Misunderstood: My Psychosis and Its Relationship to Underlying Trauma
My life and mental health was a downward slope and my psychosis was waiting for me at the bottom.
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There wasn’t a particular moment that would indicate I had entered my first psychosis, but there was a process.
I struggled with my mental health for the majority of my life leading up to psychosis. I experienced depression since early childhood, a time in which I endured a lot of trauma at home. I had trouble developing relationships and spent the majority of my time alone. In my early teen years, I dropped out of school and started drinking to cope with my isolation. During that time, my brother passed away and my depression became unbearable. I turned to substance use beyond drinking to ease the pain of loss.
The Beginning
It’s a beautiful day in early spring and I’m spending it walking outside with a friend. For the first time in years, I feel connection and joy as we talk. I think about how I want to nurture this relationship but I know it’s complicated by my substance use. I realize that I can’t be the person I want to be when I’m high. I decide that I’m done with using and I’m going to turn things around so that my friend will enjoy being involved in my life.
After my friend goes home, I resist my desire to get high even though it relaxes me. My heart pounds in my chest and it’s hard to breathe consistently. I can’t stop pacing around the house and my thoughts race so quickly that it’s hard to speak in an organized manner. I’m not able to function.
The Turning Point
I went from wanting my life to be better, to thinking it was meant to be better, and that unseen forces were orchestrating a plan for my happiness. My mind would find a special hidden meaning in everything around me. When I was watching a film, each line of dialogue and scene carried a subtle statement about my life, or a hint about my future. When a character in a film would make a statement, I would think their statement was a commentary about my life, or somehow related to my situation. I believed my favorite music record was written about my life and its content was foreshadowing life events.
Everything became a trail of breadcrumbs, guiding me along the plan.
The messages that my mind was pulling from the films started hinting that I was in danger. I developed the belief that my father was not my real father and that I was kidnapped by him as a child. A few nights into my psychosis, I had this terrifying thought — He knows that I know everything. He’s going to kill me.
The Hospital
I wait until he goes to sleep so I can sneak out of the house. Once I’m outside, I run as fast as I can until I reach a nearby apartment building. Standing at the entrance, I pull out my cell phone and call the police and tell them that my father is going to kill me. The police arrive quickly. When they ask for my name, I tell them that I don’t know who I am. They sit me in the back of their cruiser and drive me to a hospital, where I’m held in the emergency room until I’m brought to the psychiatric ward.
At intake, I tell the clinician that I need to find my “real” parents, who I believe are famous screenwriters in Hollywood coordinating with filmmakers and movie channels to broadcast messages to me. I say that the messages told me to find them.
The clinician nods while I speak without verbally responding and occasionally writes on a form stuck to a clipboard. After she’s done with the form, she places a different form in front of me with questions related to whether I’m suicidal or not. I tell her that I feel suicidal and find myself signing a form that gives them permission to keep me there. I don’t fully understand what’s going on.
I disclosed real abuse from my childhood but the staff dismissed it. They allowed my father to visit, with me crying, calling him a killer. It was emotionally devastating to be in his presence while holding the belief he was dangerous.
After my first night in the hospital, I thought that I had died and was stuck in purgatory. This focus on being dead lessened my concern with my father because he couldn’t kill me if I’m already dead. I think the fact that I wasn’t allowed to leave fueled this idea of purgatory and it lasted until the psychosis ended a few weeks later. Some of the most intense aspects of my psychosis ended abruptly while others didn’t.
Waking Up
I’m pacing in the halls, bored, when I notice the art room is open. It’s odd because it’s typically locked up at this time. I peek in the window and see a bunch of people I’ve never seen before, sitting at the tables. I immediately think they’re talking about me and my current circumstances, so I enter the room and sit down quietly. I’m expecting them to discuss my death and purgatory with me. One person is speaking and everyone is listening intently. He talks about how important church is to him and how it helped him stop drinking. When he finishes speaking, the person next to him introduces himself, stating he’s an alcoholic.
It dawns on me that I’m in an Alcoholics Anonymous meeting and that my beliefs about them were completely wrong. This meeting has nothing to do with me. I say, “I don’t belong here,” and immediately exit the room.
Being so blatantly wrong was the catalyst for questioning whether my beliefs were correct rather than just assuming they were. My beliefs about being dead in purgatory slowly shifted into recognizing that I’m alive, in treatment. When that shift occurred, so did my belief about my father. I started to recognize that he was not trying to harm me. That’s when I started to see leaving as a possibility and starting working towards doing so.
A Better Understanding
It would’ve been helpful if the hospital providers tried to understand my whole story, rather than just observing the psychosis. I needed help with things in my personal story. It’s so detrimental to be treated as unreachable. In order to increase understanding, a person must be approached as more than their present experience. Every person has a story that is immeasurably important. Genuine curiosity can make a difference, along with believing that healing is possible and can be nurtured. In the absence of trust with hospital staff, much of my trauma went unaddressed.
Dr. Constance Scharff, a researcher and author, speaks to the benefits of addressing trauma with providers and supports:
“Processing your experiences with a therapist, close friend, or in another way that feels right for you, will lead to a fuller life for you and your children, and will decrease your use of unhealthy coping mechanisms, including substance abuse.”
For my discharge plan, I was sent to a two week outpatient Dialectical Behavior Therapy (DBT) program, which is a structured form of therapy designed to help people develop skills to manage intense emotions and reduce conflict by balancing opposing perspectives. I was also referred to individual therapy, which has been a silver lining for me in terms of entering the mental health system. There was no discussion about the benefit of DBT and I wasn’t told about my diagnosis of “Bipolar I, Mania” until I received the discharge papers.
The Bipolar diagnosis meant I had been experiencing mood fluctuations that were intense enough to be disruptive to my life. The mania piece is a component of the diagnosis that was being treated during my stay. The term “mania” describes a mood that is high in energy to the extent that it’s unmanageable. It can impact thinking, the way we experience the world, and lead to psychosis.
Dr. Kay Redfield Jamison, a clinical psychologist and writer describes mania and psychosis as:
“The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption on friends’ faces are replaced by fear and concern. Everything previously moving with the grain is now against — you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind.”
Telling My Story
I was vague about my hospital stay with friends and family when I was discharged. I felt embarrassed about the interactions I had with them during the psychosis and apologized for anything that worried them. I ended up pulling away from the friend I had walked and connected with at the beginning of my mania because of the embarrassment. Everyone around me was simply confused by it.
I think society associates psychosis with being unpredictable, destructive, and dangerous, which is just not me at all. Even at the scariest of times, I ran away from perceived threats. The negative societal perspective made me feel like people would abandon me if they looked up my diagnosis or psychosis online, so I didn’t allow myself to be close with anyone for several years. Fortunately, no one I knew personally had that perspective on me.
I’ve been able to make some sense of it over the years in therapy. I learned that my actions of seeking safety made sense in relation to trauma. I believe that the theme of afterlife was related to my brother’s death. I believe that abruptly dropping substances was psychologically unmanageable for me. When my therapist learned my story, she was able to support my healing from the trauma that had influenced my psychosis.
It was an experience that has always been challenging to articulate. It’s been nine years since my last episode and over that span of time, I’ve experienced a lot of healing. During my inpatient stays with psychosis, significant traumas went unaddressed due to my treatment providers being unable to decipher what was being communicated in my words and behaviors. In hindsight, I view my psychosis as my mind’s attempt to facilitate psychological healing. The problem in treatment is that its presentation was not easily understood.
For more information and resources on psychosis, click here.
