Suppression is often inadequate: learn how people can instead “work through” extreme or psychotic experiences, resulting in personal growth.
Mainstream mental health treatment for “psychosis” in the US focuses on the suppression of non-ordinary experiences, which are framed as symptoms of illness. But is this the most helpful approach?
Using drugs, denial, and distraction to suppress experiences does seem to help some people some of the time; but many find these methods don’t work at all, or they may seem to work for a time but then cause troublesome experiences to re-emerge with more intensity later. Unfortunately, as many therapists have noted, when we resist something in our mind, “it goes to the basement and lifts weights!”
But what else is possible? Often, it may seem that the only alternative to suppression of “mad” experience is to be consumed by madness, and to have one’s life be ruined by it!
In this webinar, Gogo Ekhaya Esima and Emma Goude will discuss the very different possibility of “working through.” Instead of suppressing them, Gogo and Emma have found ways to engage with their extreme experiences, to find constructive meaning in them, and then to rebuild their lives in ways that are enriched by all that they have gone through.
Daniel Freeman provides an overview of this therapy which offers new hope for people with persecutory delusions: research shows it to be several times more effective than conventional CBT. This approach was developed in collaboration with people with lived experience of the problem.
Metacognitive Reflection and Insight Therapy (MERIT) is a form of integrative individual psychotherapy that helps people form more integrated ideas about self and others, respond more adoptively to life challenges, and live more rewarding lives.
In contrast to other approaches, MERIT focuses on core processes that should be present in a given session, rather than a predetermined curriculum. This allows for a therapy can be truly tailored to meet the needs of unique individuals in real world clinics while also unlocking therapists unique potential for creativity as they seek to jointly make meaning with the person diagnosed with psychosis.
This webinar provides an overview of CBT for psychosis, of the style and strategies used and of the research supporting its effectiveness. Some additional therapeutic approaches that can potentially be integrated with CBT are also described.
ISPS-US and Mad in America Continuing education were cosponsors of this presentation. (After you click “access webinar” below, scroll to the bottom of the page that results in order to locate the recording.)
Stephanie Mitchell explores how IFS understands and works with people experiencing voices, visions, paranoia, and other non-ordinary states.
Family members who want to help those struggling with voices often do not know how, and damaged relationships frequently result. While each family is unique, this panel discusses issues that commonly arise in communication, (re)developing trust, and providing genuine support.
Wouter Kusters explores ideas from his award winning book "A Philosophy of Madness: The Experience of Psychotic Thinking," He explains a bit about himself, and how he came to write the book, and gives an overview of its main arguments and perspectives. He presents three text fragments, pertaining to both philosophy and madness, that address the themes of nothingness, infinity, and fragmentation, then shows a 13 minutes video, "Unravelling Reality," that lets these themes come to life in a modern, metropolitan setting (that is, Brussels in Belgium), and also engages in dialogue and discussion with an audience.
Wouter Kusters obtained a Ph.D. in linguistics and earned an MA on the philosophy of psychosis. In the Netherlands, he is known for his books on the experience of psychosis and its relation to philosophy. For his books Pure Madness (2004), and A Philosophy of Madness (2014), he won the Dutch Socrates Award for the best philosophy book of the year in Dutch. The latter has recently been translated into English (2020, MIT Press).
In this talk, Robert Whitaker reviews the science that calls for a radical change in psychiatric care, and describes pilot projects that tell of a new way.
There are problems when people romanticize madness, but also problems when people awfulize it and focus exclusively on becoming "normal." Learn how having pride in "mad" experiences sometimes makes sense, and can facilitate diverse kinds of recovery and discovery.
Thank you to Patrick Galasso, M.Ed. CI/CT QMHI CHI for providing ASL interpretation. You may also click the CC button to see a live transcript produced by AI.
Dmitriy Gutkovich, a voice hearer and author of a book with the same title as this webinar, explains how people can shift from a distressing relationship with voices, to having a neutral or even a positive one.
The strategies presented include understanding the motivations of distressing voices, defending against their attacks on attention and happiness, and navigating the relationships toward harmony rather than hostility. Listeners will also gain insights on how to explain the hearing voices experience, and how to recruit a physical community that helps voice hearers, rather than causing additional pain.
The mental health system needs change and to learn from those with lived experience to create better, more holistic care for those in distress. Dr. Al Powers and voice-hearer Brittany Quagan LPC, both of Yale Psychiatry, are investigating the many ways in which people can control and influence their voices.
In this webinar, join us for an open discussion on how non-pharmaceutical approaches can be the future of helping those who suffer while hearing voices or having visions.
While the experience of psychosis can be highly distressing, many who recover report that the treatment was often worse than the psychosis itself. What is it that goes so wrong with treatment, and what could we do to improve treatment approaches?
In this webinar, we hear from two 'experts by experience,' Brenda Froyen and Dmitriy Gutkovich, who reflect on their own experiences of treatment and on what eventually worked better for them. They also discuss attempts to get professionals to be more open to learning from the experience of those who have undergone treatment.
This webinar explores different ways of understanding unusual beliefs, in particular ones we or the person we seek to help find challenging. This includes:
The presenter, Rufus May, works as a clinical psychologist in the NHS in England; his interest is originally rooted in his own experiences of psychosis when he was 18 years old.
Caroline Mazel-Carlton explores ways in which we can re-claim spiritual tools and wisdom traditions and be in open dialogue with our ancestors as we navigate extreme states of being, states that are often labeled as "psychosis."
"Assimilation, genocide, and systems of oppression such as anti-Semitism and Islamophobia have left many disconnected from ancestral traditions, spiritual tools and texts. When encountering extreme states of being such as Voices and Visions, the pharmaceutical model of chemical imbalance often steps into claim space in this cultural vacuum. However, for many, Western medicalized approaches are neither sufficient nor culturally competent."
Caroline draws on over a decade of direct experience supporting others with altered states of consciousness in diverse settings from peer respites to forensic psychiatric units, as well as her personal lived experience as both psychiatric patient and student of Abrahamic traditions and Buddhist sutras.
There has recently been a shift from conceptualizing a voice as a sensory stimulus that the hearer holds beliefs about, to a voice as a person-like stimulus which the hearer has a relationship with. Understanding voice hearing experiences within relational frameworks has resulted in the development of psychological therapies that focus upon the experience of relating to and with distressing voices. This presentation explores lessons learnt from the development, experience and evaluation of one of these therapies – Relating Therapy. These lessons are located within the broader context of other relationally-based therapies that seek to support recovery through the use of digital enhancement (Avatar Therapy) and dynamic interaction with voices (Talking With Voices).
The presenter, Mark Hayward, is both a practicing therapist and a researcher specializing in this approach.
"Comprehend, Cope, and Connect" is an experience based approach to psychosis & other mental health challenges. It integrates a number of "third wave CBT" approaches. The individual's felt sense is the starting point, with the idea that all mental health presentations stem from attempts to cope with this where it is unbearable.
Psychosis is the escape route available to some people (Clarke 2013). The impact of trauma, healing the self–relationship through self-compassion, and normalizing anomalous experiencing, are all integral to the approach. The approach is not so much trans-diagnostic as dismantling of diagnosis, and includes a perspective on psychosis that sees it as part of a wider potential of human experiencing that includes valued aspects such as spirituality and creativity.
Process Work (also called Process Oriented Psychology) has an innovative and non-pathologizing view of altered and extreme states of consciousness. Rather than dismiss such states as mental illness – as something to be discarded – Process Work takes the position that such states contain something meaningful and important that is trying to emerge.
This workshop takes you on an aerial tour of key Process Work attitudes, concepts and vocabulary as they relate to out-of-ordinary states of mind. Viewers will get a sense of how to map "process structure" – what is familiar, what is emerging, and the barrier between the two. Practical skills are then discussed which you can use to understand and communicate with themes that emerge in altered states.
John draws from his training in Process Work, personal lived experience with out-of-ordinary states as well as his time as a psychiatric patient to offer a candid, funny, and educational presentation.
In this presentation Eric Morris provides an overview of the Acceptance and Commitment Therapy (ACT) approach to supporting the recovery of people with psychosis. The trans-diagnostic and functional model of ACT targets common processes that can amplify the impact of psychosis. ACT normalises the experience of suffering, while also providing methods to create a flexible sense of self and a meaningful life in the face of unwanted or engrossing experiences. ACT offers a pathway to better psychological health and wellbeing through the cultivation of experiential openness, self-awareness, engagement in life, and self-compassion. Due to the emphasis on values-directed action and personal meaning ACT is consistent with personal recovery, and is highly acceptable by clients.
Dr. Steingard discusses the problems that have arisen from an overly medicalized approach to conceptualizing what falls under the label of psychiatric conditions. She then proposes a model in which psychiatry continues to assume an expert role in the use of psychoactive drugs but does so in a drug-centered rather than a disease-centered way. She explains the distinction between these approaches. She then discusses need-adapted approaches and outlines how psychiatry, using a drug-centered model, can work with people in distress, their families, and other clinicians in a more humane and democratic way.
Sandra Steingard, M.D. is Chief Medical Officer, Howard Center, Burlington, Vermont and Clinical Associate Professor of Psychiatry at the University Of Vermont College of Medicine. For over 20 years her clinical practice has primarily included patients diagnosed with schizophrenia and other psychotic illnesses.
Most current approaches to psychosis emphasize the suppression of those experiences, but in doing so prevent the person from working through the issues that instigated the psychotic experiences in the first place. In this presentation, Sean Blackwell and 2 people who have worked with him present a very different approach. Within a safe retreat setting, people are guided in using holotropic breathwork, moving into deeply healing experiences. Find out how this works, and hear from some of those who utilized this approach and come out healed, able now to create the lives they want without further need for drugs or other forms of suppression!
Paul M. Grant, Ph.D. and Ellen Inverso, Psy.D. discuss an approach they have helped to pioneer: recovery-oriented cognitive therapy (CT-R). CT-R is an empirically-supported treatment for people diagnosed with "serious mental illness" that operationalizes recovery and resiliency in a person-centered, strength-based way. The approach applies across the range of severity, and includes a way to understand the challenges (low energy, disorganization, grandiosity, hallucinations, aggression, self-injury, etc.) that can keep people from engaging and getting their desired life, along with strategies for action to promote that life to its fullest. Individuals can go from feeling defeated to flourishing, from chronic institutionalization to life in the community. There is a successful integration of adaptive beliefs and confidence that enables individuals to thrive in the life of their choosing.
This presentation focuses on theory and science supporting the model, the basic protocol, team-based approaches, as well as successful implementation in a large mental health system - all producing significant culture change. For additional information after you watch the webinar go to https://aaronbeckcenter.org/category/resources/.
In this presentation, Dr. Knafo explains key psychoanalytic concepts that help us to understand and treat psychosis or psychotic phenomena. These concepts include: regression, projective identification, psychic retreats, attacks on linking, islands of clarity, and finding meaning in symptoms. She emphasizes the discoveries, since Freud's time, that have deepened the understanding of the psyche, allowing the attribution of meaning to symptomology, and permitting human encounters that initiate profound change through insight and communication.Danielle Knafo, Ph.D. is a clinical psychologist, psychoanalyst, and professor in the clinical psychology doctoral program at LIU Post, where she chairs a specialty concentration on Serious Mental Illness. She is also faculty and supervisor at NYU's Postdoctoral Program in Psychotherapy and Psychoanalysis. She is a popular speaker and a prolific author who has published seven books and dozens of articles on psychoanalysis, creativity, gender, psychosis, trauma, technology and perversion. She maintains a private practice in Manhattan and Great Neck, NY.
Throughout shamanic history, extreme states have been configured in relation to states of distress and spirituality. It is however not clear to what extent these states are separated, the same or if integration is at all possible.
This presentation explores the different positions possible when faced with psychotic distress and spirituality. It draws on Ingo's experiences during his extensive shamanic training as a sangoma, a South African traditional healer, as well as his work as a clinical psychologist . It considers some indigenous and current models and interventions of spiritual emergencies, from a perspective well outside of materialism.
In 2015, Charles and his collaborators released a short film called "Compassion for Voices". Since then, the film has been widely viewed, translated into different languages, featured in TV documentaries, and has been frequently used as a resource for education, training, and therapy in mental health. But what is really going on in this film? What are the ideas behind it? What can we do with these ideas to actually improve our relationships to voices? In this talk, Charles explores the scientific understandings and research behind each aspect of the film, and then demonstrates how these can be translated into real-life practices, techniques, and experiences for voice-hearers. Some feedback from voice-hearers who have watched the film is also presented.
Dialogic Practice emphasizes listening and responding to the whole person in a context rather than simply treating his or her symptoms. In psychiatric settings, this is accomplished primarily through a treatment meeting, or Open Dialogue. Arising from the influence of the philosophical writings of Mikhail Bakhtin on systemic family therapy, Dialogic Practice can also be effectively applied to more ordinary couple, group, and family therapy, as well as community work in schools.
This conversation, or dialogue, is not about the person, but is instead a way of being with the person and living through the situation together. Referred to as Withness Practices by Tom Andersen, M.D., this process mitigates the sense of isolation and distance that a crisis can produce and gives the person at the center of the dialogue greater voice and agency. Ultimately, this allows them to participate more meaningfully in both the conversation and the resulting decisions about their own lives.
After eliciting the persons point of view at the meeting outset, there is typically a back-and-forth exchange between this person and the therapists both to develop a more lucid way of expressing the situation and to create a shared language. The voice of each participant is then woven into this conversation to create a new fabric of meaning and engagement to which everyone contributes.
Mary Olson, PhD is an internationally-recognized leader in the development of Dialogic Practice. She is the founder of the Institute for Dialogic Practice in Haydenville, MA and is a faculty member of both UMass Medical School and the Smith College School for Social Work. She has written numerous articles and book chapters on Dialogic Practice, including The Key Elements of Dialogic Practice in Open Dialogue (2014, with Jaakko Seikkula & Doug Ziedonis), and maintains a private practice in Western Massachusetts.
It's well established that for many people who experience psychosis and other extreme states, childhood trauma and problematic family dynamics lie at the root of their distress. It's also clear that regardless of whether or not a person's psychosis is clearly rooted in problematic family dynamics, providing effective support for the person can be very difficult for caring family members. In this presentation, Dr Paris Williams will outline what he feels are some of the family dynamics that are so problematic, he will outline practical methods for developing more beneficial family and relational dynamics, and invite discussion around these themes.
In their presentation for this online meeting, Lewis Mehl-Madrona MD and Barbara Mainguy MA plan to "explore the interface and the movement between at least two different worlds in which people diagnosed with psychosis interact. First and dominant is the biomedical world in which the solution to virtually all of life's woes is to take a pill and not to make personal, relational, or lifestyle changes. Important to recognize, we believe, is that these beliefs are as prominent for medical illnesses as they are for the so-called psychiatric illnesses. Then comes the Recovery Community in which people work from passivity (the biomedical model) toward agency in which they can actively contribute and create their recovery.
"We want to suggest that most psychiatrists are so saturated in the passivity model that they do not recognize when patients present from the agency model. We suggest that the two models are more widespread than mental health and represent fundamental differences in approaching health and disease. We review some of our results in working within both worlds. Specifically, the people with whom we work within a Recovery model improve and those within the passive, biomedical model, do not."
Lewis and Barbara will be discussing what they have found may assist people in making this shift from passivity toward agency, especially telling stories of characters with agency to indirectly implant ideas of the possibility of agency. With patience, and with the practice of "radical acceptance," they have found that this can be very effective!
The Hearing Voices Network (HVN) is over 25 years old and has chapters around the world in 26+ countries. It represents a partnership between individuals who hear voices or have other extreme or unusual experiences, professionals and allies in the community, all of whom are working together to change the assumptions made about these phenomenon and create supports, learning and healing opportunities for people across the country. Founded around the philosophy that those who hear voices, see visions and/or have other unusual experiences are not necessarily experiencing a symptom of illness, HVN groups create opportunities for people to discuss what happens for them in a non-judgmental environment that supports the process of making meaning and learning to walk through the world as a voice hearer. Spend an hour with Lisa Forestell and Marty Hadge, both voice hearers, as they introduce you to the history and values of the Hearing Voices movement. Perhaps, by the conclusion, youll want to get involved too!
Lisa Forestell is a Director with the WMass Recovery Learning Community (RLC). She is a voice hearer, an HVN facilitator, train-the-trainer, and a member of HVN-USA Board of Directors dedicated to bringing HVN to the US. A staunch ally and peer to all those who choose their own life path regardless, in spite of and because of the obstacles they have faced. Marty Hadge after years of receiving traditional mental health treatment, including multiple psychiatric hospitalizations, has found meaning and value to the experience of hearing voices and other extreme states through the healing environment of the Western Mass Recovery Learning Community and Hearing Voice groups. Marty is a trainer for the HVN USA. He was a Key Note Speaker at 2113 Alternatives Conference and currently works as a Community Bridger for the Western Mass Recovery Learning Community.
When we are sure that the source of a persons experience is an illness, we are then led to see that experience as invalid, and our focus naturally shifts to attempts to suppress it. This helps us maintain our sense of having a grip on reality while the other person is then forced to choose between either insisting on the validity of their own experience (appearing to us as lacking insight into their illness) or joining with us in defining their own experience as invalid and in attempting to suppress it. Under these circumstances, true dialogue, in which our own experience meets the experience of the other, is impossible. It is only when we accept and communicate the uncertainty of our own position, and the uncertainty about what truly is illness, that we can engage people in conversations which are sufficiently non-polarized as to allow exploring options for mutual improved understanding and perhaps mutual recovery from our difficulties and misunderstandings.
In his presentation during this meeting Ron Unger will draw on ideas from the Hearing Voices Movement, CBT for psychosis, Open Dialogue, and from various spiritual traditions as well as personal stories and experiences in order to highlight the value of dialogues that transcend certainty, and to identify practical ways to do this even when talking with someone whose experience is extremely different, disturbing and/or apparently dangerous. We will explore ways use such dialogue to find positive value at times in psychotic experiences as well as to cope with distressing aspects. In the process of letting go of own certainty in this way, we can model for the person we are helping how they might let go a bit of their own certainty, allowing us to meet in a way that is squarely centered in our mutual fallible humanity, a great starting place!
The Bay Area Mandala Projectis an alternative services planning and implementation group seeking to make really radical changes to how mental health services are provided. Their focus is on offering services that will allow people to minimize the use of psychiatric drugs while addressing trauma and community and spiritual issues. You can read about their innovative diversion system aimed at providing family members and their loved ones voluntary alternatives to hospitalization and/or long term dependence on other mental health treatment or psychiatric drugs here.Cardum Harmon, Dina Tyler, Michael Cornwall, PhDare key members of the Mandala Project, and they will be the presenters for this meeting, which will address "Responding to Extreme States with Loving Receptivity: Honoring the Spirit's Transformative Journey" All three have lived experience of "psychosis" or "extreme states" as well as extensive exprerience helping others with those states.
In this meeting, they will share effective ways to be with people in intense spiritual experience by focusing on loving receptivity and the importance of honoring one's spiritual journey. We will explore the strategy of being with instead of "doing to", as an accessible tool for averting prolonged crisis and supporting healing. We will discuss a diversity of research on this topic, hear about the effects and impact of undergoing altered states with a spiritual component and learn how to support individuals as a strategy to counteract the stigma and the negative impacts such experiences can cause in the lives of individuals and their families.
Bertram Karon speaks on the topic of "Who am I to treat this person? What it feels like to treat a 'seriously mentally ill' person."
For those of you who don't already know Bertram, he has extensive experience providing therapy for people diagnosed with schizophrenia and researching such therapy, and is co-author of the book "Psychotherapy of schizophrenia: The treatment of choice." You can read, or watch and listen, to a bit about Bertram and his perspective atthis link, or read an article which is available for free, "The Tragedy of Schizophrenia Without Psychotherapy.