Working in the Orthodox Jewish Community: An Interview with Leah Rokeach, LCSW

This month I spoke with Leah Rokeach, LCSW a social worker in Brooklyn who works primarily with the Orthodox Jewish community. Leah is a long-time member of ISPS and holds the position of Secretary for the United States chapter. She is also highly active in our Membership Committee and with the Hearing Voices Network in New York City.

Tell me a little about yourself

I was brought up in Montreal, Canada. My father was an Orthodox (Chasidic)  Rabbi. I went to public school, because in those years in Montreal there were no Jewish religious schools for girls. I had a difficult time integrating both worlds, my religious background and the secular education.  However this laid the foundation for  being able to integrate the two worlds as I grew up and continued my secular education.

I am married to an Orthodox Rabbi from New York, who also had a secular education, graduated from college. He is an active Rabbi of a synagogue in Brooklyn, great writer of Talmudic topics, and very scholarly. I have a BA from Queens College and an MSW from Yeshiva University, Wurzweiler School of Social Work. I have my LCSW.

From 1985, close to twenty five years,I was the Assistant Director of the Adult Mental Health Services Program at Ohel Children’s Home and Family Services. This is a very large Social Work Agency in Brooklyn that provides services to the Orthodox Communities. It was during those years that my interest and passion for helping individuals with psychosis developed very strongly.  In 2009 I retired from Ohel, and decided that it was time for me to open my own private practice and pursue my passion for helping individuals with psychosis in that setting.

In my spare time I love the New York Philharmonic and try to get to Lincoln center whenever I have a chance. I am an exercise fan and go to the gym three to four times a week. I have three children who are married and have a few grandchildren whom I enjoy spending time with. My son is an attorney and a  partner of a prestigious law firm in New York City.

How did you first become interested in psychosis?

It is very interesting, I became interested in psychosis before I went to college and graduate school. After I married, my husband was a pulpit rabbi in a small town in PA. We settled there so he can also finish his college education at the nearby city which had a university. In my role as a Rabbi’s wife, I met many people and tried to help, did volunteer work, and “good deeds.”  I met a couple who had a 29 year old daughter diagnosed with “schizophrenia.” This young woman isolated herself, stayed home all the time, didn’t go anywhere, just looked out of a window, smoked cigarettes or slept. I took a liking to her and started to visit her. She only travelled with parents to a psychiatrist every 8 weeks. Of course he  gave a very poor prognosis.

At first, she totally ignored me, but I just couldn’t give up on her. I knew, what everyone knows, that connection with others is critical in life. One day, after about four months of visiting, she agreed to go for a walk to the park with me.  We developed a routine for going on a walk three to four times a week.  I knew she needed more to get her out of the house and into life, but I didn’t know how to do it.  The family seemed to give up on her, having the assumption that that this is her life and nothing will ever change.

This young woman, loved to paint and draw, but didn’t pick up a brush or pencil for 10 years. She had started college and hoped to to graduate with a BA in Fine Arts and to continue her education further along. However, her dreams were shattered when she developed psychosis in her first year at college. I did some research and discovered an arts instructor, half an hour away, in another town. It took a while to convince her parents and convince her, to just meet the instructor, who was very welcoming and warm. After their meeting, this young woman showed an interest in restarting  painting instruction, for the first time in 10 years. By the time my husband and I moved away, this young woman and her parents became more hopeful. They eventually moved to a larger city, where their daughter was given the opportunity to move on with her life.

This young woman made an impact in my life, paving the road to begin my professional career as a social worker.

What challenges do you think are specific to the Orthodox Jewish community?

The challenges are: fear of stigma, marginalization of persons with psychosis, and, most important, which is very specific to the Jewish Orthodox community, fear of not being able to marry off their children because of the stigma.  Marriage and raising a family is central to the Jewish Orthodox culture.     Psychosis possess a challenge to marriage and raising a family, because of the stigma,and other fears. However, the Jewish Orthodox community has become  more open. There are many Jewish Orthodox mental health professionals specializing in all aspects of mental health, many outpatient clinics serving the Orthodox community, and now many professional weekend trainings that start on Sundays to accommodate the Jewish Orthodox professionals. There is also now a new  OnTrack New York for Jewish Orthodox clients. But it still has not minimized the fear of stigma when it comes to marriage and raising a family!

For myself, the challenge as a Jewish Orthodox clinician is to always be mindful and careful of ensuring that I never say anything that might be contrary to my client’s religious life style. If I find myself in a position that is contrary to my Orthodox believes, I consult with a Rabbi who is a Torah authority. If my client has or brings up issues that I find questionable from a religious point of view, I will also consult with Rabbinic Authority. Most of my clients approve and give me their permission to do so.

What advice do you have for Orthodox people with psychosis and their family members?

Everything that I  learned since I joined ISPS-US, joined Hearing Voices NYC, all the many trainings I took, has been helpful for my professional growth, to understand better and to educate others, especially family members. I educate them about psychosis, instill hope of recovery and of finding the quality of life which they aspire to, even marriage. I share with them my experience of helping a few  couples, with various mental health issues, including psychosis, get married. I share with them stories, books, videos of individuals who recovered and moved on with their life. I share with them the research, information about how the effect of trauma and adverse experiences in someone’s life can develop into the symptom of psychosis. I gave a few  presentations to a group called Family and Friends for Mental Health that meets every months on various topic such as The Hearing Voices Network,  negative symptoms,  and living with voices.  I recently showed the film Healing Voices which was very well attended. I am planning to show the videos of the Family Plenary from the ISPS-US Portland  conference and the Expert by Experience videos.

However, in the Jewish Orthodox community there is still a strong belief in the medical model. Medication is most important to them. They always look for the “best ” psychiatrist who prescribe “best medications.”

How did you hear about ISPS and what made you want to join? 

In 2011 I met Brian Koehler at a Nefesh conference.  This is an organization of Jewish Orthodox mental health professionals. It has a large membership from all over the country, Europe and Israel. Brian gave a presentation which I attended, and at the end of his presentation I had some questions for him. I also remember telling him that I started my private practice in 2009 and felt I needed to know more about treating psychosis, not only use the Psychiatric Rehabilitation approach. He told me about ISPS, about their mission, and I decided to join. It was one of the best professional decision I have made.  Through ISPS-US I was introduces to the Hearing Voices Network, met Ron Coleman, and took a few trainings with him including “How to Start a Hearing Voices Group.”

I took the CBT for Psychosis training with Yulia Landa, took ACT and Compassion Focused training for Psychosis., and I recently took a course on EMDR and how it can be used for psychosis. My focus is to have knowledge and understanding of various psychological approaches that I can use to help people who are diagnosed with psychosis. My consultant is an ISPS-US member and we meet on a regular basis.

Can you tell us about your Hearing Voices groups?

I am very excited about the groups I co-facilitate. The Hearing Voices group for Orthodox men has been meeting regularly for the past two years twice a month. It also includes individuals who are experiencing unusual or extreme states of consciousness or beliefs. It is not a very large group, we have about five  regulars and another four or more individuals who don’t come on a regular basis. This group is non-judgmental, people are free to talk about their experience in any way they choose. There is also a group for Orthodox women, but it has not started officially yet, due to difficulties in finding space and time.  As of now, the plan is to start the group on Monday March 5th at 7pm to 8;00pm and we will meet  every second Monday.

What resources (books, websites, etc) do you find most helpful for learning more about psychosis?

There are so many books, articles websites that I use and continue to use.   Some of the first books that  I started to read was Bertram  Karon’s  Psychotherapy of Schizophrenia which I still reread; Psychosis as a Personal Crisis, edited by Marius Romme and Sandra Escher has been especially helpful  in starting my development to look at psychosis not from an illness or disease perspective, especially in regard to voice hearing.

Another important book that helped me  shift my thinking and understanding psychosis was Unshrinking Psychosis by John Watkins.

Other books include: Cognitive Therapy of Schizophrenia by David G. Kingdom and Douglas Turkington, Paul Chadwiwick’s  book Person-Based Therapy for Distressing Psychosis, Treating Psychosis by Douglas Turkington and other authors.

In terms of websites: Intervoice: The Hearing Voices Network, Dr. Rufus May, Ron Unger, and The Institute for Open Dialogue.

There are many more books and articles, too many to mention, that have been and continues to be very helpful in developing my competence as a therapist   helping people with psychosis.

Thank you for taking the time to speak with us, Leah! 

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New Online Hearing Voices Group For Families



From Hearing Voices USA: Since beginning in December 2016, our Online Hearing Voices Network groups have grown into powerful virtual communities of support.  We often receive emails from the family members of voice-hearers asking if they can observe meetings to get some insight into the experience of voice-hearing , how to cope or make meaning of it and the values of HVN.  While this is not something we can accommodate in the Monday group, it has inspired us to schedule an Online Forum specific for family.

This Online Forum will give family members the opportunity to ask questions of individuals who hear voices, see visions or navigate other alternate realities (who also have extensive experience supporting others with extreme states of mind or consciousness).  Participants are welcome to submit questions in advance.

WHO:   Family members of voice-hearers

WHEN: Wednesday, February 7th from 8:00PM-9:30PM Eastern Time

HOW:  Zoom teleconference platform (one click access from computer and option to download Zoom app onto SmartPhone)

For access code please email

More info at


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Videos from the November ISPS-US Conference

We had a great conference this past November in Portland Oregon!  In case you missed it, below are some links to a few of the presentations that got recorded and released onto YouTube.

You might want to start with the keynote presentation, “Sick or Gifted? Bridging the Connection Between Mental Health Issues and Spirituality” by Gogo Ekhaya Esima:

Here are the other presentations:

Developing and Implementing Radical Peer Support in Specialized Early Psychosis Programs, with Nev Jones, PhD & Sascha DuBrul, MSW

The EASA Model of Coordinated Specialty Care for Early Psychosis: Shared Experience Informing Recovery with Ryan Melton, PhD, LPC, ACS, Nybelle Caruso, Natalie Cohrs, Michael Haines & Michelle Roberts

Experts by Experience Plenary, a variety of personal stories and reflections, with
Casadi “Khaki” Marino, PhD, LCSW, Michael Haines, Denise Maratos, EdM & Jennifer Hanley, DNP

Families: A Vital Link to Recovery, with Pat Wright, MEd, Cynthia Rubin Brown, PsyD, MFT, Georgia Case, Anne Marie DiGiacomo, LCSW & Jason Jones

Intentional Intersectionality in Early Psychosis Program Development, with Melissa D. Weise, MSW, LICSW & Julie R. Bermant, RN, MSN, APRN

That’s only some of the cool stuff you can find on our YouTube channel!  We encourage you to subscribe to that channel, so you never miss the new videos that get posted there.

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From “Recovery” to “Transformation and Recovery”

Going mad involves breaking away from, or losing touch with, group norms and ideas about reality. This routinely leads many to even extreme levels of distress and disability, so I am among those who continue to think that promoting whatever might help people “recover” from this distress and disability is vitally important.

That’s why I get involved in projects like producing the the webinar,

that happened on 12/12/17. In this webinar, Paul Grant and Ellen Inverso present approaches they have researched and developed that can often help even severely “institutionalized” people return to an active “sane” life. If only more professionals could learn and practice these methods, we’d have many fewer people permanently disconnected from productive lives, or permanently alienated from society.

But is being productive and connected to the group norms of our society really the highest goal we should be talking about?

Continue reading

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Interview with Dr. Sally E. Riggs, CBT for Psychosis Practitioner

This month I interviewed Dr. Sally E. Riggs, clinical psychologist, practitioner of Cognitive Behavioral Therapy for Psychosis (CBTp) and the founder and director of NYC CBTp.

Tell me about yourself

Hi my name is Dr. Sally Riggs, I am a licensed clinical psychologist, trained in the UK, practicing in the US for the last 9 years. I am passionate about helping people with psychosis gain access to effective, evidence based psychotherapy. In 2015 I founded NYC CBTp, a group practice in New York City dedicated solely to CBT for psychosis. We have 3 therapists on staff in two different locations, and also train other mental health professionals in NYC and all over the country in CBT for psychosis. When I’m not working with people with psychosis you will usually find me somewhere in the 5 boroughs training for marathons.

What exactly is Cognitive Behavioral Therapy for Psychosis? How does it work?

The central theory to CBT is that it isn’t the situations or adverse life events that cause difficult emotions, its our appraisals or interpretations of these life events.  In the case of CBT for psychosis it means helping someone to understand and make sense of the experiences that they are having and the different meanings they attach to them, ultimately with the goal of lessening distress and helping them achieve their life goals. CBTp takes a normalizing approach to understanding psychosis. Experiences and beliefs commonly regarded as symptoms of psychosis are believed to be often highly understandable reactions to adverse life events rather than indications of the presence of an illness or disease.

When did you first hear about it and how did you learn how to do it?

I think I probably first heard about CBTp when I was an undergraduate.  Our undergrad degrees in the UK are specialized so we study 100% psychology from start to finish.  Although we don’t learn therapy, there is some opportunity to learn about clinical applications and which evidence-based treatments are available or recommended. I was then trained in CBTp in graduate school.  The vast majority of students in graduate school for psychology in the UK learn CBT, including CBT for psychosis, its just part of the curriculum.

What makes the CBT perspective unique? What about this perspective do you find particularly valuable or helpful? 

What I love about CBTp is that it offers an ethical, person centered, effective way for people to manage their psychosis and move forward with their life. CBT can be misunderstood in the US to be “skills based” or “challenging people’s thoughts” but actually that isn’t what it is at all. It is highly individualized and collaborative, in that every therapy is uniquely tailored to each different person, solely based on that person’s goals and experiences. There is no “expert therapist” role; the person with psychosis is known to be the expert in their own experiences. Beliefs and appraisals might be explored and evaluated but never challenged or corrected as if wrong. As a therapist it is an enormous privilege to be invited to be part of that process.

What are some books/resources that you particularly like on CBT for Psychosis?

Gosh there are so many and of course my favorites are all by British authors that can be hard to get in the US.  Current favorites include Cognitive Therapy for Psychosis: A Formulation Based Approach by Morrison Renton, Dunn, Williams, & Bentall; Person- Based Cognitive Therapy for Distressing Psychosis by Chadwick; CBT for Those at Risk of a First Episode of Psychosis: Evidence-based Psychotherapy for People with an At Risk Mental State  by Van der Gaag, Nieman, & Van der Berg.

What advice do you have for people experiencing psychosis? What about their family members and loved ones?

Wow that’s a tough question. Really everyone’s experience is unique and individual so its hard to give general advice.  However I would say, not matter what you might be told, hearing voices, seeing visions and other unusual experiences are much more common than people realize and don’t mean that everything in your life now has to be different.  Your goals and dreams are still important and achievable and if you don’t find people to support you that tell you that, keep looking until you do! For family members I would say please sign up for our parents newsletter on our website – we give lots of support and advice on how best to support loved ones experiencing psychosis in a way that makes it more likely they can get to where they want to be. Kings College in London also have a great free online course for parents and loved ones that I highly recommend. 

What encouraged you to join ISPS-US?

When I finally got my greencard here in the US and was able to start building my own practice it made sense to be in touch with organizations that were also working towards supporting people with psychosis or unusual experiences and had shared and common goals about advancing access to treatments other than medication. A number of colleagues recommended I joined ISPS-US for this reason.

Coming from the UK, what are some differences you have noticed between the UK and the US in terms of approaches to psychosis? Anything we can learn to do differently from our friends across the pond?

When I first moved to the US it was noticeable just how much more prominent the medical model is here. Its not just the dominant model, if you happen to suggest that there’s no such thing as ‘schizophrenia’ or that psychosis is not a ‘disease’ that can be ‘cured’ by medication sometimes people don’t quite compute what you are saying or think you are joking, because such comments are so far outside the so called norm.  That isn’t the case in the UK. The majority of psychologists, if not all, embrace the environmental/trauma based explanation of mental health. Psychologists that don’t question the DSM are the minority. It took me a long time to adjust to this cultural difference, and to be honest I haven’t fully adjusted, nor would I want to.  I guess the other major difference is that healthcare is for profit in America.  That’s definitely something America could learn to do differently, and another thing I will never get used to… although of course that really isn’t specific to psychosis…and sadly changing this issue long term is something that probably needs its own society!
Thank you Dr. Riggs! It was great hearing your perspectives on psychosis and cognitive-behavioral therapy. 

Questions or comments for Dr. Riggs? E-mail her at:



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NEW! Rodney Waldron Memorial Scholarship Fund

I am pleased to announce the creation of the first  annual Rodney Waldron Memorial Scholarship. Rodney Waldron was a peer specialist who worked for the NY State Office of Mental Health in Manhattan and the Bronx. He used his own experience of addiction, abuse, incarceration, and mental health struggles to help others in need.  He was a member of Hearing Voices NYC. Rodney presented at ISPS conferences about his own experience as a recipient of services and as a group facilitator, giving a powerful, straightforward, and insightful message. He was also a close friend and collaborator of my husband’s at Manhattan Psychiatric Center, where he co-founded the first hearing voices group; consulted with treatment teams, and sat on the incident review committee. He also developed a mentoring and supervision model for Howie the Harp interns as well as other peer specialists.  Reflecting the sides of his own family, Rodney alway showed a keen sensitivity in particular to the background of the black and Latino people with whom he worked.  In these ways he set a new standard for peer specialist work.  

In honor of Rodney’s work, I am creating an annual scholarship fund in his name that is to be used to defray expenses for conference attendees of color. The scholarship will cover the student, family member or expert-by-experience conference fees for two people of color plus an additional $100 for each attendee (if needed) to be used for lodging or transportation. Applicants should write a brief statement explaining how this scholarship would benefit them, their interest in the conference, and an estimate of travel and lodging expenses. Inquiries and applications should be sent to The deadline for applications for the 16th Annual ISPS-US Meeting in Portland, Oregon is October 20, 2017.

If you would like to donate to the Rodney Memorial Scholarship Fund please go to the ISPS-US home ( page and make a donation, please check OTHER and put in the text box “Rodney Waldron”.

It should look like this ( )

Thank you for your generosity. And please, share this information with your networks!

Jessica Arenella, President,ISPS-US

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Expanding the Conversation: Talks on Hearing Voices, Oppression and Recovery

The Hearing Voices Congress of 2017 is over, but it’s not too late to listen to some of the key talks that happened there!


Other keynotes:
* Marty Hadge
* Akiko Hart
* Barry Floyd
* David Walker
* Val Resh

Check these out to hear some amazing stories, told with insight into some of the deeper issues we all face!

Many of these videos touch on issues of culture and cultural oppression, and intersections in identity, and how that all affects the altered states of mind that get called “psychosis.”

These are issues that will also be addressed at the ISPS-US Conference in Portland Oregon November 17-19, 2017, where the theme is “Psychosis in Context: Exploring Intersections in Diverse Identities and Extreme States.”  Note that Gogo Ekhaya Esima, featured above, will be a keynote speaker there where she will give a longer talk.  (Early bird discounts for this conference are only good till 9/17).

Continue reading

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Has Anyone Ever Fully Recovered From “Schizophrenia?”

When someone recently asked this on Quora, the first answer they received was the typical perspective offered by our mental health system.  It was stated that schizophrenia is a chronic biological illness, and that no cure exists.  The only hope offered was that many people with “the illness” can “lead productive and fulfilling lives with the proper treatment.”

I believe that answer to be horribly wrong in two respects.

  • First, it contains assertions not based on facts, and it suggests for example that schizophrenia is definitely a “real illness” based on biological differences and that people diagnosed with schizophrenia are only ever able to lead productive fulfilling lives if they continue to receive the “proper treatment.”
  • Second, since hope has been found to be one of the keys to recovery, and since this answer reduces any hope for full recovery, it functions as a kind of dark, self-fulfilling prophecy that impedes recovery.

So I offered the following answer:

The answer [to the question of whether anyone can fully recover from schizophrenia] is clearly yes. While it’s popular to say that schizophrenia is a biological illness, there is in fact no biological test for it, it is diagnosed when people talk and behave in certain ways for a period of time. And when researchers follow people who are diagnosed that way, they find that a great many of them no longer meet the criteria for the disorder when followed up later, and many of them have even very successful lives.

To give just one example: Daniel Fisher. Over a five year period, he was treated for schizophrenia, with drugs and a few hospitalizations. He then worked on recovery, became a psychiatrist, and eventually a national leader in the recovery movement. He got married, had kids, had a good life, etc. He did not continue to take drugs or to have the sorts of problems associated with “schizophrenia” and so he would meet any reasonable criteria for full recovery. He has written about his experience, and I recently reviewed his book “Heartbeats of Hope: The Empowerment Way to Recover”

I think it’s worth noting that when recovery is discussed in the mainstream mental health system, it is discussed usually in terms of working to regain a valued life despite continued illness.  I do believe that focus can be important, but as I argued in my article Moving Beyond Clinical Recovery AND Personal Recovery: Reclaiming the Possibility of Full Recovery,  it is only one side of the possibility of full recovery, which also involves getting to a place where nothing that might seem to be an “illness” remains.

For more thoughts about full recovery, and the possible role of mental health treatments in accomplishing it (or possibly getting in the way), see Questions and Answers About Recovery.

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‘Too different’ and ‘psychosis’

by Kevin Healey

I live in Toronto a city where, more than other places I’ve lived in or visited, it is easier to see what “diversity” means,  at least at one level.

For example, according to information reported on the City of Toronto website:

  • Half of all  those living here were born in another country;
  • 47% of Torontonians report themselves as belonging to a visible minority.

Not that by any means things here are all sorted, not at all, just that this is a place where there is more diversity than most and where there exists at least some degree of acceptance that diversity is a good thing.

Still, here too there are undoubtedly many people, and many groups still waiting, demanding and “fighting to be included in the idea of equality” as much as in any other place.

Where I grew up there’s a colloquialism “same difference” and perhaps those words are  imprinted within me and inform how, for a long time I have believed that we are each as different as we are the same.

More recently though, I have come to see how experiences of being deemed “too different” and “psychosis” are intertwined,  part of the same experience.

For me, experiences that get called “psychosis” are at the heart of the difficulty of living with human difference. For whatever reason we find ourselves deemed “too different” – and it seems we are constantly making up new ones – we can find ourselves overwhelmed and struggling in ways that affect every aspect of our being.

That inner struggle expresses itself in many forms and from time to time it can overwhelm us,  and it comes to the surface in ways others use to deem us even more different: “disconnected from ‘reality'” whatever that means; and “in-psychosis” again, whatever that means.

Whatever the roots of and route towards our own personal “too-differentness”, living through difficult experiences that get lumped together under the heading “psychosis” is where many of do us find ourselves.

We are now further down the road to being cast-out, trapped and seemingly condemned to remain stuck there.

“Madness is supposed to be the beginning of a journey, it’s not supposed to be the end result”
–Jeanette Winterson.

If we are fortunate, this can be a blessing, for those of us who are able to take advantage of it and see that the energy we were using up trying to fit-in, or being some version of ourselves that others would have us be; and that we can better invest that energy into breaking-free, learning and being who we can best be.

Sadly, not everyone is offered that opportunity, or able to create it for themselves and even then many are not lucky enough to be able take advantage.

My own experience has shown me that life is often about surfing that precarious, dynamic balance between fitting in just-enough and also being free-enough to be who I am.

Straying too far from either side of that can be uneasy, scary and lead to me becoming exhausted, and if I’m there long enough, not well.

A couple of years ago I was part of organizing a conference Psychosis 2.0, where one of the keynote speakers was Keris Myrick. At the pre-conference get together the evening before, I well remember hearing her talk of how pleased she was to see the city dressed up, and making a show of being very welcoming.  It was, I think, the week before Toronto Pride which was also that year hosting World PRIDE. So it was quite a show, even more than the usual show. I remember her saying something to the effect “I don’t know if it’s always like this…”  and that giving rise to rumblings in the audience that no, it wasn’t.
More particularly I remember, as she was drawing to a conclusion, speaking to her personal experience of living as a black woman in a world run and dominated by people not many of whom as she said, “look like me”.

”Difference is difficult and dealing with difference is not easy – yet we have no other option but to learn how.”
– Keris Myrick

Difference can be challenging enough when it is at the surface. Perhaps, though it is the differences that lie beneath that are most difficult – how we are affected by our difference, our too-differentness.

Whatever the nature of our own differentness we can be driven or trapped into concealing, withholding, and protecting it: from a world that does not understand and does not know how to accept, our too-differentness.

We can also be driven to protecting the world from our too-differentness, our very being, by wearing a mask or masks that show us in ways that do not cause opprobrium to be aroused in others.

Of course, we can only struggle like this so much, and for so long.

The energy it requires to live like this is just too much to sustain. From time to time it surfaces, and manifests in many ways, some of which stray beyond the boundary of what society regards acceptably different.

I can only imagine how difficult and exhausting it is to live in this world as non-male, none-white person: I only know how difficult it has been and is for me sometimes.

Hearing voices is one of the ways I am different – though, truth be told, even though some people talk of it as “unusual experience” it is really not all that unusual. Three-in-four of us will hear a voice no one else does at least once, usually around significant life events and about one in seven of us of us do regularly.

Like Tom Jones sang, admittedly in a wholly different context, “it’s not unusual” – hearing voices is, actually, remarkably bloody common.

It is, though, another of the ways we can be too-different in a way that our society has yet to develop the capacity to understand, to accept,  and to accommodate such differences, and so instead we construct stories that would have us fear what is a not that unusual at all but very human experience.

It strikes me that within the many ways that we can be different, there is perhaps some shared experience in the many ways we might find ourselves  deemed  too-different.

For whatever reason we that are first deemed to be too-different, that we don’t fit in, and that we’re not good enough to be worthy of being considered as a being-being, as fellow human, the pain that we can feel as a result sits deep within us.

The wound is embedded within every fibre, every synapse and every fleeting second of our being.

William James, who first coined the term psychological trauma, also described this effect as like “thorns in the spirit”.

At those times when life overwhelms us, and which for some of us can be a near-constant experience, the pain from those thorns pops-up to the surface and expresses itself into the world, often in one of the many ways that come, at some point, to be called ‘psychosis’.

And so, once we have been deemed “too different”, we become a sticky target- to which other sticky labels stick themselves all-to-easily.

We too easily find ourselves boxed into categories of others’ making and it can easily happen that we find ourselves cast out to what Franz Fanon called the “zone of nonbeing”, outside of “self”, even beyond “other”, beyond worthy of being regarded as human, more a denial of existence and right to exist as human.

Eventually those cast out there come to believe: “I deserve this”.

This zone serves a function: it allows us to separate ourselves from those who have now been placed within it, so that we can feel ok about whatever is done to them.

And then, one day, we find that we too have been placed within this zone –   or that it’s boundary has been extended far enough that it now includes us too.

I’m interested in dialogue, so I’d like to sign off by asking you to share something:

Q. In what ways have you found yourself deemed “too different”?
Q. And what helped you find your way?

Kevin Healey






Kevin Healey hears voices that you don’t and has done for as long as he or his voices can remember.  Founder and coordinator of, Toronto Hearing Voices group and the Hearing Voices Café.

Drawing on skills and experiences gained from three decades of group work in organizations, in peer support and the wider community he develops innovative trainings and workshops that enable others to better understand and support those who struggle with the kind of experiences that get called “psychosis”.

A member of the hearing voices worldwide community, in Oct 2016 was honored to receive the Intervoice annual Award for Innovation at the World Hearing Voices Congress in Paris.


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Minority Mental Health Awareness Month: Spotlight on Psychosis

Faith Ringgold, Listen to the Trees

July is Minority Mental Health Awareness Month . According to the website for the National Network to Eliminate Disparities in Behavioral Health, Minority Mental Health Awareness Month was started in 2008 by the US government in an effort to improve access to mental health treatments and services through public awareness. In an effort to raise awareness about BME (Black and Minority Ethnic) individuals and psychosis specifically, I wanted to blog a few facts and resources I recently learned about:


  1. Black people seeking mental health services are three to four times more likely than their white counterparts to be diagnosed with a psychotic disorder (Schwartz & Blankenship, 2014).
  2. Black patients are prescribed higher doses of antipsychotic medication than white patients (Arnold et al., 2004).
  3. Black patients are are more subject to polypharm prescribing practices than white patients (Chaudhry, Neelam, Duddu, & Husain, 2008).
  4. The pattern for over-diagnosing black people with schizophrenia been long-standing throughout the history of the United States, with the association between schizophrenia and blackness  developing as a direct reaction to black protestors during the Civil Rights era (Metzl, 2010).
  5. Although comparative studies have not been done in the United States, the over diagnosis of schizophrenia in Afro-Caribbeans in the UK (including non-immigrants) has been the subject of marked controversy (Ayonrinde, 1996; Pinto, Ashworth, & Jones, 2008).
  6. Public health researchers have explored the reasons behind this over-diagnosis from a variety of angles including, cultural bias among clinicians, acculturative stress, genetic predisposition, greater cannabis-use, and other social factors, including racism and poverty (Pinto et al., 2008). It is important to note that psychosis does not occur more frequently in Afro-Caribbeans living in the Caribbean, indicating migration/immigration and sequelae as highly important (Pinto et al., 2008).
  7. In Haitian populations specifically, paranoia and suspiciousness have been found to be common symptoms of depression. Bibb and Casimir (1996) state that the common presence of symptoms such as persecutory delusions, suspiciousness, and paranoid ideation in depressed Haitians is a leading factor in the misdiagnosis of schizophrenia in this population.
  8. Irrespective of depression or other mental health issues, Bibb and Casimir (1996) state that paranoid discourse is common in Haitian clients, and has “historical, political, and religious underpinnings” (p.107). Specifically, mass intergenerational traumas of the Haitian people, including colonialism, torture by dictatorial regimes, oppression, and slavery have all led to the development of a “socio-cultural paranoia” that is not necessarily “pathological” in nature.
  9. Racism is a risk factor for psychosis.
  10. Mental Health Foundation & SurvivorResearch created a highly informative document called “Recovery & Resilience: Lessons in Healing From Black Women’s Stories” – a must read!
  11. Icarus Project offers a free guide called Madness & Oppression that can help inform personal wellness as well as illuminate important connections between oppression and mental health
  12. My Damn Mind is a harrowing interview with Alan Pean, a young black man shot by police while attempting to seek treatment for psychosis.

This year, ISPS-US’s national conference is focusing on the issue of psychosis and intersectionality. Here’s a description:

Extreme mental states and psychotic experiences occur within a context that includes a person’s unique family story, ethnicity, religion, race, socioeconomic status, gender and sexual identity, trauma experiences, and more. The attempt to isolate these states and experiences from the soil in which they grow often results in diagnosing people instead of understanding them. Yet individuals’ reactions and adaptation to the nexus of social constructs, cultural beliefs, and personal and collective histories that form the backdrops of their lives are sources of their strengths and their suffering alike. How can those who are struggling come more fully to appreciate the complexities of who they are, why they hurt, and what the possibilities might be for transformation? And how can helpers better understand the intersection of these layers of relevant factors so that assistance can be provided that truly fits the person?

ISPS has focused on psychological and social approaches to psychosis, madness, and extreme states of mind for over 50 years. The ISPS-US 16th Annual Meeting will feature a diversity of perspectives on psychotherapies, research on recovery, and theoretical developments. The points of view of experts by experience and family members will be highlighted. A main focus will be intersectionality or the interconnected nature of social identities as they relate to systems of discrimination and oppression.

Come join us in Portland November 17-19th as we discuss these complex questions.


Arnold, L. M., Strakowski, S. M., Schwiers, M. L., Amicone, J., Fleck, D. E., Corey, K. B., & Farrow, J. E. (2004). Sex, ethnicity, and antipsychotic medication use in patients with psychosis. Schizophrenia Research, 66(2-3), 169-175. doi:10.1016/S0920-9964(03)00102-6

Ayonrinde, O. A. (1996). Schizophrenia in Afro-Caribbean immigrants. Journal of the Royal Society of Medicine, 89(8), 480.

Bibb, A. & Casmir, G.J. (1996). Haitian families. In M. McGoldrick, J. Giordano, & J.K. Pearce (Eds.), Ethnicity & family therapy, 2nd edition, (pp. 97-111). New York: The Guildford Press.

Chaudhry, I., Neelam, K., Duddu, V., & Husain, N. (2008). Ethnicity and psychopharmacology.    Joural of Psychopharmacology, 22(6), 673-680. doi:10.1177/0269881107082105

Metzl, J.(2011)  The protest psychosis: How schizophrenia became a black disease. Beacon Press.

Pinto, R., Ashworth, M., & Jones, R. (2008). Schizophrenia in black Caribbeans living in the UK: an exploration of underlying causes of the high incidence rate. British Journal of General Practice, 58(551), 429-434. doi:10.3399/bjgp08X299254

Schwartz, R. C., & Blankenship, D. M. (2014). Racial disparities in psychotic disorder diagnosis: A review of empirical literature. World Journal of Psychiatry, 4(4), 133-140. doi:10.5498/wjp.v4.i4.133







Posted in Advocacy, Minority Mental Health Awareness Month, Psychosis | 2 Comments