All About Psychosis - Part II

When it comes to understanding and being able to identify psychosis in another person, we tend to avoid doing so.  Why is that?  Well, as I hope I made clear enough in my last blog post....it all begins when someone you love and/or care about says or does something that makes you question their relationship with real-life reality.  Instead of asking questions to find out more about what is going on with your person, whomever he/she/they may be, our natural bent is to ignore it.  It just is.  I am hoping that this series on the topic of psychosis will help remove the fear from your perception(s) of what psychosis actually is and how it can show up in our day-to-day exchanges with other people.  If I can assist even one person in getting (or assisting someone else in getting!) proper help and support for this issue, then I consider this series worth having presented here...

So, last post I began talking about "hallucinations" as one of the four major areas of symptomology that identifies psychotic behavior.  I presented information about auditory and visual hallucinations, as these two types of hallucinations are most commonly experienced by people with psychosis.  I want to make clear here that "how" a person becomes psychotic is another topic altogether, and it will be addressed in a future blog post.  For now, however, I am staying focused on presenting the facts about what psychosis is and looks like in real life.

Beyond auditory and visual hallucinations, a person experiencing one or more psychotic episodes may also experience any one or combination of the remaining "types" of hallucinations:  olfactory (smelling things that aren't truly present in the current environment), gustatory (tasting things and/or having a "taste" of something specific in one's own mouth that won't go away that, once again, is not a reflection of real-life reality in the current environment), and tactile (feeling and/or touching things that aren't truly present in the current environment).

What does this look like in real life?  A stranger you see on the street seems to be jammin' to some music, while also talking out loud, and making gestures as if someone is in their presence, while boppin' down the sidewalk.  The "music" and the "person" are reflections of both auditory (music and voice) and visual (person present) hallucinations.  I know in today's modern age, people can actually be listening to music and engaging in conversation through their phone/earbuds;  this isn't the type of "real" interaction that I am referencing here.  Just to clarify....

Getting back to our stranger on the street, you may notice that he/she/they are dressed inappropriately for the weather outside.  Too many clothes on if it is "hot" out...and not enough clothes on if it is "cold".  Also may be wearing gloves when gloves are not an appropriate choice for the situation you are observing.  Or a hat with glasses with a face mask on when it's 85 degrees outside.  You may see the person scratching at the same or different parts of their body and/or reacting to a perceived threat to their physical body (ducking, flinching, jumping back, going "around" something when their body should be moving forward, etc.).  These would be examples of tactile hallucinations (clothing choice(s) and scratching issue(s)) in combination with a visual and/or auditory hallucinations (dog approaching and barking, person running up and threatening, etc.).

If I had to throw in the remaining types of hallucinations with our stranger on the street, olfactory and gustatory hallucinations might involve picking something out of a trash recepticle to eat at one end of that spectrum...or refusing to eat and/or drink anything at all on the other end of that spectrum.

With hallucinations of any type, these are considered "positive" symptoms when it comes to psychotic behavior.  The next two areas of positive symptoms are Delusions....and Disorganized Speech and/or Behavior.

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Delusions are very firmly held false beliefs that are not consistent with the reality of one's culture.  I put it that way because some cultures engage in belief systems that we, as Americans, can't compute in any way, shape, or form.  Like cannibalism.  Like marrying off our own small child(ren) in exchange for $$$.  Like ingesting noxious substances as a "cure" for...you name it.  I could go on...but you catch my drift.

Delusional beliefs cannot be shaken despite logic, despite facts, and despite proof to the contrary.  Delusional beliefs are going to be unique to the person who suffers from them;  it is often extremely difficult for other people to understand why the person they love and/or care about adheres to the delusional beliefs he/she/they adhere to.  One category of delusions has to do with persecution which, in fact, represents the most common type of delusion with psychosis.

The other types of fixed false beliefs humanity struggles with when psychotic can involve jealousy-based delusions, grandiose delusions, paranoid delusions, somatic delusions, religious delusions, nihlistic delusions...and the list goes on from there.

In all cases, whatever we are capable of believing about the Universe and how it operates, about God, about the "Illuminati" of our current culture (celebrities and/or "super rich" people), about ourselves, about other people we do and don't know personally, and about the way the world is and operates...these are the very "topics" that are subject to the focus of our own delusional belief system....

I remember when the Son of Sam serial killer back in the late 70s was finally caught and prosecuted for his crimes.  When evaluated by the court-appointed psychiatrist, he indicated that he was obeying the command to kill from his neighbor Sam's black lab, which Son of Sam believed was possessed by a demon. I also recall a young woman on the psychiatric unit where I worked decades ago.  She had taken some Ecstacy at a club a couple nights beforehand...and experienced psychosis for the first time.  When she was on our unit, she told me I had "red" eyes.  I mentioned they might be bloodshot from lack of sleep.  She replied, "no", they were red all the way around my eyes.  Upon further questioning (by me), she indicated she saw red all around my eyes as if I were wearing red eyeliner around the top and bottom of each of my eyes.  She was not a predator.  She was not "dangerous".  She was sick.  When she melted down on the unit, it was because she was fearful of one of the male nurses who she claimed was "going to rape me".  Not to change the subject too much, but that nurse eventually was discharged due to repeated inappropriate physical contact on the unit.  Just saying.

What we don't understand as John Q Public is that people experiencing psychosis aren't all like David Berkowicz or any other murderous predator.  In fact, the majority of people who struggle with psychosis are more fearful than anything else, like the young lady on the unit where I worked.  As such, being too afraid to verbally engage with a person in psychosis is often the excuse which keeps us from better understanding their situation when we find ourselves in it....

Next post, we will discuss disorganized speech and/or behavior, as well as the "negative" symptoms of psychosis, which represents the third and fourth areas of psychosis examined as part of this blog series.

Until then....

All About Psychosis (Part I in a Series)

You know how you get to talking to someone?  You may know the person very well or only slightly.  This person you are in conversation with may also be someone you have intimate knowledge of, because he/she/they are your parent, sibling, bff, "ex"....or perhaps even your own child.  

...and then they say it.  Say what?  Say "it", which means that whatever they are saying, "it"sounds insane as hell, that's what.  Maybe they say "it" just once...and that was a month ago....and you haven't heard anything irrational since.  Or...maybe he/she/they have kept talking about "it" once they recall they told you a first time.  Everybody's situation is going to be unique when introduced for the first time to a loved one who is behaving actively psychotic.  Just saying....

I remember talking with a friend's daughter one night.  We were at the same place at the same time, and we got to talking.  And then "it" came up in the conversation and I instantly knew she was in trouble.  What did she say?  She said she had conversations with ghosts and that the ghosts directed her in what she should or should not do when she's debating about what to do in a given circumstance or situation.  Okay then.  So.....  

...I asked her about her spiritual world view to start, because sometimes people who sound insane are, in fact, merely practicing their own brand of their own spirituality/spiritual world view.  I can't judge that.  Neither should you.  Of course, I don't know which brand of spirituality involves conversing with ghosts who also function as spirit guides....so that's why I asked her about her spiritual condition.  As it turned out, she wasn't a religious person or even considered herself very spiritual at all.  No affiliation with any specific group...no practices to do with sacrificing anything on any altars....nada.  She just happened to talk to ghosts who suggested what she do when she wasn't sure about what to do in her own life.

Is that weird, by the way?  Don't we ALL often wonder what we should do in our own lives when we don't know what to do?  Who or what do "you" go to for support, encouragement, inspiration, and/or motivation in that regard?  Here's a clue:  don't go to whatever will give you supernatural "insights" that involves the use of a substance containing hallucinatory properties or the potential to cause hallucinations (too much adderall, too much anything "stimulant"-based)....  Believe me, that route won't help you figure out your life in a good way.  It never does.  Devil's not stupid....

Then I asked her about her history with alcohol and/or drug use.  Turned out she smoked a lot of weed.  As in every day and multiple times a day.  I asked her if there was a time when she conversed with and took the advice of ghosts before she started smoking pot.  She said she didn't ever think about that before, but she sat for a while and considered her response.  Then told me that she doesn't remember even ever thinking of and/or interacting with ghosts at all until recent years and yes, in fact, it was after she made a habit of smoking weed on a daily basis. 

When it comes to psychosis, we all may "think" we know what it is and means...but we really don't.  Why would we?  I mean that's like expecting anyone who owns a car to "know" when it's broken before it takes an actual dump on the road and stops working altogether.  Or, how to fix a car once it does stop working.  Not happening.  Same is true with psychotic episodes and the mental health and/or substance use/abuse issues that can create and/or exacerbate them.  So....today's post is all about that.  How to discern what's going on when you, or someone you love and care about, starts talking and/or acting psychotic!

So let's begin by defining psychosis.  In all cases, psychosis may involve any one of four behavioral patterns which the rest of the world would not experience.  First, hallucinations.  Hallucinations may be auditory in nature (hearing things that are not "real" and happening in real life in the moment they are experienced), visual in nature (seeing things...), gustatory (tasting things), olfactory (smelling things), and tactile (touching/feeling sensations that are not "real" and happening in real life in the moment they are experienced).  When it comes to the majority of hallucinatory experiences of people who do alcohol and drugs to whatever extent that takes them over the edge (of sanity), their hallucinations will be most often be auditory in nature, with visual hallucinations representing the second most common form experienced while under the effects of alcohol and/or drugs.  Auditory hallucinations are also most common for people with diagnosed major mental illness(es) involving psychosis who do not indulge in drug and/or alcohol use and abuse.  

So, what's an auditory hallucination like?  It's like I'm sitting with you listening to you tell me about your ghosts who tell you what to do because they are your friends, and you believe I just said, "Oh, that's so nice!  I wish I had ghost guides in my own life!"---when I DID NOT SAY THAT AT ALL!  So, that's how an auditory hallucination can manifest itself.  BUT, auditory hallucinations can also manifest themselves by hearing commands or hearing conversations inside (or outside) your own head.  In other words, you are either being "told" what to do by the voice(s) you hear---or that voice/those voices are talking "about" you---and usually not in a positive way.  Or...you may hear someone walking outside the door of your bedroom, or something scratching at your window behind you, or someone singing a song you hate in the distance...whatever it is you believe you are "hearing"---without being able to quickly locate and find its true source in real life---chances are very high it is an auditory hallucination at work.  Just saying.

Next, visual hallucinations are not always like what we see in horror movies.  By the way, do NOT watch horror movies if you have ever ever EVER experienced a psychotic episode, okay?  Promise?!?  Talk about infecting your mind with something that you can't unsee in the first place...and then it coming back up in some form when the psychosis returns for a second act.  Not a good plan!  Also, don't take acid.  Puleeze DO NOT TAKE ACID!  Taking acid when you already have issues with psychotic episodes is like voluntarily jumping into the ocean in the middle of nowhere, completely naked, during Christmas, up in Antartica, and you got asthma besides.  The outcome will not be good.  

Psychosis, when it pertains to visual hallucinations, may be no more "intense" than believing you see something out of the corner of your eye that would be like a "shadow" or "shadows" moving across your field of vision.  You know and feel "What just happened here just now?  Who was that?!"...but then it's suddenly gone.  This is especially disturbing when your sense of "Who was that?" is accompanied by an auditory hallucination:  "I heard the swift footfalls, and I saw only the shadow of somebody running across the kitchen as I stood in my foyer.."  Yep, like that.

Visual hallucinations can also involve really seeing whatever and wherever when not considered or expected.  Like driving down the road in your car, and every time you look up at a road sign or street sign...it says the same thing!  Or talking to someone and their face suddenly becomes someone else's face instead of their own.  Seeing your dog or cat talking to you.  Not knowing where you are "now" in spite of the fact that last time you thought about it, you were in your bed and in your own bedroom.  Stuff like that.  

And yes, visual hallucinations can also involve seeing a giant man or a giant woman or a giant spider...whatever!  Like you are in the middle of some horror movie and you can't do a damn thing about it!

Next post, we will talk about other forms of hallucinations before we get into the second form of psychosis which has to do with delusions (aka fixed false beliefs)...

Until next post....

Resistance: When Your Fear Trumps Your Logic....

Resistance is a thing among us.  We resist.  We are, in fact, really good at it.  We don't notice when we don't want to.  We don't think when we don't want to.  We don't listen when we don't want to.  We don't even do what would come naturally for most when we don't want to (like eat when we're hungry, drink when we're thirsty, pee when we have to go, etc.).  Most importantly, we don't speak the truth or do what's right when we don't want to.  We are resistant.  We are rebellious.  We are  J-U-S-T-P-L-A-I-N-D-U-M-B when we allow our fear(s) to trump our ability to think straight and do the right thing!

In therapy, I will often use the analogy of someone who comes to us and cries out, "I'm starving!  Whatever you have to give me to eat, I'll take it!  I haven't eaten in days!  Please help me before I pass out!"  So you run to your pantry, make a peanut butter and jelly sandwich and pour a glass of milk.  As you hand it to your starving person....he looks at you and replies, "What?  No tuna?  And I don't do milk!  Don't you have any Diet Coke?"  

Yep, like that.  Looking a gift horse in the mouth and complaining about its bad breath syndrome!

If you're going to resist as a lifestyle, please don't involve the rest of us.  It's so annoying!  And painful for us to observe and/or experience with you oh by the way!  

Resistance is not a new concept.  People were resisting over 2,000 years ago just as they are today.  Where we get it wrong is that when resistance works to actually save us in some way, we erroneously believe the practice can still save us when it has the opposite effect.  Kind of like pain killers.  They work until they start causing new and more intense pain than the original pain you began taking them for!  That's how the practice of resistance as a lifestyle can really and truly ruin us and screw up our own lives worse than we could imagine possible.

Even though your personal suffering may be extremely intense and chronic in nature, which is worse?  To stay as you are experiencing the same degree of suffering day in and day out?  Or are you willing to actually "risk" making one or more positive changes that will mitigate your suffering to some degree?  Well, as motivational guru Tony Robbins once said, "Change happens when the pain you are in is greater than the pain of change."  Or words to that effect ;-)  However he put it, he is correct.  Without opening yourself up to making positive changes by actively working to overcome your resistance, you are pretty much doomed to remain stagnant and suffering just as you are now.  Not a good look.  Not a good lifestyle.

My "big" reunion from high school is coming up this fall.  When I think of all the King and Queen Bees and Wanna Bees from that era, there are those who truly maintained and/or achieved their desired status because of all the work he/she/they invested in themselves since high school graduation.  The "work" in this case may have involved spiritual growth and maturity, educational goals and pursuits, career aspirations, getting married and creating a family, charity/volunteer work, achieving optimum health status, maintaining and/or improving one's physical appearance...and I could go on.  Good for them.  There is no reason to ever stop doing your work, because we are all works in progress until we die.

Then there are those of us who graduated from high school all those decades ago...and who are even bigger train wrecks than we were back then.  How sad is this reality?  We may think and believe we did a whole lot of work, but instead what we did was choose the easy path to feeling good fast and without a clue as to its long term effect(s) on our own minds, bodies, and souls.  Don't misunderstand, we all get dragged through the dung in this life;  many of us have tasted that dung since our own infancy.  Others, when our parents unexpectedly divorced...or a beloved parent/family member died...or when we were repeatedly abused and/or neglected by people who were supposed to love us.  Doubt all of this when major mental illness and/or traumatic brain injury is present and...oh well!  No time to think about any of that!  Yes, I do understand how we can go from A to Z in a bad way without doing much else about our present state of existence....  

YET......yet we still get to choose how we are going to "cope" with ourselves and the world around us in ways that are not supposed to add to or complicate our present suffering---but instead actually work to decrease it and/or eliminate it to a significant extent.  And do we do what's right when we are resistant by nature?  Hell no we do not!  Because why should we?  We have become comfortably familiar with our own bad selves and blah blah blah de blah we know better than you or anybody else knows or does anyway.  Spare. Me. 

Our fear(s) are not our masters unless we allow it/them to be.  Besides that, our pride and arrogance feeds the beast of our own resistance because we really do believe we are smarter, better, more sensitive, and definitely more "right" than anyone else on this planet---including the Real "G" God who created us.  (And as I have heard many times before, "What me?  God!?  Are you kidding?  All that He did for me was let all this *$)_@ happen to me to *($_@# me up!")

How's that way of believing and living been working out for you so far?

Resistance as a lifestyle is toxic.  You may have done it a whole lot to survive your childhood as I know I did...but it doesn't work now all that well when you aren't still stuck in the mire of your traumatic past with no escape hatch (as was true back then).  Even if your own trauma-filled and disappointing past extends all the way back to your early childhood...or happened seven years ago when you found out your spouse had been cheating on you since you got married.  Or your child died.  Or you got diagnosed with inoperable cancer. Etc. etc. etc.  Again, we all get dragged through the dung in this life.  What are you going to do about getting OUT of the dung instead of continuing to allow yourself to be dragged through it now?  And so often, by your own choices!

Stop resisting and start your work to get your act together.  It's possible to heal.....to recover your real and authentic self...and to grow/mature from the inside out as the spiritual being you have been designed to be.

Start your work. It's never too late unless you are dead.  Then it's too late.  Just saying.

Until next post....

 

When the Bullies in Your Life...are Still There!

Today's blog post is about the bullies among us who are hiding in plain sight.  In every group we are a part of I hate to remind you, exists one or more seasoned bullies.  What they bully others about may be non-specific in nature "Oh hi Sam!  Nice to see you wearing those jeans that look like they were just put through a meat grinder!".  Or....the bullies among us may be very specific about how and when they target others, "Oh, here comes the Alzheimer's Society ready to protect and serve our *$))@ loser President again today!"  Whether your "bully" is a family member, friend, co-worker, neighbor, or just someone you cannot avoid seeing and interacting with when you do....bullies are here to stay.  They don't just disappear.  And when we walk out of a bully's life once and for all, don't be surprised when another one pops up to replace him/her/them in our own life.  You know, like Murphy's Law....

Whatever the exact nature and extent of bullying we observe and/or is personally directed at us, it's time to learn how to respond back, in the moment of the offense, without reducing yourself down to your bully's own lowest level of functioning.  As such, today's blog post provides us all with what we need to understand---and then do---in order to stop the madness of any bully who feels comfortable using us or our minor child(ren) as a dart board....

First, understand your source (of the bullying).  Let's face it.  Not everyone is right in the head, okay?  Whether they took too many hits while playing football in high school...or were in a motor vehicle accident....or drink too much...drugged too much...eat crap food.....don't exercise or take care of their physical bodies...you catching my drift here?  And what I am writing here represents just some of the more "basic" reasons why someone gets goofy when it comes to not being able to think clearly and speak intelligently about much of anything!  

Then when you add mental health-related issues like an undiagnosed and/or improperly treated mood, personality, trauma-induced, and/or brain-related functioning disorders...what do you expect?  The patience of Job?  The grace of Mother Theresa?  The wisdom of Solomon?  Get a clue!  People who make a habit of bullying are not simply sociopaths who make a career out of using people without a conscience attached.  They are, most often, the products of a family system and a chosen lifestyle that actually and truly did them more harm than good from however far back---just saying!

As an aside, one of the bullies I experienced in elementary school was someone, I later found out, who came from a highly dysfunctional home life involving an abusive stepfather and step-siblings.  Well, how was that supposed to work out in the end for this person?  It just didn't.  So before you jump to crucify your bully up down and sideways---try to understand what happened to him/her/them that made him/her/them the way they are "now".  When you gain that insight, you begin to recognize that you can't expect a garbage can to magically transform itself into a gleaming castle---when around you.  In this way, it would be a good time to check yourself---before you waste any more time wrecking yourself in a relationship with someone who cannot and will not change for the better no matter what "you" do to try and get that person to change!

Once you better understand "what" you are dealing with in terms of the damage done to the bully in question, you do have a choice.  Do you still allow yourself to remain silent and fume on the inside each and every time he/she/they make that nasty and unnecessary caustic/sarcastic/hurtful/accusatory remark to you in front of....???  Do you reconsider your presence at events where your bully is present?  Or do you learn how to proactively and verbally empower yourself so your bully is interrupted and disarmed as a result of your response?  I vote for #3.  How about you?

Here are some things you can say to any bully under any circumstance that offends you in the moment:

1.  "Are you o.k.?"  (Seriously and with concern as you ask this...and then leave the area if he/she/they don't respond truthfully and/or starts clapping back at you negatively).

2.  "You may want to talk to someone about that.  I'm not a therapist." 

3.  "I can see that you are extremely agitated right now.  I don't do agitated."

4.  "You understand that unless a person is asked for their opinion, nobody wants it, correct?"

5.  "I'm not a dartboard, and your darts can't pierce me in case you are confused about that."

6.  "I wouldn't want your nerve in my tooth right now."

7.  "Keep talking.  I'm diagnosing you."

8.  "What made you say that to me just now?"  "Can you explain what you mean by that remark?"

9.  "I believe you are confusing me with someone who allows you to bully them."

10.  "Whatever is making you so angry right now, I know it has nothing to do with me."

11.  "By the way, you have something stuck in your teeth.  You may want to go fix that."

12.  "If you are setting yourself up for having a stroke right now, keep going."

13.  "Whatever it is that made you this way...it's not a good look."

14.  "Are you capable of communicating without all that drama attached?"

15.  "You know, when you act first and think last, it's no wonder to me why you have the problems you do.  You might want to see a professional about that."

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Yes, of course.  Some of the above statements horrify you, make you laugh, or you actually can imagine yourself saying them out loud to your bully in the moment of an offensive behavior.  All good.  Just do it.  If you don't start speaking up, nothing is going to change based on you keeping your mouth shut.

It does take courage to stand up to bullies.  Of course it does.  But not standing up to avoid any sense of real or imagined conflict is worse.  That signals to the bully that you don't know how to manage yourself in the face of blatently rude and disrespectful behavior.  As I just pointed out, the above-mentioned responses will appear to some like "Oh, those are so harsh!  I could never say that!"---while to others, "What a joke!  Saying those things won't stop any bully!"  Yes, and that's how the dynamic nature of life and relationships are!  One man's poison is another man's pablum.  You have to still decide what you are going to do about someone in your life who can't seem to stop himself/herself/themselves from bullying YOU when you are in one another's presence.  

Figure it out.  If you don't, you'll end up taking your bully's bull**** for as long as you keep allowing it.

Think about that.  Can you practice standing up for yourself, instead of allowing the bullies in your life to use you as target practice?  It is up to you...not them!

Until next post...