The Transformative Potential of Psychosis

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The idea that “madness” can be transformative and a catalyst for growth may seem absurd in the dominant biomedical-psychiatric paradigm which favours the language of pathology. Yet theorists such as R.D. Laing and John Weir Perry viewed psychosis as a crisis that has potential transformative value—as not only a meaningful and understandable response to life circumstances, but as a purposeful process that can disrupt and heal dysfunctional aspects of the self—given the right support.

As a researcher with lived experience of psychosis, I wanted to understand how the meaning-making process impacts the potential for positive transformation and growth, post-psychotic break. In other words, how do the narratives available to us, the way our distress is framed, whether we are allowed to find meaning in intense experiences dismissed as a misfiring brain, impact the outcomes of psychotic crisis?

Psychosis can be a terrifying and disabling condition, and by no means do I wish to romanticize this state. Yet, for some, myself included, the “psychosis” (or what some prefer to call “extreme distress,” “spiritual emergency,” or “altered state”) became a catalyst for greater connection to self, others, and a sense of purpose.

A painterly illustration of a woman's eye with a butterfly in the pupilSuch narratives are often written off as delusional or wishful thinking in favour of describing and monetizing psychosis as a burden on society; a path to chronic and disabling disease. Those with lived experience are deemed by psychiatry as “lacking insight” into their condition, echoing the paternalistic and discriminatory history of psychiatric treatment that is still used to justify human rights violations and coercive care. Yet psychiatry itself operates on a dangerous lack of insight, treating psychosis primarily with harsh medications despite no consistent evidence that psychosis is pathological.

By ignoring diverse conceptualizations of psychosis, we reduce hope and agency in those forced to accept a bleak diagnosis, and we obstruct the improvement of services.

To challenge mainstream assumptions about psychosis and understand how this state can be transformative for some, I conducted in-depth interviews with five people who experienced positive transformation and growth after psychosis: Megan from Canada, Darryl from the UK, Sofie from Denmark, Alke from the Netherlands, and Hannah from Finland.

The Harm of Removing Meaning from Madness

For most participants, the psychiatric care they received was coercive and harmful, and impeded their right to make sense of their experiences and make decisions about their own treatment. Being told their psychotic states, often deeply meaningful and spiritual, were merely symptoms of illness in need of suppressing often exacerbated the very distress being treated and hindered the opportunity for growth.

Sofie lives in Finland where she has been involved with peer support and advocated for more compassionate mental health services such as Open Dialogue. She works, parents, and studies holistic healing modalities. She believes coercive care “stole years” from her life, and experienced traumatic hospitalisations in Finland that included being handcuffed by police, forced into medical restraints, given forced injections, and placed in isolation cells.

She believes the trauma of the first hospitalisation at age 17 was so severe she went on to have ten subsequent episodes, saying “it took me six years and six hospitalisations to work through that trauma.” Besides experiencing harmful interventions, Sofie spoke about the impact of not being allowed to talk about her psychosis:

“It was so bad, you don’t get to talk about, I mean you should be able to talk about it, but it was like shut up we don’t want to encourage any hallucinations. Or then if you show too much emotion, they threaten you with injections, or they inject you, and then they put you in isolation. I completely every time broke down. I think that’s the worst torture you can do to a person when they’re completely disorientated and psychotic, you put them in isolation for eight hours.”

Hannah had similar experiences in Denmark of not being allowed to talk about her psychosis, or what she refers to as “altered states,” in early psychosis intervention family groups. “Either the subject was changed, or it was made very clear that us talking about our psychosis was not helpful.”

Originally from Denmark, Hannah currently lives in the UK. She writes poetry, facilitates Hearing Voices groups and trainings, works as a public speaker, and has published a book that beautifully illustrates her relationship with voices and altered states.

Hannah experienced “altered states of mind” for as long as she can remember, saying “what was distressing was not so much the altered states of mind as the awareness that I got that other people didn’t understand, so that was where the distress started, the sense of loneliness and the alienation.” Her sense of alienation contributed to emotional overwhelm and suicidal ideation, and these overwhelming states, not the “psychosis,” was what she sought help for. But she was often turned away by services until she revealed she heard voices. Treatment then became about fixing the voice hearing rather than addressing the suicidal ideation, and services told Hannah’s mother once the voices were silenced, “everything would be better.”

This narrative didn’t make any sense to Hannah, as the more she tried to suppress the voices, the angrier and more frightening they became. Hannah needed her own “wisdom to be recognised” and to “be given choice about what made sense.”

The Importance of Meaning-Making and Community Understanding

All participants described aspects of their psychosis as personally meaningful. Finding a community where they could openly share and formulate meaning in their experiences, without fear of coercive care or having their experiences written off as delusional, led to greater self-understanding and wellbeing.

Darryl lives in England and constantly takes courses and educates himself about mental health recovery, saying “you’re probably not going to learn and develop from any situation unless you have a little bit of belief and hope that things can get better.” Darryl doesn’t discount the biomedical model but found treatment in the NHS overly reductive and reliant on medication.

Through researching the correlation between psychosis and adverse childhood events, Darryl realized his psychosis was likely a response to severe bullying during his formative years, which led to a damaged sense of self. This insight led to greater self-compassion and a roadmap for working through issues around confidence and trust. He also found meaning in his experiences of psychosis through connecting with peers and by setting up a mental health blog with friends, including creating anthologies of poetry, artwork, and recovery resources.

Sofie was raised with a scientific upbringing and initially accepted her diagnosis of schizophrenia. She still finds “some truth in how psychiatry views it,” but also found value in alternative healing modalities, and now interprets what she went through as a “shamanic initiation crisis.” This framework provided Sofie with deeper self-understanding, a feeling of having control over her life, and the agency to “build [her] own happiness.” Shamanism helped her heal from traumatic and violent hospitalizations while addressing the spiritual layers to her wellbeing, which are frequently ignored.

Megan is currently writing a book to help others going through psycho-spiritual crisis or extreme states; a tool of navigation she feels would have helped her during the 17 years she spent in an “expanded state of consciousness.” She kept her altered states largely hidden due to negative encounters with medical professionals in Canada, until she began connecting with online communities that “had personal experience with different ways of being, seeing and knowing.”

For Megan, “reassurance” and knowing “you’re not going crazy, you’re not alone” were vital aspects of her healing process. Framing altered states of consciousness as fitting within the normal and valued spectrum of human experience helped Megan cope and grow from her distress. Finding people who “could meet you exactly where you’re at and just sit with you as it is for you” helped her feel like she could “breathe for the first time,” and was more beneficial than the medical system which surrounded her with “fear and scepticism.”

In the mental health system, there isn’t always time, resources, or a philosophy that enables an approach of holding space or sitting with someone through their discomfort. Rather, patients are dragged forward with harsh interventions, and in the process lose the ability to consent to, make sense of, and navigate their experiences in a way that is relevant and meaningful to them.

Psychosis as Purposeful Process

Participants rejected the claim that their experiences were only symptoms of illness disconnected from the web of their life circumstances and worldview. As they researched other frameworks for conceptualising distress, they began to understand psychosis as a type of “purposeful process” for working through trauma, enhancing insight and consciousness, undergoing a spiritual awakening, or even as a valued state of being. This conceptual shift allowed transformation and growth to occur, including a re-evaluation of selfhood, purpose, and worldview.

While Megan uses psychiatric medication and acknowledges the challenges extreme states can entail, and her fear of entering that state again in an uncontrolled way, she rejects the diagnosis of schizophrenia and feels there was a “purposeful process” taking place that needed to reach completion:

“I could see that processes were taking place with the dismantling, there was a purposeful process that was going on… it’s so important that when this ego dismantling process starts we… respect what’s going on, and we give space for it and support, because I can see, wow, the psyche is so masterfully putting things back together in way, you know with limited abilities, our mind is very limited, even our hearts are limited to the extent that psyche was just reorganising everything spontaneously.”

Megan and Sofie both spoke about their ego dissolving in altered states. They viewed the ego as a rigid identity structure that inhibited greater connection with others and their authentic self. While the lack of differentiation between self and the wider world could be terrifying and problematic, the disintegration of self-limiting beliefs and patterns provided an opportunity for a transformed sense of self.

Sofie shared that for the past five or six years she hasn’t been on medication, is working, and feels the psychosis and schizoaffective disorder are “a thing of the past.” While some might view this as wishful thinking, a key shift for Sofie is being able to think about her “trauma memory” without being triggered into another psychotic episode, as had always occurred in the past. She described her psychosis as “trying to solve something”—her psyche healed itself once she was allowed to complete the process in the altered state, in a supported way, and confront, express, and resolve her trauma so she could move forwards in life. She believes a person should:

“be allowed to go through a psychosis without it being interrupted, and have somebody support you through it and it can be a healing crisis, it can be that something in your psyche heals itself and you become stronger. And I think that’s where Western medicine fails, because if you treat it the right way, psychosis doesn’t become chronic. Schizophrenia is psychosis when it becomes chronic and it’s totally unnecessary that it would be chronic if you treat it the right way.”

Participants felt the psychotic content revealed useful insights or a path out of crisis, despite hallucinations and delusions being treated as meaningless symptoms in need of quashing.  Sofie believes the fear brought up in psychosis can be so intense that the mind identifies with a “hero on a holy mission to conquer the dark forces, because that’s what you’re doing within your psyche, and you need something to block the fear.” This heightened, metaphorical narrative could be a protective strategy, helping the psyche overcome the fear and confusion and process what it needs to.

From the Netherlands, Alke is completing her PhD on the topic of psychosis while raising children and working as a lecturer in social work. Alke experienced a post-partum psychosis and was hospitalised shortly after the birth of her daughter. While she experienced support in the Netherlands’ mental health system, staff told her there was no meaning in her psychosis.

Alke feels that despite the intense fear, the psychotic content was a spiritual or psychological process occurring on a metaphorical level that needed to reach completion: “you can feel like you are in a labyrinth in psychosis, and it is not nice, but it is transforming you, and all the monsters are essentially there to help you in this transformation.”

Hannah considers her altered states to be more than transient processes, they are an integral and continuous part of what she values about herself and how she experiences life. After discontinuing her medication, she recovered her altered states. “I was like oh my god I’ve missed this, that was the initial response, oh I’ve so missed this sense of… I don’t know how to describe it, it’s life, other dimensions other levels to life.”

Hannah used to feel resentful and scared of her voices and visions before she learned how to work with them, benefiting from the Hearing Voices Movement, which views voice-hearing and other anomalous experiences as meaningful and existing within the spectrum of normal human experience. Now she describes her altered states as life-affirming as they are “rich and deep,” something she wouldn’t want to live without. She still struggles with societal pressure to suppress these states, yet it’s in these experiences that “being alive makes sense” to her, “it’s not in all this doing. It’s in feeling connected to something more than the superficial busyness of life.” While her experiences have been painful, there is a vast spectrum that includes beauty, creativity, and joy.

Whether participants felt their psychosis or altered states were a “purposeful process” or a valid way of being in the world, these perspectives allowed them to perceive value in their experiences, which was inextricably linked with how they valued themselves.

The Potential for Growth and Transformation

While negative changes occurred such as difficulties securing employment, struggles with cognitive challenges, and moments of despair, participants asserted the psychotic process also deepened their capacity to love and have compassion for self, others, and nature; fostered a greater alignment with authentic self and purpose; and had the potential to benefit the wider community.

Alke was raised in a religious home where she was taught to “love everyone,” but said it was still common to look down on certain people. After her psychosis, “it changes from selective love, from exclusive love to an inclusive love towards everyone—this universal love for everyone and everything.” She admits this shift could be a result of motherhood and not necessarily psychosis, but considers it likely due to the intense “transformation” within herself: “all systems of meaning can change through psychosis. And belief systems can come to an end, and new systems start and can begin.”

Megan’s altered states helped her become kinder. She sometimes feels a “divine grace” between herself and strangers, and can intentionally shift into an altered state to feel this deep level of connection and “grace” with another person. The difference between her 17-year state of psychosis and now is that she can “shift into other ways of seeing, but it’s not presented to [her] continually without choice.” The choice to oscillate between these “different ways of being” de-escalates the fear and trauma of losing control. While she recognizes she will always be at risk of becoming “stuck” in these states, she views her increased capacity to love and feel “divine grace” to be an immense value.

Megan says her altered states also led to “an improvement in wholeness” which she defines as “balance and connection to nature, soul, self, and others.” Megan adds, “in those states, that was for me the sanest I’ve ever been. I was seeing more of reality not less.” Megan acknowledges the paradox of this statement, as altered states can make day-to-day functioning incredibly difficult. Yet our culture focuses heavily on the limitations, so Megan feels we must acknowledge how these states can enrich our sense of self and understanding of consciousness.

In addition to experiencing the “intense love that you have, that your system has for yourself,” during her psychosis, Sofie believes the experience helped her gain a sense of purpose and greater authenticity. She shared that her first psychotic break at age 17 has “taken me on a path which has led me to find the things that are really me, and find the things I really want to do.” Emerging from difficulties strengthened her sense of self and “it’s a valuable experience to have for helping other people.”

Minimal attention is given to how neurodivergence and altered states may benefit society. Our limited understanding of altered states of consciousness and propensity to pathologize the abnormal is potentially disrupting opportunities for growth and insight that could not only be of value to the individual but to their wider communities.

Creativity is a gift Hannah shares with her community through poetry, art, and public speaking. Her altered states are “extremely creative,” and she views this enhanced creativity as “one of the gifts that is not being appreciated at all.”

Hannah has written and spoken publicly about the possibility that anomalous experiences don’t only reflect individual struggles, they can provide insights into the wider culture, as these states reflect: “something that either the person or the context they’re in have lost touch with. Whether it’s trauma or whether it’s cultural denial, whether it’s emotional disconnect. People who do get into altered states of mind seem to be connected into things that we are likely either individually or collectively suppressing.” For example, she has very “powerful” and “relational” interactions with nature, and can sense the land grieving the impacts of colonization, resource extraction, and human interference:

“Painful stuff is never individual, it may be part of an individual journey, but it’s likely to also be part of greater issues that the individual could never tackle on their own. And we all miss out when we don’t see, when we don’t face that issue or that complexity or that pain.”

As Hannah suggests, perhaps the wider community benefits when we value and incorporate diverse ways of knowing, sensing, and experiencing the world, the ones deemed abnormal and deviant in our cultural context and responded to with coercive and traumatizing treatment.

Part of Darryl’s healing process was “going on to help other people,” based on the wisdom he’s gleaned from being unwell. Darryl acknowledges he was out of touch with reality in that he had a dark worldview and harsh internal criticism. He says, “if I had continued meeting unpleasant people who were knocking me down all the time, then I quite possibly would continue having more and more psychotic episodes.” A pivotal shift for him was meeting others who’ve “been in a similar position” and developing “more trusting relationships over the years” that fostered self-compassion and a less distorted sense of self.

While he volunteers his time helping others and updating his mental health blog, Darryl explained the bind he is in: wanting to find paid employment and a meaningful career, but if he works over 16 hours per week he will lose his benefits, and there’s no guarantee he could regain them if he became unwell. This risk “prevents me from moving forwards” until there’s a more compassionate government in place that provides “grace of support for people to gain employment” without putting their health and financial wellbeing in jeopardy.

Darryl raises an important insight: that growth after psychosis is contingent on social support systems and economic circumstances.

While altered states can be a catalyst for growth and transformation, psychosis can also be devastating for individuals and their social networks—particularly in a society that misunderstands and mistreats the condition. The aim of this work is not to place additional expectations of recovery and growth on people who are suffering, but to question our current biomedical paradigm and the myths it propagates about chronicity, illness, and symptoms devoid of meaning, while ignoring the broader context of people’s lives and cultures. We must challenge narratives of what it means to be “mad,” “psychotic,” and “sane,” and shift from paternalistic treatment to care that values the insights and agency of those it claims to support.

As Sofie found alternative therapies to process her trauma, as Hannah accepts her way of experiencing the world through public speaking and poetry, as Alke marches onwards with her PhD, as Darryl helps others with his insight and compassion, as Megan writes her book so others don’t feel afraid and alone—those of us deemed mad take up space and refuse to disappear or submit to the idea that our way of being and making sense of our lives is a delusion to be cured. For if psychosis is indeed transformative, do we not have an obligation to support the potential growth available in this misunderstood and deeply human process?

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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.

30 COMMENTS

  1. This is an interesting topic, but I still think it important to be clear that one is not promoting the concept of ~Mental Illness~, as that is still routinely being used to delegitimate people. Usually it is directed at racial minorities and the poor. Right now CA Governor Gavin Newsom and State Senator Susan Eggman are pushing through legislation which allows for internment and forced treatment of the homeless.

    Joshua

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  2. Thanks Robyn for your work on this! I’m someone who had something like “psychosis” but was lucky enough to escape psychiatric intervention – it was essentially a crisis in meaning, but I always feared it being seen as meaningless or just an illness, when it was about everything that is most essential!

    These days I also use another description, that of a “revolution within the mind” as I did in this talk “Revolution Within the Mind: A Common Factor in Psychedelic Experience, Madness, and Spiritual Awakening” https://www.youtube.com/watch?v=BS29nRGaWys

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    • Would you also say that for someone experiencing one of these “revolutions within the mind”, that the worst think they could do with that is discuss it with a state licensed psychotherapist, social worker, or behavioral therapist?

      Joshua

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      • I would say that you need to be very careful who u speak to re these matters. It’s that very real, potentially tragic, thing of who you trust with yr deepest, most vulnerable, most precious parts of yrself. If you present them to someone who will listen to u from that DSM, symptom identification, let’s-medicate-this-out-of-existence perspective, chances r you’ll lose yr life for the rest of yr life.

        This happens. It didn’t happen in my case but only because I lucked out and did my own research and knew abt Jung and Campbell and other bits and pieces from psychology and anthropology that made sense to me so I cld use them to put all the little bits and pieces of me back together again. But that took decades.

        Good luck. Ask other people who u trust what worked for them, who they trusted to help them.

        **And yes, meds can be useful and essential at crisis moments to help you through and stabilise you but you need to be aware of potential adverse impacts and the possibility of addiction/withdrawal.

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      • Joshua, I am concerned less about what the “state” licenses as many states will license almost anything, than what each individual gives their power to; rather keep it themselves or leave it in the hands of God; the latter being the religious alternative. It is a matter of not giving power away to someone who may not deserve it or should have it. Thank you.

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        • If you discuss your private affairs with a therapist, you are giving them power over you. And you should not do this. And the reason that this is happening is that we allow our government to license them. We don’t let them license fortune tellers, channelers, or faith healers. We should not let them license therapists either.

          Joshua

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      • Hi Joshua,

        I agree with you that it can often or most often be dangerous to talk to the mental health professionals who are licensed to provide “help.” But they do vary: I am myself a state licensed mental health professional, and I work help people make sense of what is going on and to work things out rather than try to suppress everything. There are others like me here and there.

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  3. Thank you so much for this beautifully written piece. It makes my heart sing to know that there are so many others who’ve navigated their way through these experiences and, in many cases, out of the mental health system.

    And yes, it’s a very great good to be offering the world alternative ways of dealing with this aspect of our humanity. Ideally, no one will ever end up misdiagnosed, medicated, dehumanised by a system which continues to do such extreme harm, all in the guise of helping.

    Thank you, again.

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  4. This is fabulous, Robyn. Thank you. From an email to friends earlier today on this subject …

    As to my own transformative psychosis, my counsellor & I talk about my manic self offsetting somewhat the constrictions of my regular self. That whole Fuck You, I’m Amazing thing that I do when I’m psychotic is a maladaptive attempt to overcome the obsequious little milquetoast that I grew up to be.

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  5. Diaphanous Weeping, I always cry at Disney Cartoons especially when the Prince awakens Aurora from her sleep. There are many cultures who do value Psychosis as a spiritual thing reserved for priests, priestess, and shamans, etc. In many ways, it is impossible to engage in creative work without tapping into psychosis. And of course, there are the psychadelic drugs that people take to get to psychosis. Then, for some running and like activities can lead to psychosis. Also, in religious services, psychosis can occur. All of these do lead to some sort of “altered states” as one of the participants described as her experience. Maybe what we really need to do is acknowledge that “altered states” or “psychosis” is as normal as apple pie. And perhaps rethink the use of drugs to suppress it. I am not going to speak against those who choose drugs, as it is a personal choice. But, for many, drugs are not a good choice as to their suppression and possible synthetic factors. So what we really need to do is accept and acknowledge the uniqueness that allows some, for whatever reason, so predispose to “altered states” or a different way of looking at the world have every right to live their world as they so choose. The world will be a richer place. Thank you.

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    • Have they made a Disney Noah’s Ark cartoon?

      The Hoover Dam explosion comes first and after that I keep hearing of “The walls of Jerico”. So I believe that a city will crumple from strategic noise weapons or just shouting.

      After that debacle at some stage comes an enormous sea flood.

      I predict a sudden global huge flood and I tell everyone to go live on higher land, where feasible. If this really does come true then it won’t be a surprise and therefore it will buy everyone enough time to react with instant cleverness. When such floods occur it is the commotion of other dithering sight seers that slows reaction. A wave is not going to be crystal blue surf water but is more like a mountain boulder landslide because of the maelstrom of debris and cars and street furniture, all churning like a giant foodmixer. Find tall trees to bind to if needed. I dont feel it will be any time soon. It may take a decade. It will be meteors that cause it. But we will survive it, we just have to know what to do if say at the time of it we are sitting in a dentist’s chair, or singing lunchbreak karaoke in a birthday treat, or trying on prussian blue boots in a shoe store cubicle. A wave sucks out then bashes back in. Neither will be slow enough for planning what to do in that surreal moment. Keeping phones dry and charger dry is an idea. A backpack with sources of water and food and a heatstroke scarf, that sort of thing. People find salvation in pocket fluff. Enough fluff to kindle a fire. A regime is rising and they will want to say the flood is a punishment from a wrathful God. It will be tricky in that crisis to tell the millions of bereft that it was not a meteoric thump delivered by a punitive God but just a random natural disaster from space. Like Jupiter had, five impacts. The people who will lose loved ones will blame whoever seems most sinful for angering their God. Being blamed by the grief stricken makes the blamed into second class citizens. This division is useful to the regime.

      I could say more but I have to rest now. Take time out. But do click on my name to reach prior comments in a similar light, if you want to.

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  6. Thank you so much for putting in words something that I’ve felt for a long time. I witnessed my brother get medicated to death because of his struggles with psychosis. I felt like no one was ever patient enough or willing to hear what he had to say when he would ramble.

    I have been more fortunate and managed only to be arrested but never hospitalized during a psychotic break. I’m just very uplifted to know that someone else has similar feelings about the spirituality that exists in people’s crazy.

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  7. There are some grains of truth in this article, and it’s certainly worth exploring the concept of “post-traumatic growth.” I would just hesitate to glorify or romanticize bona fide psychosis, which the author seems to define quite broadly as opposed to the traditional clinical characterization of hallucinations, delusions, and extreme psychological distress.

    I think rather than encourage folks to embrace psychosis, it’d be helpful to delineate the various clusters of symptoms people experience more distinctly. For instance, depersonalization, derealization, disassociation, and “shamanic awakenings” are not the same as clinical psychosis. Hypomania and mixed mood states are not psychosis. Most people with psychosis do not experience “expansive feelings of love,” that’s likely something else akin to hypomania. This article conflates a lot of anecdotes that do not align with traditional concepts of psychosis. Although the author has a point that most of these experiences are medicated in the same way.

    We can appreciate neurodivergence and the diversity of human psychological experiences without promoting psychosis. I just fear that this article borders on the latter without drawing important distinctions. Your perspective is certainly valuable and worth developing further, so I’m grateful you published this piece.

    Most people who experience acute psychosis want and need relief, and you’re correct that Western medical interventions for them are crude and sometimes deleterious. Hospitalizations rarely lead to post-traumatic growth. But the general purpose of this step is to protect the patient’s life and/or the safety of others.

    The most important point you make has to do with the support and resources that patients receive during and after a psychotic episode. This is what has potential to transform someone’s mental health trajectory. Not the psychosis itself. In general, we don’t want or need vulnerable people to go through psychotic episodes. I would dispute any arguments that psychosis is necessary for someone to heal and recover from severe mental illness. But this seems to be a commonly held belief.

    I’m glad there’s a disclaimer at the end of the article, but your statement that there is no consistent evidence of psychosis being pathological is blatantly false. Psychotic episodes have been consistently linked to suicidal ideation and attempts. The suffering associated with real psychosis has been well-documented for over a century from case studies to high-level RCT’s and meta-analyses. The handful of anecdotes you mention are interesting, but again, the literature on this topic is robust. Just be careful making seemingly factual statements about the scientific literature to support your thesis. There’s no doubt that psychotic episodes are a form of psychopathology.

    Perhaps there’s a need for an expanded framework addressing “altered consciousness” as you mention, which includes psychosis, but also much more. Rather than walking the fine line between exploring and normalizing psychotic episodes (which I see as a risky endeavor), I might focus more on the process of “post-traumatic growth” and the specific salutogenic influences that would help patients recover from and prevent future episodes.

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    • No-one i know, myself included, who has been through the experiences described by the author, would ever ‘glorify or romanticize’ what they’ve been through. It’s not something i’d wish upon my worst enemy … oh, ok, maybe her.

      But regardless, the point which has been made, i think very well, as opposed to containing ‘some grains of truth’, is that these experiences are often MISdiagnosed as ‘traditional concepts of psychosis’ by professionals who’ve been ill-educated and misinformed and who do far more harm than good in this area.

      Experiences such as these are not for the faint-hearted, and given the opportunity to choose, no, i certainly wld never have consented to this happening in/to my life. But often the ‘extreme psychological distress’ which is often part of these experiences – it’s definitely not all joy and light and ‘expansive feelings of love’, dammit – pale in comparison to the consequences of being misdiagnosed and medicated and ‘cared for’ by the mental health system.

      For many people who are ‘helped’ in this way, who have to fight their way out of the system which has so badly treated them, where any ‘post-traumatic growth’ thereby caused is hard fought for and hard won, it’s safer to educate yourself, do your own research and thereby protect yrself from professionals who truly do not ‘get’ this and possibly never will.

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    • Emceejc, At the end of your post, you use the word, “salutogenic.” I looked that word up. The gist of the meaning, as I read it, is that it seeks to concentrate on the wholistic health of the individual rather than just the disease or disease model. With all due respect, that is not what I read when I read your post. From what I have read on this site and even my own experience, there are about as many experiences of psychosis as there are individuals who experience it. In my opinion, it would seem there is validity in all experiences. I would also say there are cultural and societal determinants in psychosis. Additionally, there is the belief of the person who experiences the psychosis as to whether it might be a negative or a positive event. It is in the experience of each person and their relating of that experience, if we are willing to truly listen that we learn something. However, sadly, when I read your post and in my opinion, there is more a glorification to a disease or medical model of psychosis and of all of mental health. This keeps most people sick, rather than assist them to wellness. I am betting on a world that accentuates the positive of almost any experience rather than the negative and even in the most traumatic experiences, what one can glean from them to make their lives happier and healthier. Thank you.

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    • During my drug withdrawal induced super sensitivity manic psychosis, I did experience “expansive feelings of love.” Just like my favorite painter, Marc Chagall, I’ve got a love story within my dreams. It was an amazingly serendipitous experience, implying a connectivity and love story with all, within the “collective unconscious,” or dream world.

      But I will admit that “psychosis” created via anticholinergic toxidrome – with the antidepressants and/or antipsychotics – is a disgusting experience.

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    • Hi there,

      Thank you for your thoughtful comment… lots of interesting points to address! I’m certainly not aiming to glorify or romanticize psychosis or “promote” psychosis–my own experience of psychosis was horrible and I never want to have another episode. I don’t think talking about the way people make sense of their experiences and grow from them is going to encourage people to enter a psychosis, nor do I think people can wake up one day and decide to have a psychotic break.

      Your point about conflating psychosis with other experiences such as hypomania and mixed mood states is an important one. Yet, the people in my research study had all been diagnosed with psychosis and/or schizophrenia by psychiatrists, so if conflation is happening, it is occurring within the psychiatric system. Altered states, voices and anomalous experiences are pathologized, feared, and medicalised when they don’t always need to be. It’s also dangerous to think that we can neatly categorize these experiences into their own separate boxes.

      As to psychosis being pathological, as far as I know, we have yet to discover a biomarker that proves psychosis is a brain disease. If there are articles you can suggest that demonstrate clear and consistent evidence that psychosis is caused by some kind of pathogen or structural brain anomaly, I would appreciate knowing about such studies. Lots of people experience suicidal ideation for non-pathological reasons–oppression, social injustice, poverty, trauma, etc. Just because people suffer in psychosis doesn’t mean the cause is biological or that it needs to be medicalized–much research points towards social determinants.

      I think the post-traumatic growth model is definitely valuable. But it’s not the only model that people can benefit from. It’s vital that we listen to people’s lived experience, insights and perspectives on what they have gone through and what it means to them. Ignoring these insights and labelling them as delusional only increases distress and doesn’t make the psychosis disappear. There are many people who might benefit from the biomedical narrative to explain their distress. But many others are harmed by that narrative, and it does not address the wider context of their lives or provide them with the tools and understanding they need. I certainly do not believe that people need to have a psychotic episode to heal. I chose to focus on how psychosis can be a catalyst for transformation because it is a narrative that is too often silenced. It is certainly not meant to be a one-size-fits-all model or approach–we need to move away from those. My objective is to give voice to people’s diverse experiences and to understand what has helped them, so that we can create services that are growth-oriented, culturally relevant and consensual.

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      • Beautifully answered. Thank you. It’s rare to find such clarity of thought and expression in this arena. And it’s that clarity and solidity in ourselves of what we’ve come to know without a shadow of a doubt re the misdiagnosing and medicating of these states which gives me hope that the tide is turning. Enjoy yr day.

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  8. I totally agree, what is called “psychosis,” can actually function as a transformative experience.

    But I don’t actually agree with those who believe in “psychosis,” since I know their belief system is scientifically “invalid.”

    http://psychrights.org/2013/130429NIMHTransformingDiagnosis.htm

    Thanks, Robyn, for pointing out the invalidity of the “psychosis” theology.

    Let’s hope and pray more people choose to stand against defaming people with the made-up DSM “mental illnesses.”

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  9. I like most of what you say here but I am offended by this sentence, ” and shift from paternalistic treatment to care that values the insights and agency of those it claims to support”. To say that we have a paternalistic treatment system is deeply offensive to all fathers. Symptom based treatment yes, but why do you specifically mention father? You might equally describe the current system as maternalistic treatment because mother is more likely to be the one who administers calpol, rather have the time to talk. Perhaps “treatment as usual” might have been a more appropriate description of the current system of care.

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  10. A lot of the issue comes from the lack of provision of a safe space and time frame in a non medical setting to experience bursts of creativity labeled as psychosis. These experiences described in the above article are obviously beneficial to the overall progress of the person human experience. If we, instead of stifling the instance of any “unreasonable” behavior and just allowed the individual space to create, the label would be less likely invoked and less fear would be attached to the definition. Medication should never be used as a bandaid but should be used in conjunction with spiritual awareness and overall health. Simply having the freedom to express and create, be honest and open about the experience and unconditional support from those that understand you would have an impact world wide.

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  11. Incredibly insightful piece of research that articulates the voices of individuals with lived experiences of psychosis. Of course, nobody would wish Psychosis on anyone but the ability to connect with the deeper meaning of the experience alongside the individual meaning has huge healing power to some. It further supports the need to move away from the psychiatric model that seems more like hearding sheep or cattle in a non- individualised fashion.
    As an individual that shunned psychiatry following Psychosis alongside multiple other attempts to pathologise, I feel this type of research is very much needed so that people know it okay to have different beliefs and emotions about the experience. I have no problem with either an illness or healing approach so long as an individual is given the appropriate support to decide which offers most meaning to them, rather than beliefs being labelled as right or wrong, black or white and used to support manifestation of potential more serious mental illness if different to mainstream psychiatry.. A human rights centered approach would allow multiple perspectives.

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  12. What an insightful and well written article. I left Scotland in 1968 and 1978 I had my own transformative episode. However I viewed this as Psychosis produced by over active transformative process or the psychological equivalent of a cytokine storm rather than Psychosis as a Transformative process. Slightly different viewpoint. Anyway the Psychosis was over in 1978 but the transformation at a less deep level goes on.

    I see you are also a film maker. After my wife died I found this standup comedian Shelley. She is my girlfriend. During the pandemic lock-down she recruited me to play Mr Smartly in her sketch comedy The Smartlys which you can view on Plex TV.

    I am available if you wish more details of my transformation/psychosis.

    ML Eric

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