiences having nothing to do with mothering. Research is showing that these developmental issues are often biological in nature, although with warm environments, targeted behavioral interventions and neuroplasticity, they too can be overcome.

    We must be very careful not to fall back on blaming mothers. Mothers in particular often carry (much) more of the parental responsibility and are also the first to be blamed for complex problems, sometimes having to do with absent or abusive fathers, school systems that don’t work, employers that are not flexible etc. I much prefer dialogue in which professionals come in to the family meetings as humble listeners and try to understand and facilitate communication between others and ultimately healing.

    I realize that both of you, Paris and Matt, appreciate the complex causes of family issues and what may lead to “psychosis” or other extreme experiences and are not intending to blame anyone, especially fathers or mothers. However, some of the theories themselves jump to conclusions such as the concept of “disorganized attachment” which may have some value, but also may be entirely wrong as an explanation. These concepts are at best theories and may not be anymore helpful to the family than diagnoses are. In fact, I find some of these ideas presumptuous and harmful. Non-judgmental and humble dialogue can instead be immensely helpful in the process of crisis response and longer term transformation.

    • Truth in Psychiatry,
      You have described perfectly my own concerns about this discussion . I too appreciate very much the work of both Paris and Matt, but I feel your comment here is a very necessary addendum to this article.

      Paris and Matt , Thank you so much for this article. I am so sorry to hear about the New Zealand health care system. I hope, Paris, you will be able to continue your good work in some capacity that will lead to more positive changes there.
      About the ‘names’. I really agree with what someone said on this comment thread that saying someone is ‘going through psychosis’, sounds much different and better to me then describing someone as ‘psychotic’. Saying someone is psychotic sounds more like a ‘character trait’ rather than a hopefully temporary state they are going through. It also lends itself (in popular culture) to being used interchangably with other terms such as ‘psycho’ or ‘psychopath’.

      • saying someone is ‘going through psychosis’, sounds much different and better to me then describing someone as ‘psychotic’.

        I still hope to talk Richard out of this formulation eventually, largely for the reasons you go on to describe. In my book the “P-word” should be recognized as being to survivors what the “B-word” is to women and the “N-word” is to Blacks. I really don’t see “going through psychosis” as much more than a variation on this theme. “Psychosis” is a word for the most extreme form of “mental illness,” hence very medical model as well as the ultimate in “stigmatization.” The more people take such terms seriously the more power they are handing to psychiatry in its endless quest to mystify.

        • Hi Oldhead,

          I do know what you mean about ‘psychosis’ being the word for the most extreme form of “mental illness” and have experienced first hand how that word changes everything in the eyes of both the mental health system and society. This reminds me of Noel Hunter’s articles about when she has tried to press psychologists who ‘treat’ dissociative disorders to describe how ‘dissociation’ is different from ‘psychosis’, and how the professionals’ responses indicated how uncomfortable they felt about there being any connection between dissociation and psychosis. I think I am going to be more careful in the future to talk about ‘extreme distress’ or extreme states so as not to push my loved one further into that ‘box’. Perhaps not having a ‘word’ can help us look at ‘individual situations’ as per the open dialogue approach.

          • Glad you’re getting this. I have a friend who is an activist of sorts with very progressive outlooks on most things, but, as I was stunned to discover, has basically Neanderthal conceptions about psychiatry and “crazy” people and has some kind of major resistance to understanding any of this. Under heavy pressure from me about all this he keeps ostensibly “trying to understand” and wanting me to tell him “what the right words are” to call people; in other words he’s looking for an alternative way to “other” people. It begs the question of what possible good can come from using these terms in the first place, being that they’re generally used to reduce highly complex situations to simplistic generalities.

    • Hi Truth In Psychiatry,
      Your comment highlights exactly my own concerns about this discussion, and I think it is a crucial ‘addendum’ to have with the article! I do think it is important to consider all the risks and factors that may play a role in an emotional breakdown, but unless professionals or other helping people approach any specific situation with a great deal of humility, and without preconceived ideas about what has happened, they run the risk of doing great harm. This is so especially true for something like psychosis that seems to have so many different causes both physical and emotional. (Like Paris says things such as heavy metal posioning, but there could also be other physical reasons that we haven’t yet figured out) That is why I also believe that the open dialogue approach is such an important approach to take.

      I also think that it is so important to so careful when writing about theories, and to always be careful not to overstate theories, I actually feel more concerned about the lack of ‘accuracy’ than about whether something sounds ‘parent blaming’ or not. For example a statement such as “so much of the trauma that shows up in psychosis is actually preverbal experience contained in the body”, is overstated, in my opinion. It might be or it might not be, and though there can be great value in working through plausible theories, one must be always aware that they are theoretical, and treat ideas related to theory with the necessary humility. Likewise although I found this idea interesting and think it could have some truth “….if some terrible trauma happens later in life they’re less likely to develop psychosis due to having a stronger foundation (they might develop PTSD or mood problems instead)”, I don’t think it is NECESSARILY true, It could be that people’s bodies react in different ways to trauma.
      If writers could be really careful about how they state theories and how they talk about ’causes’, then maybe we could avoid these kind of back and forth comments, and discuss the content of the article more freely.

      Otherwise I really appreciate this article and commend both Paris and Matt for their work!
      ps I have tried to send a comment about this 3 times and I never see it so hopefully multiple comments wont be posted!

    • I am a child raised under an official government funded infant management system that insisted on the mother being detached from the child from birth, the `Truby King’ method.
      My mother was an anxious first time mother, (the youngest by a long way in her family so she never saw babies being raised) and eager to do the right thing. She embraced the `wisdom’ of the time without question. The baby was to sleep in a different room, only picked up for feeding every four hours regardless of its crying, sometimes for hours. It was fed and put back to bed, playing with the infant was restricted to 10 minutes per day. Failure to adhere to this regime was heavily discouraged by the infant welfare nurses, making the mothers feel guilty if they transgressed as they would be “turning their babies into self indulgent, weak people”. This, of course amounted to a failure to attach for both and serious emotional deprivation for thousands of children over a 50 year period. I did not become psychotic because there were not enough other adverse experiences in my childhood to tip the balance. But there were enough to badly effect my ability to make trusting, meaningful relationships for my entire life.
      Without understanding why, (at that time), as a parent I made absolutely sure I was a hands on, touchy, feely Mum. Did I get it right? My kids have their issues, so not all the time. Do I feel guilty? Yes, sometimes. Does it consume me? No.
      Parents often don’t get it right. When their child disintegrates into psychosis/extreme states/emotiona/spiritual crises, whatever you want to call it, there has to be a reckoning, at least inside a parent’s heart. BUT most don’t do the wrong thing on purpose, my mother didn’t, she was trying very hard to do the RIGHT thing. She didn’t know how much harm she did to our relationship, but it was done, and it was hard for her, too.
      Having talked to many people in these crises, the worst thing that can happen is for people to deny their reality. I knew a girl who heard voices telling her to kill her mother because her mother wanted to kill her. In many talks with her worried, very caring mother, it emerged that she had protected her daughter from every adverse event in her life, that she had done so much for her child that it was so hard to see her “like this”, but she would be prepared to care for her for the rest of her life, just the same.
      I doubt I need to interpret this too much. The girl was swamped, controlled by a mother who considered any independence a threat, plied her child with guilt, and the “extreme state” was a desperate plea to be allowed to grow up. It didn’t end well for the girl.
      My point is that we all, as parents come with our own baggage and a psychotic child is just one expression of a chance to fix things, not to deny it. Open Dialogue does this, NAMI and psychiatry don’t. Maybe courage is one of the most important factors in the quest for inner peace?

  9. Matt and Paris
    Thank you both for this.
    On the topic of vocabulary
    Sometimes one needs to use words for their ability to convey a certain understanding regardless of its political references
    I understand both viewpoints but if a word gives some folks more clarity than I would say use it but make sure somewhere is the acknowledgment of its political difficulty
    It would be nice to convene a congress for a new vocabulary for all of us!

  10. Matt,

    Yes, I am familiar with object relations theory. I agree with the central tenets of this theoretical understanding of human development in relationship to others (initially parents). People must overcome both the fear of abandonment and engulfment in all relationships. The safer we feel with our first caregivers the more we build a strong sense of self. Yet, having worked through many, many crises with many people, including my own, it’s not always this straightforward, not at all.

    The most hopeful response(s) to crisis I have found is Open Dialogue and Need Adapted Tx. and peer support. The worst response is the hospital and the medical model. Hope we can move toward person-centered dialogue without preconceived ideas about the cause of crisis. Humility sometimes is more important than the most well conceived theories. Thanks again Paris and Matt. All the best…

  11. Hi all,

    I’m sorry I haven’t been able to contribute yet to this rich discussion–my plate’s very full at the moment–I was intending to have some input, but then was delightfully caught off guard by how quickly such rich discussing has formed about this article.

    Rather than submitting multiple comments, I’ll just go ahead and submit this one long comment to address some of the major themes I’ve seen here:

    1) Regarding terminology:

    I agree wholeheartedly with the importance of choosing our words carefully–words are powerful! And I find it heartening that so many people here take this issue so seriously. Ordinarily, when I write, I am quite careful about my choice of words—but as this was a spoken interview, I see now that I wasn’t quite as careful at times with my use of words as I would have liked, and I was guilty of allowing convenience trump care.

    I pretty much avoid using the term “schizophrenia” as much as possible, except when using it to make it clear that I disagree with the reductionistic medical-model connotation that this word has evolved. (Ironically, I think that for some, including myself at several crisis points within my own journey, the literal meaning of this term–“split mind”–can be somewhat fitting, in that it implies extreme ambivalence, and I think that many people who receive this label actually do experience this at times). I do, however, think that it helps to have some kind of a balance between ease of communication on one hand and doing our best to avoid using terms loaded with problematic assumptions on the other hand.

    In most of my articles, presentations, etc. on the topic, I begin by defining the terms I’ll be using. My preferred term for many of the experiences that get referred to as “psychotic” are “anomalous experiences,” “anomalous beliefs,” “anomalous perceptions,” “nonconsensus beliefs/perceptions,” etc., as I think these terms point clearly to these experiences without loading them with too many problematic assumptions. I define “anomalous experiences” as simply those that generally fall outside of what that individual’s particular group/society considers valid. Additionally, I think it’s important to distinguish anomalous experiences that cause harm/distress vs those that don’t; and also anomalous experiences that are relatively stable/coherent vs those that are relatively unstable/chaotic. I do find it helpful to use the term “psychosis” at times when speaking to certain groups and within certain contexts, but with the caveat that I’m using this term to represent a TRANSIENT state in which a person is experiencing relatively UNSTABLE and/or DISTRESSING anomalous experiences, and that this DOES NOT INCLUDE anomalous experiences that are not distressing and are not interfering with the person’s ability to live a relatively enjoyable, functional life. I DO definitely prefer terms such as “extreme states” and “spiritual/existential crisis” rather than “psychosis,” but I have found it helpful to use the term “psychosis” at times for ease of communication within certain forums/settings (with the above caveat). I have found that using my preferred terms within these settings can simply lead to confusion or to my work not being taken seriously (especially by indoctrinated medical model reductionists, which unfortunately is the vast majority of MH professionals as well as probably the large majority of the general population). I think there is something to be said for meeting indoctrinated reductionists where they’re at, and then trying to find a way to guide them towards a more holistic perspective. Otherwise, I find that I just end up in futile head-butting sessions that go nowhere.

    Yes, I concede that the particular strategies I’ve developed for working with terminology in this way leaves a lot of opened cans of worms lying around, especially when dealing with such a complex and broad array of conditions, but it’s the best I’ve been able to come up with so far—I’m always open to more helpful approaches. (I go into these ideas a bit further in Part Two of this article: https://www.madinamerica.com/2012/08/op-ed-schizophreniapsychosis-brain-disease-or-existential-crisis/ ).

    (2) Regarding factors that contribute to the onset of “extreme states”:

    Thanks to everyone and especially “Truth in Psychiatry” for pointing out the importance of not being overly reductionistic when discussing psychosocial factors that may contribute to extreme states. I have certainly given medical model MH practitioners a hard time for being biologically reductionistic—I don’t want to be guilty of being overly psychosocially reductionistic(!)

    To put my thoughts on this complex topic in a very small nutshell, I try to think very holistically about health (I go into much more detail about my holistic perspective in this article: https://www.madinamerica.com/2013/06/rethinking-mental-health-part-1-from-positivism-to-a-holisticorganismic-paradigm/ ) I generally consider that achieving and maintaining one’s wellbeing is a very challenging and precarious (and nonstop!) undertaking, especially given the many inherent dilemmas inherent in our existence (making peace with death and impermanence, balancing love and autonomy, finding meaning, balancing freedom and responsibility, etc.). So one analogy that may help here is seeing our lives as being akin to riding a small boat across turbulent seas. At times, the water is relatively calm; and at other times, we find ourselves struggling to stay upright during wild storms and massive waves. We each find that our own vessel is somewhat unique, with different strengths and vulnerabilities, based upon a multiplicity of factors: our psychosocial development and environment during our key developmental periods; perhaps some degree of genetic/epigenetic determination (another can of worms, I know, but it seems pretty clear to me that we each do emerge from the womb with somewhat unique temperaments); our degree of physical health and fitness (determined by past and present physiological input—both nourishing and toxic); and of course the many different conditions of our present environment. All of these many factors come together synergistically to determine the stability of our “vessel” at any given point in time; and when these add up to a sum total that is simply not sufficient to maintain stability in the face of our present conditions (both externally and internally), we are bound to find ourselves overwhelmed by the existential dilemmas that are our constant companions; and our “vessel” capsizes. However, as long as we still have life within us, our organism is perpetually striving to survive and thrive. The desperation of such overwhelm (the “capsize”) requires a desperate response, and I believe that what gets called “psychosis” simply reflects this desperate response, this desperate attempt to regain some degree of stability, to make the intolerable tolerable, to regain some semblance of peace with the dilemmas of life, to “right our vessel.” Of course, such extreme strategies are not always successful (especially when we don’t receive adequate support from others, or worse, are “held down” by the fear, greed or ignorance of those placed in support roles); but when we are successful, we learn some important lessons that will hopefully allow us to be less vulnerable to capsizing in the future.

    So from this perspective, I think it’s key to realize that we all have a “tipping point,” though we each have different strengths/vulnerabilities in this regard, and that our early development plays a particularly crucial role in this regard. Can someone with a very solid/healthy early development become overwhelmed and “capsize”? Sure, of course—apparently no one is free from experiencing “psychotic experiences” during such extreme situations as prolonged sleep deprivation, torture and prolonged isolation and/or pain, the ingestion of certain toxic chemicals or psychoactive drugs, brain injury, etc. However, I think that the research is quite clear that the more adverse childhood experiences a person experiences (using this term broadly and holistically, including physical/sexual abuse, parental attachment issues, neglect, peer/sibling bullying, political oppression, war, poverty, exposure to toxins, etc.), the greater the likelihood there is of “tipping over” later in life. So there is no doubt in my mind that parents by necessity hold a particularly high burden of responsibility with regard to fostering the healthy development of their children’s “vessels”; and yet I think it’s also very clear that there are so many variables that impact that child’s development which are simply beyond the parents’ direct control (broader social adversities, environmental toxins, and even intergenerational trauma, “goodness of personality fit” between parent and child, etc.). So I think it’s “both…and”: The quality of parenting is very important in a person’s developing a relatively secure “life vessel” AND ALSO many other extra-parental factors are also clearly very important; AND even when someone has developed a relatively secure “life vessel,” we are all vulnerable to running into that “perfect storm.”

    I better stop there, or we’ll have to publish another article… 🙂

    Again, thanks to all of you for the rich discussion and passionate sharing,

  12. It wasn’t my intention to divert this discussion from the issues you address, as much of my terminological dispute with Matt is ongoing and has little to do with the subject matter per se.

    I think you have a pretty good understanding of the issues surrounding terminology, and I understand the logic of your using the term in professional seminars or whatever where what you’re trying to convey transcends for the moment the semantic restraints and medical parameters with which your audience is burdened. (The question is whether you would then go back and deal with the semantics once the “main point” has been conveyed.) I don’t think that usage of the term should be encouraged among clients or anyone else; in fact I’m strongly opposed to such. Anyway, thanks for your patience.

  13. Thank you again for all the discussion,

    I like Paris’s suggestion to use “both…and” to describe how a combination of adversity, developmental issues and many other factors may contribute to extreme experiences or other emotional/mental distress. More than anything, I hope we hold our theories lightly and remain open to the dialogue as it unfolds with the person experiencing distress and his/her network.

  14. It seems like what’s needed is a more humane and ethical treatment of people in distress. What if someone very influential wrote something which changed the public’s perception of those who have painful emotional problems?

    What it could say is that the brain is like a computer, and has software and hardware. The hardware is the neurons, and the software is the meanings in the organized connections between the neurons.

    Now the basic idea with the article is that mental distress is mostly a software problem, not a hardware problem. In fact, the brain’s hardware conforms to the software. It increases or decrease it’s resources to accommodate the software.

    All that is done by drugs is to interfere with the hardware so it can’t efficiently run the software. But this is an impossible job to do without undesirable side effects, just like in a computer in which you sabotaged the hardware by cutting wires and circuit traces to inhibit some rogue software.

    And now the clincher is that you say something like, if a person can become part of a social grouping in which they are unconditionally accepted and acceptable, their brain software is gradually rewritten and new software put in place that will allow them to feel much better.

    The goal is to have an analogy that ordinary people can understand. Of course it would be written better than this, but I hope you can see what I’m getting at.

    • Hi dfk,

      Very well stated. I’ve been contemplating such analogies for a while, and while I think the software/hardware analogy works quite well, I think it risks maintaining a kind of “mechanistic” flavour. I’ve been contemplating/writing on a very similar approach used within a number of contemporary systems sciences, which talks about living organisms and living systems being holistic entities comprised of two different aspects–“process” (i.e., “software”) and “structure” (i.e., hardware). I wrote a fairly in-depth 3-part article here on MIA where I go much more deeply into considering the problems of “mental health” and health/wellbeing in general from this perspective (you may enjoy it):

      …granted, that article is still not super accessible for “ordinary people,” as you say, being still fairly academic. But my goal has been to translate that into a much more enjoyable reader-friendly experience with case studies, etc. (unfortunately, due to my commitment to other projects recently, I haven’t been able to tackle that one yet, but I agree that something like that is very important–maybe you can give it a go!)

      Best regards,

    • The software/hardware analogy (or maybe more than an analogy) was brilliantly delineated by a former poster here named “Cannotsay”; his comments are worth retrieving and reviewing, so I hope the site
      (re)designers make such retrieval possible again soon. It’s an explanation that should be used more often, as it is understandable and spot-on.

    • Governmental-Pharma-Psychiatry poisons with toxins and/or burns out with electricity, stifles the individual’s power to gain equilibrium, at the same time force’s ongoing compliance to their negatively evolving pseudo scientific virus program forced on to living human beings.Those touched by it transformed into virtual non person pariah’s or dismissed as anecdotal speakers at best.

      • If a psychiatric survivor who was captured by psychiatry for near 40 years finally escaping it’s clutches like myself —- and I can demonstrate how others can more effectively help themselves ( concerning extreme states) by many methods just as valuable if not more so than open dialog.Is it right for the lived experience info I can offer to be dismissed as anecdotal by those academics pushing the one or two trick pony’s of therapy and open dialog as the only answers to extreme states who many times have no substancial long duration lived experience at the point of psychiatry’s spear nor comprehensive knowledge of how to help other’s escape from it nor even the desire in some cases to even do so.
        One explanation of even more value than the conventional drum beat.
        http://www.yuenmethod.com Under -about – look at FAQ .
        “The Yuen Method is the resulting product of ancient Chinese Shaolin temple energy harnessing methods combined with the knowledge that anatomy, physiology,structural analysis,energetic techniques,quantum physics and Qi and Shen
        Gong collectively offer. The Yuen Method was created by Dr. Kam Yuen as a result of his lifelong study and experience with martial arts, nutritional therapy, homeopathy and in-depth experience as both a structural engineer and doctor of chiropractic.
        The underlying premise of the Yuen Method can be explained as follows. Your body is best thought of as a biological computer. It is a miraculous piece of high tech equipment and it is time we started treating it as such. But when you buy a computer or any piece of equipment for that matter , it always comes with a manual. Something that gives you instructions on what to do and how to do it. And as they say , life comes with no manual…Or does it ?
        The Yuen Method is your manual!
        Because your body functions much like a computer -you are either on or off, or more specifically “strong or weak” to any given subject matter,person, or scenario in life.
        The Yuen Method shows you how to precisely identify your weaknesses and strengthen yourself accordingly, all without any type of physical contact.These collective weaknesses are the core cause of the differing types of problems we experience in life, whether they are physical,mental,emotional,spiritual,psychic, or psychological.
        There is no doubt that changes in internal, mental energy can create visually measurable external, physical changes. This is most easily explained by the experience of goosebumps. And so it is by energetically strengthening our collective physical,mental,emotional,spiritual,psychological, and psychic weaknesses that we can in fact delete the resulting symptoms they have unknowingly caused us, even preventing those we may have experienced in the future otherwise.
        Strengthening a weakness is much like flipping a switch on a computer. It is instantaneous. If you are weak to to any given thing, you simply make yourself strong. Of course the obvious question then becomes , how exactly does one go about identifying their weaknesses?
        First , one must identify the root source that is causing that weakness. The Yuen Method provides a systematic process enabling you to use the insight you already have in order to identify the deeper core issue(s) that are related to the problems you may be experiencing in life. It is only by precisely identifying the true root cause source of the weakness that it becomes an instant possibility to delete the physically manifested symptoms of that weakness as well as any related fears, phobias,and/or limitations.
        Humans are multi-faceted beings with the aforementioned six levels of conciousness. We are multidimensional and thus need to utilize a multidimensional approach to our own health. That is exactly why the Yuen Method is both incredibly efficient and unique in that it works to ensure that all levels of conciousness are congruent so that weaknesses can be strengthened on all levels, enabling pain to be deleted and goals to be attained immediately.The Yuen Method makes it possible to strengthen our weaknesses and achieve our own infinite potential.
        The path of health,prosperity,integrity,success,and freedom from stress and pain are the birthright of every human being.The insight we need to achieve these things is already inside us. You do not need any special gifts. You don’t need to meditate, be psychic or have any specific religious beliefs. You do not need to rely on expensive health experts to provide you with their high priced opinion. You only need to allow the results the Yuen Method achieves before your very eyes to speak for themselves.”

  15. Oldhead, one of the greatest forms of oppression in our society is the way that the middle-class family exploits and abuses children. They do this, what some have called “othering”, and it is very hard for the child survivor to ever re-gain their place in society. They just don’t have the kind of biography which people will respect.

    And then doctors, some drug, some anti-drug, are called in to aid the parents.

    And then adult survivors use every means available to remain in denial.

    You seem to want to talk about this all like it is a joke.

    I want to let you know that I strongly disagree with you.


  16. I think when a person feels unloved, without unconditional support in life, and chronically devalued and dehumanized, they are particularly vulnerable to going into dark and chaotic space quite easily, flip-flopping between rage and despondence. Feeling unconditionally loved, supported, and valued are what lead to stability, centering, and grounding.

  17. I agree Alex, and if that lack of connection or misunderstanding begins before language when emotion is perceived but not in any context, then denied, how easy it must be for the infant or tiny child so see the world as chaotic and unsafe, all of which can resurface under enough, or the ‘right’ kind of stress, that others or even the individual, may not recognise as enough to drive one mad. Hence everybody’s confusion and the need for people without imagination such as most psychiatrists to claim hardware causes. Most people like neat solutions so that the uproar that psychosis can cause is very readily made acceptable to families by doing this. ‘He was such a happy baby and we loved him so much, so how could we have caused this’, the cry of truly distressed families, but we have to remember it was what HIS experience was, what HE took from what the environment as a WHOLE as well as what a parent might think they gave and meant, that is the relevant issue. Most parents mean well, none are perfect, all babies are different, most of us muddle through, some fall over and those of us who have remained intact must say, ‘ there but for the grace of God, go I’ and reach out with understanding and respect for our fellow survivor.

    • “…how easy it must be for the infant or tiny child so see the world as chaotic and unsafe”

      Yes, exactly. That becomes a neural pathway, which is why it feels chronic, regardless of circumstances, until one makes a deliberate effort to shift it into new and more supportive, safe-making, self-loving, and self-compassionate internal messages. I do believe there is healing for this, which would be a shift in consciousness.

    • deeeo42

      Your response reminded me of two sisters that I know. The older of the two was a good friend of mine. She believed that her parents were wonderful and that they’d given her and her three younger siblings a great upbringing. They were the perfect Beaver Cleaver parents according to this woman. But you get a totally different story from the next oldest sister. She stated that the parents were less than helpful during her growing up years, stating that they were demanding and nosey and always barging into her business. This viewpoint of the parents was also held by the next child in line who was a boy. He won’t even allow his children to visit the grandparents on Christmas and never visits his parents at all. So there’s this huge chasm of disagreement between the oldest child and all the others about what their parents were like. The youngest child doesn’t seem to care one way or the other about what her upbringing was like. I always found this very interesting when talking with all of them about their family life.

      • Great example of how each of us projects our reality, according to who we are and what our personal experience is. Even in the same household, we each come from a unique perspective.

        In addition, each and every relationship is entirely different. One sib might be willing to conform to a family social structure, garnering them “approval,” while another may not, despite the consequences (“parental disapproval” aka conditional love). This is where scapegoating happens, because the one not willing to conform is seen as a threat to the system. Imo, a dysfunctional system is going to feel threatened by anything that is authentic, because dysfunction relies on people buying into an illusion.

        • Occurred to me after posting this–if the family scapegoat is, indeed, scapegoated because they are being authentic and true to themselves, and therefore not playing the abuse-enabler game to protect the system, then it would stand to reason that were the family to actually take the example of the one they scapegoat and marginalize–to see past the social programming, disregard expectations of others, and not buy into the illusions of dysfunction–then a lot of healing and personal growth for everyone concerned, including family healing, would more than likely occur because that is going in the right direction, toward universal truth, true diversity, and honoring the greater good, without exclusion.

          Whereas diagnosing, drugging, demeaning, stigmatizing, and marginalizing the one that is courageous enough to be themselves, despite community “disapproval” (via harsh judgment and shaming), then that pretty much spells doom for everyone, in my book. How does anyone win when a system fights so hard to remain dysfunctional by punishing the truth-speakers and visionaries, by basically cutting them off from their natural functions, their innate creativity, and their self-healing process, and then taking away their right to free will and self-respect? Everyone gets hurt in that scenario, and it is the norm!

          When is society going to learn that the scapegoat is the one being true to themselves, and PUNISHED for it? That is really backasswards, and, I think, how a sick society is created. And we have, until the perspective on all of this shifts 180. That’s how I see radical change happening.

          We are all so very powerful. Not just some people, with $$ and “position.” EVERYONE is powerful.

  18. So do I ans so does Olga Runciman but she is the only psychologist in Denmark who actually specialises in working with it. How many others, world wide, are there who do? Considering the need surely there could be a place for a course, some formalised training? Runciman is a peer, so her understanding is personal, but she’s also a trained psychologist. I don’t know if that’s necessary but a set of guidelines might be necessary to make sure there isn’t chaos in the therapist as well as the therapee.

    • That’s what I do, this is the work I’ve been doing with people for 12 years now, and counting. I’ve helped several people make radical shifts in consciousness, which changed their self-perception in a positive way, as well as their entire outlook on and navigation of life.

      I come from family dysfunction, lots of emotional neglect, invalidation, shaming, and gaslighting–extreme pressure to be “a certain way,” to play the game, like everyone else. Which, of course, is not me, I did not fit into their box, so even though I did well in school and seemed to have a “normal” life as a teenager–I was quite sociable–I felt really bad about myself, very anxious all the time, so I thought something was wrong with me.

      And then I went through the mental health system, which added insult to injury (as well as injury to injury, like pouring acid on a wound). That was years later, after this all started, being diagnosed and drugged. I worked and went to school, lived a normal life while on psych drugs, until they turned on me and made me very sick and disabled. I had not realized they were eroding my system, and after 20 years of this, my system crashed and thus began my dark night of the soul.

      Coming out of all that, releasing psych drugs, crawling out of second-class citizenship and systemic stigma took exactly a radical shift in consciousness. I not only wanted to heal, I also did not want this to ever happen again. I had to learn how to protect myself from a toxic society, in a way that I could still feel free to be and to create as I desire. I was not about to isolate myself from the world, that is no solution.

      I discovered many things about myself which I could shift, and that changed my entire reality and personal world. It was vital, first, to feel good about myself, and people don’t make that so easy in our society, all sorts of name-calling occurred toward me, as I grew into myself with new confidence. I had to ignore that and continue to heal the negative inner voices, so that when these messages came at me from the outside, I’d have the perspective that it is more about the one trying to shame and marginalize, and not about me.

      That was when I started feeling relief, and felt more comfortable being in the world again, protected by my own grounding, personal power, free will, and perspective, while moving forward with a new mind–one that was kind to me, rather than denigrating. For that, I had to heal the heart wounds this all created for me.

      In the end, it was my heart which needed healing, and my own inner voice I had to change. Thank God for neuroplasticity. We are not stuck with what was dished out to us as children. We have the power to change at any time, and grow ourselves up.


    Here’s the text: http://docs.house.gov/billsthisweek/20161128/CPRT-114-HPRT-RU00-SAHR34.pdf

    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.”


  20. About opposing Murphy. First of all, thanks to Oldhead for keeping us updated.

    Part of the problem, as strongly evidenced here on MIA, THERE IS NO ANTI-PSYCHIATRY MOVEMENT!

    There is though a Therapy, Recovery, and Healing Movement, and this is the problem, because under the cover of this all manner of child abuse, psychiatry, and oppression have free reign.

    Back when Laing and Cooper were writing, this was not a problem, as Therapy and Recovery were not the government sponsored, politically neutral, evangelical aligned religion which they are today.

    So the first thing is that whatever is done, there must be zero support, not one word, for Therapy, Recovery, and Healing.

    Then I suppose outlawing forced procedures, maybe outlawing giving drugs to children, or maybe outlawing all psych drugs, will be the agenda.

    But then, it is imperative that we make it clear that any forced procedures will be opposed by ANY MEANS NECESSARY.

    One of the reasons that psychiatry is able to prey on people is because they don’t resist. Since they don’t resist, the eugenic arguments come into play, saying that these people must be somehow defective, and so the treatments must be necessary. What this is about is the creation of an untouchable cast, in order to maintain work force discipline.

    So we must make it clear, Any Means Necessary, and we must be ready to deliver.

    Then, we must show people the truth, all this Mental Illness, Autism, ADHD, Eating Disorders thing is, is child abuse. A child is ‘othered’, so they come to believe that they have something wrong with them. So if the parent is not driving the kid to the doctor, they will eventually seek one on their own.

    And we have seen people post here about how their son needs to be on meds or they would have to live in the homeless shelter. This starts with parent v child conflict, and so we have to start holding the parents 100% financially accountable. Make the parent(s) live in the homeless shelter.

    This creation of an untouchable basket case caste starts with familial child abuse. We must show this.