Psychotic episode happens when the mind cannot cope with the challenge it is presented with. Although psychosis is not a personality disorder, it can be experienced as a symptom of bipolar disorder, schizophrenia, schizoaffective disorder, delusions, gender identity disorder or severe depression as well as physical illness – malaria, Alzheimer’s disease, HIV, Parkinson’s disease, Lyme disease, multiple sclerosis, stroke, epilepsy and brain tumours. It can happen as a single experience due to excessive stress especially when paired with lack of sleep due to intense work load, childbirth or relationship difficulties. Recreational drugs such as cannabis, amphetamines, cocaine, magic mushrooms, ketamine, ecstasy and LSD are known to cause psychosis.
Some people are more prone to psychotic outbreak than others. Genetics has often been implicated in the increased likelihood of psychosis, however, there is no particular gene that was found to be responsible. It may be that heritability of psychosis is due to repeated unhealthy environment and parenting strategies that in itself can cause changes in the molecular structure of the brain. It is well known that our experiences can shape our brain and vice versa, especially during pre-verbal stage. For example, if the child was repeatedly left alone to cry in his or her cot for hours at a time, this will inevitably have an impact on the brain structure. Predisposition to psychosis is often associated with early physical or emotional neglect or abnormal family dynamics such as “double binding” where a child receives contradicting messages most of the time. For example, smiling caregiver asks the child to go away. In this way, psychosis can be viewed as a temporary disintegration of the mind with loss of inner coherence.
The task of psychoanalytic psychotherapy is to assist an individual in their recovery post psychotic episode. Depending on your experience and robustness you may want to understand your experience and its causes in order to prevent it from occurring in the future. This may include adopting slower paced life style, learning to recognize personal triggers and first signs, reviewing career prospects, dedicating time to wellbeing and sleep and choosing healthy relationships. You will have an opportunity to address any fears relating to your psychotic experience such as whether it may happen again, whether others will be there to help or whether it will last longer or be more difficult to bear. Your psychotherapist will keep an eye on your wellbeing to ensure that psychotherapy is designed to feed your curiosity about the self without disturbing your mental equilibrium.
In cases where an individual finds themselves in a more vulnerable place – frightened by the experience, just out of the mental health hospital, feeling stressed or attending because of the request of another family member, therapy pace will adjust to these needs. This may mean that your psychotherapist will adopt slower therapy pace and utilise supportive rather than exploratory interventions. The focus of psychoanalytic therapy will be on designing coping mechanisms and strengthening the core of personality so that psychic re-integration can take place again.
If psychotic episode was an expression of other mental health disorder, this disorder will be treated with the tools from various therapy traditions to ensure faster recovery process. Although psychosis is an unsettling experience it can be quickly and effectively treated with an appropriate medical intervention.
Before your sessions begin you may benefit from starting a diary or writing down any reassuring statements and reflections on your condition. Becoming curios about your condition you may wish to use your diary to write down your observations of yourself. This way you will gradually learn more about your condition and process your experiences. The more you know about your difficulties the more in control of your life you will feel. You may use your diary as an encouragement to yourself and others, reminding yourself that psychosis need not necessarily happen again, it is temporary and that you have what it takes to cope with it.