Beyond Madness: Psychosocial Interventions in Psychosis

Beyond Madness: Psychosocial Interventions in Psychosis

Beyond Madness: Psychosocial Interventions in Psychosis

Beyond Madness: Psychosocial Interventions in Psychosis

Excerpt

In everyday language psychosis is associated with wild frenzies, crazed deliriums, and frightening activities. It conveys confused and confusing states of mind and behaviour, and a wide array of seemingly inexplicable experiences. Psychotic individuals appear to be living a waking nightmare, to inhabit a frightful world, which they seek to assuage by pulling friends and family into it, or by erecting barriers around themselves and others.

In psychiatry the description ‘psychosis’ is often used synonymously with the diagnosis ‘schizophrenia’. The latter denotes signs and symptoms which include a wide variety of perceptual, cognitive, emotional and behavioural disturbances. These have been defined and refined over the past century, in particular, by the Swiss psychiatrists Eugen Bleuler and his son Manfred, and others. Major diagnostic manuals, such as the DSM IV, continue to objectify, and try to gain consensual agreement about, the nature of ‘schizophrenic’ symptomatology. Interestingly the manuals pay little attention to the interpersonal implications of the condition, although the 19th century psychiatrist Emil Kraepelin described what he called ‘the praecox feeling’, an eerie, uncomfortable experience he felt in the presence of a schizophrenic.

There remain considerable differences between the two terms which are worth noting. Schizophrenia is a medical-psychiatric entity with specific diagnostic and prognostic (outcome) features. Psychosis is a state of being which may be considered aberrant in some cultures, but socially syntonic in others. A ‘schizophrenic’ may or may not be psychotic, and a psychotic person may or may not have been diagnosed as schizophrenic.

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