Making Sense of, and Responding Sensibly to, Psychosis

Abstract

This article argues that words like “psychosis” and “schizophrenia” create the illusion of an explanation for certain behaviors and thoughts but actually explain nothing. Hearing distressing voices and feeling very paranoid do not occur because someone has something called “schizophrenia” that causes them to act in certain ways, although many psychiatrists still cling to this delusion. The behaviors and thoughts that experts in some cultures label psychotic or schizophrenic are usually understandable reactions to our life events and circumstances. So rather than ask, “What is wrong with you?” and “What shall we call it?” It is more sensible, and useful, to ask, “What happened to you?” and “What do you need?”

Girl's and women's experiences of seeking mental health support for symptoms associated with psychosis. A narrative review

“…What shall we call it?’, services should be asking ‘What happened to you? What do you need?’ (Read, 2019). For people who do not feel as though a diagnostic label would be validating or beneficial for treatment options, this approach could facilitate collaborative formulation and reduce the risk of iatrogenic harm.…”

How important are informed consent, informed choice, and patient-doctor relationships, when prescribing antipsychotic medication?

“…Accurate or not, this explanation clearly locates the problem within the person's brain rather than in their developmental history or social circumstances (Longden & Read, 2016b;Read, 2019;Read & Dillon, 2013).…”

“…The findings that two thirds were offered no alternatives and only one in seven was offered some form of talking therapy clearly breach this principle. There are numerous evidence-based nonmedical approaches to treating or supporting people who experience psychosis, all of which have fewer adverse effects than APs, including, for example, CBT for psychosis, Open Dialogue, and Soteria, (Calton et al, 2008;Cooke, 2017;Cooper et al, 2020a;Hurley et al, 2021;Morrison et al, 2018;Nelson, et al, 2020;Read, 2019;Read & Dillon, 2013;Ridenour et al, 2019;Steele et al, 2020). Although the evidence base is still being developed, peer-led Hearing Voices Groups also seem promising (Hornstein et al, 2020;Longden et al, 2018).…”

Psychological Formulation, a Critical Viewpoint: Illness Ideology in Disguise

“…As a profession, clinical psychology can be viewed as one of the forces in society that has promoted a medicalized approach to psychological distress (Maddux & Lopez, 2015). However, as already mentioned, some contemporary clinical psychologists do now question the reliance of their profession on the medical ideology and the language of disorder and deficit (e.g., Division of Clinical Psychology, 2015; Maddux & Lopez, 2015; Proctor, 2017; Read, 2019). Unfortunately, few of the contemporary scholars critical of the medicalization of the distress seem to be aware of the history of client-centered therapy and the details of its theory and practice.…”