Understanding Psychological Disorders: My Personal and Professional Journey


In early adulthood, I believed that the source of psychological disorders was conflict and trauma. However, that view changed when I became a caseworker at my state’s Department of Social Services in Adult Protective Services.  In that position, my job was to assist people who were unable to meet their basic needs and had no one willing and able to help them.  I assisted my clients with obtaining housing, medical care, income, and mental health services and provided financial management.  Most of my clients needed help because of severe mental illness.

I started the job in the early 1980s, monitoring people recently released from mental health facilities as part of the move to deinstitutionalize the mentally ill. Psychotropic medication and caseworker services had made it possible for most of these people to live in the community.  My clients were always prescribed these medications but often went off them.  There would be a re-hospitalization and a reinstatement of medication, which I could see had a profound and positive effect on these clients.   I saw people with severe delusions (such as believing people were walking through the walls or that snakes were entering their body) stabilize and become much more clearheaded.

This type of experience led me to believe that at least some severe psychological disorders were biological in nature. I concluded that since the medication provided a marked improvement in such people, their disorders must have a biological cause.  In addition, it was hard for me to imagine that emotion from trauma would impact the brain to such a degree that not only would a person see people coming through the wall, but also strongly believe that they were real.

However, a conflict in my personal life not only made it possible for me to imagine, but also gave me many new insights about what can exacerbate a mental health disorder—and what can help heal it.

Hostility, Confusion, and Alienation

The conflict started when I rejected the romantic advances of a male member of a group of friends (I’ll call him Bill). This wasn’t done through open, direct conversation, where both parties make their viewpoints and positions clear, but rather spoken through what I’ll call “references.” He would speak of his thoughts, feelings, and viewpoints about a scene in a movie or a friend’s relationship problem but make it clear that he was actually referring to issues concerning me.  If I attempted to have an open conversation, he would play dumb.

In response to the rejection, Bill alternated between acts of hostility/revenge and continued pursuit. For example, when angry, he would try different insults, clearly looking for a point of sensitivity.  If I wasn’t bothered by the insult, he would frown. But if he found a sensitivity, he’d continuously attack me. At other times, he would express an expectation that we would have a relationship.  I was initially sympathetic to his feelings of rejection and drawn in by his vulnerability.  I was concerned for him.

Although I knew Bill was moody and in therapy, he seemed like a thoughtful, sensitive person— not someone who would abuse anyone.  Had I known what I do now about psychological disorders, I would have realized by his behavior that he was potentially dangerous. But at the time, I didn’t understand the seriousness of the situation.

From the beginning, the emotions he directed toward me were extreme, unlike anything I had ever seen. More than in what he said, I could see the emotion in his eyes and hear it in his voice. His hostility didn’t make sense to me because it wasn’t over my rejection of a relationship we already had, but of starting one in the first place.  In addition, he was well aware that I wasn’t available; I was in a good marriage and not one to have affairs.

Besides underestimating the danger, I was in, I failed to recognize how my confusion over Bill’s erratic and intense behavior could affect me psychologically.  Since I couldn’t end contact with him without dropping out of the group, I thought I would give the conflict time to blow over.  My expectation was that if it became a serious problem, I would simply leave our friend group.

But his acts of revenge had an unexpected impact, further entangling me.  His hostile acts were left unexplained.  What discussion there was, was in references.  What was said in the references was frequently open to interpretation.  Sometimes, it was unclear whether his comment was a reference to the conflict, or unrelated.  This ambiguity made my head spin. One offensive action was just piled onto others as the conflict remained unresolved; as they built up, so did my emotions.  Simply leaving becomes difficult when there are both unresolved issues and significant emotions connected to them.

There were other issues I hadn’t anticipated, such as how Bill would involve mutual friends in the conflict, spreading his negative narrative about me and then requesting secrecy from them. I also didn’t anticipate how multiple mutual friends would follow his lead, attacking me directly and spreading his narrative while simultaneously not admitting that anything was wrong or informing me what he had told them.

Eventually, his emotion became so intense, I felt my life was in danger.  Enough emotional stress had built up in me that by this point it became difficult to get a clear picture of anything.  Threatening, hurtful, maddening behavior of unknown origin mixed with denial is a damaging cocktail. The hurtful behavior creates emotional upset, the unknown origin prevents closure, and it all creates a vicious cycle that diminishes clarity of thought and memory.  The denial prevents resolution or even an outlet to express one’s viewpoint and vent all of these emotions.

My focus now turned to how to safely walk away completely from this man. I decided on a strategy to calm him by not challenging him on anything and speaking favorably about him without actually accepting an advance.  That tactic gradually calmed him, but he remained angry. I never knew what to expect, and his further vengeful acts left me very angry.  All my effort was directed at calming him and all his effort was directed at upsetting me.  Bill was now feeling better but I was feeling worse. He seemed to feel he had gotten his revenge.  I felt that if there were a safe time to leave, this was it, and I ended our friendship.

However, I still didn’t understand the reasons behind everything that had taken place. There is always a slim hope for some resolution or closure while you’re still in a relationship, but that ends when you leave.  And it was after I left that I was hit the hardest with all the emotion that had built up inside me.

In addition, I continued to have problems with our mutual friends.  Any attempt at a conversation with anyone in the know met with the friend playing dumb.  Also, it became obvious that anything I’d said to any individual member was later shared with the whole group. However, anything Bill or a member of the group said about me was kept secret from me.

Untangling the Mess

This may seem like a pretty weird situation, but I don’t think it’s all that rare. In my work, I saw abusive behavior of many types conducted in secrecy, mainly sexual abuse.  I’ve seen denial not just from the perpetrators, but throughout the families involved. I once read an article by a survivor of child abuse who said that the worst thing his father did wasn’t breaking his bones—it was denying he’d done anything at all.

It would be nice to just be able to forget my problems with Bill and our friend circle and move on to other things.  Many argue that whether or not you know what drove a behavior and the thinking behind it, you should be able to let go of it once that person is no longer in your life.  That may be true of something minor, such as if someone once insulted you, but a conflict of a more serious and long-lasting nature is an entirely different matter.

The brain doesn’t ask whether you want to concern yourself with wondering What was that about? or whether you want to stew in all of the intense emotion you felt during these incidents.  If it did, I’m sure anyone would say NO.  I certainly would have.

Unfortunately, when people experience conflict and/or behavior that we wouldn’t expect and we can’t incorporate it into what we understand about human behavior, the brain typically just sits on the emotion and we become mentally stuck in the emotional state generated by the negative experience.  And it’s more than just the emotion generated by the events that is trapped inside us. It’s our very identity: who we are, the emotions we feel toward others, our perceptions of relationships and our role in them.

Now, all of the emotion I felt –whether it was about the situation with Bill and our friends or anything else— became ridiculously intense.  Staying trapped in a high level of emotional upset takes its toll.  In the beginning, I could remember who I was prior to what happened.  Over time, I no longer could. I could physically feel the strain of the conflict on my nervous system.  It felt as if my brain were floating in a toxic fluid.

As I said previously, I had believed psychological disorders categorized as psychoses were due to a chemical imbalance.  But recognizing the high level of stress that trapped intense emotion puts on the brain, it now makes perfect sense to me that people can develop delusions and/or auditory and visual hallucinations based on stress alone. Studies have found such symptoms occurring when people are deprived of sleep, for example.

That is what seemed to be happening to me. I was constantly battling paranoid thoughts.  I didn’t sleep much; I was in such a chronically agitated state, I was surprised I slept at all.  My moods shifted from one intense feeling to another. By this point, my psychological problem had become too severe for me to continue to look for ways to cope with it.  I needed to find a way to reduce its intensity before I could get back to being myself.

I started out very determined that there had to be a way out of this mess.  I noticed early on that whenever I was able to bring some positive feelings to the surface, I felt a corresponding reduction in the intensity of my negative emotions such as anger, hurt, and fear. So I actively tried to do so, but it isn’t as easy as it may sound.  The psychological problem I’d developed caused my thoughts and perceptions to turn much more negative.

For one thing, I felt like a drain on others, of less worth. When you’re mentally healthy, it’s relatively easy to have good relationships.  But a severe psychological disorder comes with the inability to feel connected to others, as well as irritability, mood swings, impulsivity, and so on.  Also, the problem I was having resulted in criticism and attacks from many around me.  People didn’t understand why I had this problem, saw symptoms that were out of my control as being in my control, and had an opinion about what I should do about it.  My failure to follow others’ recommendations led to the withdrawal of their support and more criticism.  In short, I struggled not only with the disorder but also others’ reactions to it.

Still, I was determined to find a way out of the mess I was in.

I began to notice that the intensity of my emotions went down after some buried emotion came to the surface. Some see mood swings as just an abnormality, but I saw mine as a positive thing: the mind’s way of surfacing and releasing emotions.  Barring any resolution of the conflict that created the emotion in the first place or closure on the confusing elements of that conflict, I think this process must be how the brain heals itself.

During this period, I was hesitant to take psychotropic medication because I understood that it wasn’t a cure, just a tool for symptom control.  My thought was that if the medication would control the mood swings, but my mood swings were actually serving to reduce the severity of my disorder, then the medication could actually keep my disorder in a stagnant state instead of helping it to improve over time. Without improvement, I was in an unlivable situation.

Unfortunately, I can’t say I found an easy solution.  It has taken several decades for me to heal psychologically from this experience, but I did reach a complete resolution of my symptoms rather than merely symptom management.

Lessons Learned

Based on my experience, I gained three insights.

The first is that emotion from trauma can have an extreme impact on the brain. I don’t believe even the most extreme delusions indicate a physical abnormality.  While I was battling my psychological disorder, I would try to explain to people that although psychological disorders are not the result of a biological abnormality, they are also not usually preventable nor quickly remedied.  The response I often heard was that a long-term disorder must be biologically based or due to a person’s choice to ruminate over the past.  Some people would say that if my problem wasn’t biological, then there was no excuse for it.  I would argue that the psychological problems people experience are their brain’s normal response when severe emotional upset is mixed with confusion, and that people don’t choose to place themselves in the many situations where this occurs.

One might say, “Well, that may have been true for you, but that doesn’t mean it’s universally so.”  But I spent my 30-year career working with people suffering from mental health issues.   Although everyone’s psychological disorder will manifest itself differently because everyone’s experience is different, there’s much that is universal.   Even among these differences, there are common clusters of symptoms, which in turn produce similar feelings.  The DSM simply takes these clusters and puts labels on them.  However, I disagree with calling a cluster of symptoms a disease.

So I’m encouraged that there are people challenging what has been promoted as known truth: that psychological disorders are (at least in part) caused by a genetic defect or a biological abnormality resulting in a chemical imbalance in the brain.   Of course, biological brain diseases do exist. But the vast majority of people experiencing psychological problems are not suffering from them.

The second lesson is a confirmation of my belief in what causes people to develop intense drives.  Being driven to do something is not necessarily a bad thing.  Sometimes people are able to direct their drives toward positive goals.  For instance, an obsessive interest in science may result in important breakthroughs.  But there are also people with very harmful drives that hurt themselves or others.

Drives are very clearly tied to suppressed emotion, not just in their presence but in their strength. When I felt ridiculously extreme emotions, I also felt ridiculously extreme drives that I wouldn’t want to give in to. In particular, I felt a drive to re-engage in problematic relationships.  I can see that drives can be of such high intensity that is hard to prevent them from affecting behavior. My drive gradually diminished as I released my “stuck” emotions until it was gone.

Third, and most importantly, I learned how much of an impact my stuck emotions had not only on my perceptions but also on how strongly I believed those perceptions.  I found that my perceptions were more farfetched when my emotions weren’t yet processed.  For example, I would feel that conversations I overheard in a restaurant were references to my personal conflict.  I would believe that the diners speaking had an association with my friend group and were speaking on their behalf.  I knew that this was unlikely, but my mind kept going back to it.  I realized that my thoughts were undoubtedly untrue, but at the same time, it was quite hard for me not to believe them.

It’s not a good feeling not to be able to trust your own perceptions, and it’s very problematic to believe and follow inaccurate ones. I didn’t want to do that.  So when I perceived something in a way that brought up a lot of emotion, I would wait for the emotion to subside and think about when I’d felt that way before.  Invariably, I would remember that I had felt that way all the time during the conflict that had triggered my mental health problem.

This is just a hypothesis, but I believe another way the brain releases emotion (other than shifting between emotions in a mood swing) is to alter one’s perception in such a way as to surface emotions that need to be released.  For example, people often repeat the same conflicts in different relationships.  I believe this is because people believe in their perceptions, act on them, and thereby create a conflict similar to one they have experienced before.

Ultimately, my recognition of the way a psychological disorder affects perception— making it less accurate but more intense—allowed me to understand the confusing personal conflict I’d had.  Several years after I had ended my relationship with Bill and a year after dropping out of the friend group entirely, I received a call from a woman in the group looking to resolve the matter.  During that conversation, she said she understood that I had had feelings for Bill prior to his pursuit.  One day I thought about that conversation, and realized: What if a person strongly believes a perception is actually true—even if it is not— and continually believes it to be so in spite of any evidence or statements to the contrary?  How might one act?

Then every piece of the puzzle fell into place.   I hadn’t realized that Bill had been telling people that I was coming on to him before he began pursuing me. If I had, I would have thought he was lying to gain support.  But now I realize that someone can very passionately believe in their gut that something is occurring that isn’t.  I knew this to be the case with people in psychosis, but until then I hadn’t recognized that it also occurred in people generally living in reality. And that when people passionately believe what they’re saying, others believe them.

I also saw that, as with destructive drives, the greater the amount of suppressed emotion within a person, the stronger their belief in a distorted perception will be. And similarly, with the release of the suppressed emotion, the distorted belief will disappear.  Obviously, many personal and societal problems can develop from false perceptions; combine them with extreme drives, particularly anger, and it’s a recipe for trouble.

Today, I believe that an increased understanding of the nature of psychological disorders will lead to better treatments.  Dangerous traps could be prevented with such knowledge. People could be provided better support that would put them on the path to healing over time.

My experience has been that helping others to understand their own symptoms as well as helping them to unravel others’ behavior does seem to be healing.  And it’s driven home to me how important it is to recognize that when you speak to someone with a mental health problem, remember that they are most likely a person who has a legitimate problem that they couldn’t have prevented, not someone with a physical disease that precludes their recovery.


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


  1. I wonder why you repeatedly called your own normal and expected adaptive response “disordered” while never once calling “Bill’s” abusive, manipulative and gaslighting behavior “disordered”. You went to some trouble even to suggest that he was living in consensus reality while never exploring the way men, and especially abusive men, are so often assisted in their abuse by their associates. You didn’t explore any of the power imbalances inherent to your relationship, either.

    It disturbs me when people who have been victimized portray their own responses as the disordered behavior but not the behaviors of their abusers and the abusers comrades in at least the same way.

    People who have been victimized like this are not disordered, they are expressing adaptive threat responses because of the brain’s remarkable ability to rewire itself in response to hostile environments. You, my dear, may well have been quite distressed, but you were never the disordered individual in this situation. The ability to develop increasingly reactive responses to continued threats is exactly the mechanism that helps us escape such situations. We are wired to survive predators like the “Bill’s” of the world.

    Well done. But I do hope you will eventually #dropthedisorder.

    As for the DSM, clusters of behaviors are not “symptoms” with any meaningful result. This gaslighting needs to stop for doctors to practice actual medicine for those who are sick and for psychologists to see their clients in a light other than “mentally ill”. Given all I’ve survived in 42 years, “Titanium Woman” is as apt a ‘diagnosis’ for me as anything in the DSM. A lot of diagnosed people decide not to have children but I’m glad I reproduced because toughness and grit and inner fortitude are what I’m made of and the world needs more of us, not less.

    Disordered… pfft!

    • It’s always the victims who are called “disordered”, or “mentally ill”. Then it’s like the abusive treatment just continues. Nobody wants to admit that bad treatment can affect a person mentally. NAMI formed so that parents could defend themselves against accusations of abuse. Now it’s all “nobody is responsible for anything, it’s all just a brain illness”. Nobody wants to hold the abusive people responsible for what they do. Men are supposed to be able to do whatever they want to do. They aren’t held accountable for abuse.

  2. Those are great points, KindredSpirit.

    I took Christine’s story in a different light; as portraying the idea that enough interpersonal stress can drive anyone “crazy.” Meaning so overwhelmed by negative emotion that it becomes difficult to think straight or function. I’m not a fan of the word “disorder,” either, but it does help us distinguish such a state from our usual baseline. Perhaps “injury” would be a better term!

    I got a certain catharsis from this story, because it made me recall abusive or confusing relationships I was in in the past that led to severe anxiety, mood swings, and even physical health issues. At the time (surprise, surprise) I blamed myself for being “neurotic,” rather than recognizing the distress as the warning it was. Now I realize someone drove me to that state, which improved once they were out of my life.

    • “ portraying the idea that enough interpersonal stress can drive anyone “crazy.” Meaning so overwhelmed by negative emotion that it becomes difficult to think straight or function.”

      Fair enough. I totally identify with “crazy” by that definition.

      I did resonate with the experience of being part a harmful friend group who participated in vilifying me while supporting my abuser. That probably has something to do with how strongly I felt reading this.

      Maybe I’ll get to catharsis some day but mostly I feel outrage and pain that nothing seems to change and these dynamics just repeat themselves with a regular fresh influx of victims who often end up psychiatrized as a result.

      Mental injury as a concept has potential and I like the implication of healing that injury suggests rather than disease or disorder which tend to imply a chronic or permanent state.

  3. Hi Christine.
    I think you wrote a very fine article and expressed yourself clearly.

    It made me think of how psychiatry wants to own every word and use it to try and prop up their ill house of repute. 🙂
    Sometimes we are led to believe that some folks are not resilient enough or they are “predisposed” to being brought down or into confusion.
    BUT, no one even knows if this is a fact and it’s one of those statements that psych uses to try and have their “genetics” chatter mean something.

    Anyone can be squished, beaten up and suffer. Anyone.
    No genetics needed.
    Are some folks more sensitive? Yes. And so what. Should we then alter those genes so that during abuse, and being a slave or raped or whatever won’t squash someone?
    And if my body cannot bear hard work day in day out, if my body gets so sore and tired as opposed to someone that endures without sweat or pain, is my body ill or disordered?

    So that we can tolerate any and every oppression? Well that would be perfect then. There could be a bunch of willing robots who just let happen whatever happens without any reaction or “overreaction”.

    And so, I am glad to hear that you were at an age and maturity where you could see that seeking help would give you grief. Psych would have continued the oppression and control that you were trying to get out of, that IS their job, to continue what one is already dealing with. And even a lot of “therapies” are really just platitudes which is not what someone like you was needing or seeking.

    I love Kindred’s responses to you too.

  4. Though this prose was a bit dense for me, I can see that there is value in this story and this experience.

    What is frustrating for me is to see how difficult it was for Christine to understand what was going on with “Bill” and with her based only on the theories of “modern” psychology. She was so inclined to give Bill the benefit of the doubt, when what was really needed was a recognition of how insane he was acting and a very firm handling that would put as much distance as possible between him and her.

    Though I am in no position to diagnose, Bill’s behaviors, as portrayed here, were typical of an anti-social personality. Such people are extremely dangerous! There is zero expectation that such an individual will behave or react as “normal” people do. One of the great failures of “modern” psychology is to downplay to the point of utter ignorance the destructive role such personalities play in life.

    You see this, of course, as “stress” in personal relationships, but also in the areas of finance, politics, education, business and religion. Living in constant poverty is a form of stress. Living under a dictatorship is a form of stress. So would be war, of course. Living with a punitive school system is a form of stress. Living under the constant barrage of propaganda from the corporate world is a form of stress. And living in a fanatical religious culture is also a form of stress. What is common to all these problems that cause so many critics to call them “systemic?” The anti-social personality. You get rid of that person’s influence in a group and you get peace, calm, relative sanity.

    A truly modern psychology would recognize this, as well as understand the mind as an energetic structure rather than a biological structure and the personality as a spiritual construct and not just a mental construct. Until psychology (and psychiatry) is willing to advance in these directions, it is much safer to just walk away from it and take up horticulture of solar power or some other subject less warped by the broken understandings of broken beings.

    • It seems like a lot of times guys who rape women or who attack them don’t respond normally. You try to talk your way out of the situation, trying to get them to stop, but they just keep on going. They won’t react to emotional things normally. Sometimes it is surprising how much they just disregard what you are saying, and they just keep going.

  5. Thank you so much for writing this, Christine. As I was reading about Bill’s abusive behavior, it gave me hope that it will be possible for me to synopsize my own story, of very similar abuse.

    “Bill’s” behavior was very similar to the behavior of my former pastor – who ultimately had me misdiagnosed and drugged, based upon his own odd delusions, according to my medical records. I’d say “Bill,” and my former pastor, are both psychopaths.

    And I agree with others here, who say such abusers are the problem. As opposed to those of us who were gaslighted by an insane psychopath, then neurotoxic poisoned, by “mental health professionals,” who deny such abuse happens.

    I did finally have to leave that pastor’s church, but over 200 people also left that church the same year – according to friends, due to that pastor’s subsequent odd behavior. And that pastor has now had three major exoduses from his church, according to trend reports.

    I did also need to leave my former religion all together, due to their systemic “partnership” with the DSM “bible” believers. Since I’m not a believer in the DSM “bible,” and believe the Holy Bible has a great deal more wisdom to be found within it, than the psychiatrists’ “invalid” “bible.”

    Again, thanks for sharing your story.

  6. Thank you for sharing your story and the important insights which you gained from this experience which led to your healing. This is an awakening.

    I feel as you do, that this is more common than not. Healing from gaslighting and narcissistic abuse is the order of the day, and it’s a complex healing to unravel systemic lying, many layers of “reality” become vague and corrupt in this dynamic. This needs to be brought to light and disentangled, as you so skillfully have done, in order to relieve the extreme stress that builds up from chronic confusion, disorientation and paranoia. New truths can then reveal themselves through newfound clarity, a much, much better feeling.

    I believe this is where social transformation will occur, with this particular healing. The issue is rampant. Brilliant work, kudos!

  7. About the author’s experience, I like the term, “injury” better, also. Sometimes, another term, “damage” or “damaged” works, too. “Disorder” is a deleterious term that is falsely used by psychiatry. “Disorder” is the mess after a hurricane or tornado blows through town. “Disorder” is the mess on my desk, etc. When we apply “disorder” to humans, we just cause “pain” to roll around and roll around until a natural reaction to any kind of abuse or stress becomes a life-threatening illness in actuality. I hold no criticism for the author for using the term, “disorder” as it is well-used term in America, but over-used. In fact, so over-used, it is becoming “trivial.” That could be helpful, for as we begin to bring out how psychiatry, etc. contributes to making people diseased, rather than being helping to end “disease,” we could wipe out the word “disorder” in these illegitimate situations. I should add two points. One is that not only does psychiatry bring about “disease” rather than healing “disease” it would be impossible for psychiatry to heal something which doesn’t exist. I am not saying we are never sad or angry or confused or grieving or etc. It is just psychiatry, etc. has made a fortune out of “diagnosing” normal reaction to various life events and calling them abnormal and in need of drugs, therapies, and treatments. The fact that the author did seek “therapy” for this distressing events has probably saved her life. Finally, back to the terms, “injury” and “damage” , I think that are the term usually with the word “brain” prefixing that most of use in one or another to describe the horrible effects these drugs and therapies, etc. had on our brains. I also think it is a way to describe our adaptation to our lives after these drugs, etc. that doesn’t lessen us any more as humans that psychiatry, etc. already has. Psychiatry, etc. is a dirty and smutty business. It is nothing less than the rape of the brain and mind. Thank you.

  8. I agree with the very first response from KS.. Good old Bill was enabled and supported by a group of accolytes, so called friends of the victim the main error I see was hanging around for a year waiting for it all to nicely play out in a civilised fashion these things never do…and leave a legacy of deep hurt and damage.
    . I am intrigued as to your husband’s response which is not mentioned, to this clearly unacceptable situation. I would have no qualms or regrets in this situation of letting my dog off the leash!. I also feel your deep hurt and disappointment at your bullying at the hands of your “friends” contributed to your subsequent situation you must have felt incredibly unsafe and unsupported in the world at that point with nowhere to turn. I am glad this is now behind you but pity whichever victims Bill turned his attention to next as he was a toxic and serial abuser of women in a friend circle that thought that was acceptable.