Blogging With ISPS-US

This is the fourth article in the NY times “Lives Restored” section by Benedict Carey. This is a link to the article by Ben Carey.

In it, he profiles Mr. Milton Greek and his journey from sensitive, passionate and eccentric to delusional and psychotic… and how he returned to being his sensitive, passionate and slightly eccentric self again.

Here are some excerpts:

“When I began to see the delusions in the context of things that were happening in my real life, they finally made some sense,” Mr. Greek said. “And understanding the story of my psychosis helped me see what I needed to stay well.”

I really like how Mr. Greek is able to use a variety of methods to treat the psychotic symptoms while retaining an appreciation of the feelings, beliefs and dreams that became distorted in the symptoms.

Mr. Greek’s regimen combines meditation, work and drug treatment with occasional visits to a therapist and a steady diet of charitable acts. Some of these are meant to improve the community; others are for co-workers and friends, especially those dealing with a psychiatric diagnosis.

And, of course, he talks about the impact of childhood trauma as contributing to his psychosis.

To help others experiencing psychotic delusions, he relies on his own theory of what delusions may mean. In an analysis of 20 delusional experiences, all described by sufferers in the first person, Mr. Greek identifies four story lines.

Among them are the rescuer (on a mission to save a particular group); the self-loathing person (lost in a sense of extreme worthlessness); the visionary (on a journey to spiritual realms to bring back truth); and the messianic (out to transform the world through miracles, or contact with deities) — the last of which is his own psychosis story.

Each, in Mr. Greek’s reading, grows out of a specific fear or trauma, whether isolation, abuse or family dysfunction, in the same way his own delusional story symbolized a fear of being a social reject.

He interviews ISPS-US Member Paris Williams as well:

“By exploring a person’s anomalous beliefs and experiences, we are better able to understand the underlying feeling and needs that give fuel to these experiences,” said Paris Williams, a psychologist who has struggled with psychosis and recently published a doctoral dissertation analyzing the content of six people’s delusions, which has informed Mr. Greek’s work.

For instance, said Dr. Williams, who is working on a book called “Rethinking Madness,” “we can find ways to make them feel safe when they believe they are being persecuted by malevolent forces, or find ways to help them feel empowered when they experience demanding voices.”

By the way, there is a word for this phenomenon of listening to people and putting their current distress in the context of their past experiences while helping them to feel safe in the present moment: It’s called    PSYCHODYNAMIC THERAPY!!!

Jessica Arenella

People commented on the great convivial mood of the group, the openness and enthusiasm, and generally wanted more time in future programs for workshops so they could get to share their ideas even more. There were many graduate students and young professionals who were very happy to have discovered us, who said they learned approaches that had never been mentioned in their training, and who volunteered to help us get the word out. I also learned from Richard Bentall that he and John Read (the editor of the ISPS journal Psychosis) were among the 13 experts who gave the push-back to the EPPIC research project that would have medicated those in their “early psychosis syndrome” protocol. “We are singing from the same hymnal,” he told me. In short, it was a magnificent meeting in a great setting. My only regret is that I didn’t get a chance to buy some of those gorgeous nectarines at the farmer’s market right outside the conference center. A-LS – p.s.-this was my first time blogging; it seems habit-forming. Thanks, Jessica, for your help!

Thanks everyone for participating online and at the conference in San Francisco. A special shout out goes to Ann-Louise Silver for her prodigious blogging during the conference. It’s been another great conference, spending time with good people and learning lots from everyone. Tomorrow… long plane ride home… back to the work again.

Jessica Arenella

This clear but very packed presentation rested on a strong philosophic foundation, drawing from both Western and Eastern traditions. He is preparing a book, on the factors that led to recovery in six patients who had struggled with chronic psychosis. I believe this will be a very valuable resource, based on Dr. Williams’ clear thinking.

This talk focussed on finding an alternative to the Madness vs. Normal split. We need to maintain a continuum view, where the spiritual experience spans a continuum from helpful or “spiritual” to definitely problematic.

Ann-Louise is giving a rousing talk on the perils of the proposed DSM 5 diagnosis of Early Psychosis Syndrome. She notes some of the motivation for this new diagnosis, including not just the expansion of the pharmaceutical industry, but also the ongoing fear of violence (especially gun violence) by individuals in a psychotic state. But, as Noel Hunter noted on her presentation yesterday, people with PTSD are more likely to engage in violence than people diagnosed with schizophrenia. Nonetheless,  the stigma against people with schizophrenia continues to dominate the culture. In some respect, I think that the fear of the other and discomfort with transgression is will always make it difficult for people with psychosis to be accepted,  but that doesn’t mean that stigma and domination is inevitable.

Ann-Louise also points out that teens are prone to unusual thoughts, perceptions, unstable emotions, as well as schizoid behavior that is often transient. Screening for EPP in adolescents is like fishing in an aquarium.

I’m typing this on the phone, so please forgive any spelling/grammar errors, or more likely, strange and embarrassing word substitutions due to an overzealous spellchecker.
Jessica Arenella

This intensive and devoted work with a distant and deeply angry young woman led to a very informative discussion–the sort of experience that goes way beyond summarizing.

They presented two classic presentations of devoted analytic therapy. Both addressed early trauma, working with the patient to bring the trauma into the world of the symbolic. They reminded us that Harry Stack Sullivan said that the moment of madness creates the moment for hope and reintegration.

1) you MUST establish a group study group
2) you need to find common ground between what you are interested in and what the institution wants from you.
3) Learn from your patients!
4) Learn what your local government provides and what local services are – the businesses that are friendly to mental health work. Build a team.
5) Don’t be a hero.
6) Get professional support – form a peer supervision group.