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Psychology essays | Trauma of Psychosis

• Understanding the Nature of Experience - Part:1
• Understanding the Nature of Experience - Part:2
• Understanding the Nature of Experience - Part:3

Schizophrenia is argued to be a disorder which is largely inherited. For example, if both parents have schizophrenia then there is a one in four chance of them inheriting the disorder compared to the one in one thousand chance that the rest of the population has (Williamson, 2000).

There are approximately four new cases per one thousand sixteen to twenty four year olds (Tsuang & Farone, 1999) and the lifetime risk for schizophrenia, according to the World Health Organisation, is one percent. This basically means that one person in every one hundred will develop schizophrenia (Tsuang & Farone, 1999) therefore schizophrenia is not a rare disorder.
The implications of Schizophrenia on an individual’s life was the topic of investigation of the “The Iowa longitudinal study” in 1979 which spanned thirty to forty years and included 186 individuals with SZ. The findings of this study uncovered some startling implications fort he individuals suffering from SZ:

Table 3: Implications of Schizophrenia

While the implication that one may never marry or that ones marriage may fall apart due to the symptoms of schizophrenia seems harsh, perhaps the most startling finding from today’s research is that 30% of individuals diagnosed with schizophrenia are estimated to attempt suicide at some time with a further one in every ten achieving this goal (Tsuang & Faraone, 1999).
The likelihood of attempting suicide according to Emile Durkheim is though to be exacerbated by the social
ties one has, or lack of them (Bernstein et al., 1997). In today’s society much of our social support stems from contacts made in the workplace. Therefore the inability of the sufferer to carry out their normal work duties may exacerbate the symptoms of schizophrenia via a reduction in social support. This, however is a catch 22 situation in that “for a great many of sufferers, work of any kind is a practical impossibility…the severity of symptoms and the chaotic pattern that their lives have followed combine to make the

demands of even the simplest work unrealistically high” (Tsuang & Faraone, 1999:134). The severity of the symptoms may also be so extreme that the individual prefers to be left alone with his or her own individual thoughts (Tsuang & Faraone, 1999). Unsurprisingly, the negative symptoms displayed by the sufferer are “unlikely to impress the prospective employer” (Tsuang & Faraone, 1999:134). Moreover, if the individual with schizophrenia does decide to continue to work and is over challenged, even during remission, the impact of this stressor is likely to be negative, prompting the onset of schizophrenic symptoms by pushing the individual over their vulnerability threshold (Normal & Malla, 1993).

Diagram 1: Stress and the Onset of Schizophrenia

(Norman & Malla, 1993)

How then do the individuals with schizophrenia cope in their day-to-day relationships and what are the coping mechanisms are used by the sufferers?
Horan & Blanchard (2003) recently conducted a study investigating the influence of coping styles on psychosocial stress in individuals with schizophrenia. The authors measured the following coping styles:

1) Avoidant Coping; denial & behavioural disengagement.
2) Adaptive Coping; planning, suppression & competing activities
3) Acceptance Coping; positive re-interpretation, growth and acceptance.
4) Maladaptive Coping; denial, mental disengagement & behavioural disengagement.
(Horan & Blanchard, 2003:277)
The results of this study showed that the maladaptive coping style was meaningfully associated with emotional responses to psychosocial stress and was found to amplify the individuals stress levels. These findings suggest that perhaps encouraging active stress-management and using problem focused coping styles may be effective in aiding the individual with schizophrenia to cope in stressful situations and ward of the exacerbation of the symptoms (Horan & Blanchard, 2003). However the authors do highlight a need for continued investigation into this area before any concrete recommendations can be made.
Ongoing research in this area is crucial in that…

“The outlook for the individual with Schizophrenia is not good…he or she will show an incomplete response to treatment and will be prone to flare-ups and florid symptoms from time to time…any and every treatments have been explored in schizophrenia …from psychoanalysis to frontal lobotomy... all are merely measured designed to improve the quality of life of the sufferers of a chronic incurable disease”
(McKenna, 1994:219)

This poor prognosis may be attributed to the lack of insight in to the fact that they have a psychotic disorder. Insight being ‘awareness that they have a mental disorder’ and that certain symptoms, signs and consequences can result following the onset of the schizophrenia (Mintz et al., 2003). Research suggests that as many as 50%-80% of patients with schizophrenia are unaware that they have a psychotic illness (Mintz, Dobson, & Romney, 2003). Some researchers such as Moore et al. (1999) believe that poor insight is a coping mechanism rather than an element of the illness itself (as cited in; Mintz, et al., 2003). Thus, lack of insight may be viewed as a tool to ward of the depressive symptoms which may accompany insight of such a disorder on any level (Mintz, 2003). This point is afforded legitimacy in that a positive correlation between insight and depression was found to exist in the meta-analysis by Mintz et al., (2003).
In spite of this lack of insight, the medical model purports to provide the sufferer with some respite from their symptoms. The first Anti-Psychotic drugs were introduced almost 50 years ago. The newer types of medication such as Clozapine and Resperidone, among others, are helping to “revolutionize the treatment of schizophrenia (Williamson, 2000). Anti-psychotic drugs can help to reduce or eliminate the hallucinations and delusions experienced by individuals with schizophrenia in 70% of cases. 15%-20% of individuals with schizophrenia are able to work and lead relatively normal lives as long as they adhere to their medication guidelines and avoid stressful situations (Williamson, 2000).
Between sixty to seventy percent of individuals with schizophrenia will respond to anti-psychotic medication (Martin, 2003). However many individuals suffering from schizophrenia prefer not to take drugs and many feel that they should accept treatment for the sake of their families rather than for their own benefit (Mintz et al., 2003). This aversion to medication can be linked back to the delusions they often suffer from. Alternately, some sufferers “dislike the unpleasant effects of the anti-psychotic drugs and would rather suffer the psychotic symptoms” (Warner, 1994:216). Some of the common side effects include some sedation, dry mouth, blurred vision, constipation, tachychardia, memory impairment, confusion delirium and exacerbation of hallucinations (Williamson, 2000). 40% of patients on anti-psychotic drugs will experience some weight gain and erectile dysfunctions occur in 24% -54% of patients while loss of libido occurs equally amoung both genders (Williamson, 1999). The treatment still seems to be in the early stages of development. So how do individuals with Schizophrenia cope with the trauma of psychosis? This question will now be answered by describing the experiences of two individuals who received the diagnosis “schizophrenic”.
Sally Clay depicts her experience of being diagnosed with a mental illness in graphic detail. Perhaps the most gripping part or her retrospective account is when she is describing how it felt to ‘come to’ after being ‘out of it for a few weeks’…

“A feeling of cold horror grew inside me. I had awakened into a nightmare, deepened by a strange grogginess that made it difficult to even to open my eyes or move my head…my mouth was dry and foul tasting and I would have a hard time speaking even if I wanted to. I knew where I was. This was a mental hospital, the bottomless pit where society’s refuse was thrown”

(Clay; as cited in Barker et al, 2000:17)

Sally Clay describes her awakening a very frightening and traumatic experience. She awakens in a cold dark gray room where other women are sprawled across the floor, some of whom are strangely twitching which she herself is also doing and only realizes this once she looks down at her hands. Sally Clay describes this terrifying experience of near paralysis in a way, which both enthralls the reader and induces real feelings of terror and concern. The recount continues to describe the lack of dignity, respect and information she is offered during her stay in the hospital and she is forced to take medication that she does not know the content or side effects of. The reader is then informed that Sally Clay becomes diagnosed as schizophrenic due to a spiritual experience she had before being sectioned and because she likes to spend time alone, often meditating and communicating with her ‘inner self’. These are behaviours she has carried with her from childhood. Clay continues by describing that on her release from hospital many others validated many of her ‘spiritual’ experiences as ‘real’, mostly by people who originated from the east, thus reflecting cultural differences in what is deemed as ‘mad’. This validation aided Clay significantly in recovering from the trauma of her psychosis and incarceration where her spiritual experience was disregarded as a symptom of an illness, of something that was wrong with her that needed to be fixed. Clay recovered from the trauma of psychosis by acknowledging her experience as valuable and refuting the disregarding nature of the medical model. Moreover, Sally Clay has used her experience to advocate on behalf of other suffers and to enlighten people as to the positive aspects of experiencing such mental illnesses (Barker et al., 2000).
The experiences of Simon Champ another individual also diagnosed with schizophrenia are also reviewed in the book “ashes from experience”. Champ describes the debilating nature of the disorder that he experienced early in his life where he was unable to do any work of any kind. Simon deals with the trauma of psychosis experienced as part of schizophrenia by investigating the nature of the disorder and the deviations of the disorder when comparing the symptoms between genders. Simon states that “on my good days I think that schizophrenia is a gift”. This appreciation of ones mental illness challenges the both the notion of it being it an ‘illness’ and that it is something the sufferer would like to be taken away or cured.
Therefore the trauma of psychosis may not actually be so, the experience may be a very positive one, valued and accepted as part of the self by the individual experiencing the symptoms.
To conclude, this dissertation has introduced the symptoms, history, implications and nature of two different psychotic disorders. It has been demonstrated throughout that the implications of the disorder depend very much on the individual. However, this final paragraph examining the trauma of psychosis from the individual receiving the diagnosis awakens the frightening reality that individuals need not be alone when managing their disorder and that access to services which staff open-minded respectful people will lead to a more positive experience of the individual showing the symptoms of either disorder. This dissertation concludes by proposing that perhaps the attitude held towards mental illness in general causes the trauma of psychosis which may be reversed be changing the perception of mental illness to one of a ‘gift’ rather than a ‘burden’ or something to be cures as suggested by Simon Champ.

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