2. Anchors away: How reasonable is hypomania and psychosis?

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16 November 2021

By Amy Pollard @AmyRPollard


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In the first piece of this series, I described the six broad principles which underscore Enlightenment thinking, and how the most dominant of these, “Reason”, meant that non-reason was banished to the cultural wilderness. Through a historically contingent process which accelerated from the 17th and 18th centuries, those with mental health difficulties found themselves out in the wilderness too. We use the term ‘madness’ both to talk about mental illness and also to refer to illogical or irrational behaviour. Where modern society has been forged through “The Age of Reason”, those who are non-reasonable – the mad – have no place within it. As part of a process which bolstered the norms and values of mainstream society, the unwell were scapegoated; sacrificed to the cause of purifying Enlightenment culture and forging boundaries from within which the well could drink.

In this piece, I want to test the fundamental assumption on which this argument rests – that ‘madness’ is aligned with non-reason.

If we were more imaginative, open-minded and better informed, would we actually see that the states of mind that people enter into when they are seriously unwell have their own patterns of logic and order? Is madness in fact perfectly reasonable, just in an unusual way?

If hypomania and psychosis turn out to be quite reasonable when understood from the right angle, then perhaps we can include mad people within Enlightenment culture after all. Could we repeal the banishment by showing that people with severe mental illness have been excluded in error?

I’ll explore these questions with reference to hypomania and psychosis – states of mental ill health which look particularly ‘mad’ from the outside.

What is whizziness?

Whizziness is my preferred word for hypomania. As someone with a bipolar diagnosis, it’s a state of mind I’m very familiar with. Other people with bipolar would describe being hypomanic in different ways, and everyone makes sense of their experiences uniquely. With my social anthropologist hat on, I’ve been observing whizziness in myself when it has arisen over the years and have been taking fieldnotes on my version of it since 2006.

It is hard to describe whizziness with words, because there is inherently something beyond language about it. There’s something about it that resists representation and dances across your mind, body and spirit, changing the essence of what it means to “be”. It’s tempting to follow Joaquin Phoenix as the Joker in Batman, who laughed to himself under questioning and declared: “you wouldn’t get it”. Gap year students coming back from Ayahuasca retreats often say similarly, and are typically held to be wankers.

As the name suggests, there’s a speed to whizziness. You have lots of ideas. You make lots of observations. A lot of thoughts come, and there’s a sense that the rhythm in which you are operating is higher tempo than everyone else around you. Some people have a lot of physical energy: I remember once being at a bipolar peer-support group in Camden, where a whizzy young man shared that his plan for the next day was to walk all the way to Newmarket.

Most people – “neurotypical” people – would naturally get tired and rest if they were walking all the way from Camden to Newmarket. They’d probably stop and sleep a few times. But it’s not safe to assume that this will happen for those who are in a hypomanic state. Before modern psychiatric drugs were available, bipolar people would often die of exhaustion or dehydration. It was more common for us to die this way than to perish from suicide; and we frequently died before we were middle-aged.

Sometimes people use physical activity as an attempt to get tired, hoping that the thoughts in their heads will then slow down. You might find yourself being irresistibly drawn to write – getting your ideas down onto paper in an attempt to stop them whirring in your head. You might want to manifest your ideas and get lots of things done (once they’re done you can stop thinking about them, right?). Sometimes this can be a very productive and creative time, and it’s fun for some people. But it becomes very challenging as you get more and more exerted but are unable to rest. It’s not necessarily a question of willingness – you might want to rest or know that you should. But you just can’t. The energy is beyond your control.

It can be quite lonely. Because ideas and thoughts are coming to you much faster than they are coming to other people, it often feels like the normal ‘throwing and catching’ of social communication is broken. Other people don’t want to play at your speed. When you throw an idea to them, they don’t catch the ball. They can’t grasp it; they can’t hold it; and they don’t throw it back to you. Sometimes they attempt to stop the game and slow down the energy by taking the ball away. This may well remove your fragile coping mechanisms. When this happens, you are left with no option other than to throw the ideas around in your own head.

If you can’t find a person who is able to handle a high-intensity game of whizzy ideas ping-pong, it can be comforting to be in an environment which is whizzy and full of energy too. Some people surround themselves with pumping music. Some bathe in the high-octane cacophony of Twitter. Some people go Downtown, as Petula Clark would suggest, and walk in the bright lights of the city. I know people who ride out the frenetic early hours going nowhere in particular on the night bus, and who travel back and forth on the Central Line so they can be immersed in the screech of the underground. Some people have sex with loads of strangers or spend all their money – anything to find a connection to a person; to their body; or (failing that) to things.

When he really wasn’t well, a colleague of mine tried to walk up a subway tunnel in New York to trace the electricity cables. I found this story frightening and very relatable. It was like he was trying to trace his own synapses; to step into the high-voltage blackness and find out where these relentless trains of thought kept coming from.

Of course, this story also illustrates why people who are operating at normal speed are reluctant to play whizzy ideas ping-pong! As a carer, you don’t want to engage with the whizziness in a way that revs it up, or encourages trains of thought from your loved one that are headed in an unwise direction. You don’t want to accidentally imply that walking up a subway tunnel is a good idea! And it can be difficult to tell where trains of thought are headed. That’s where another phenomenon arises, which I call the Anxiety Vortex.

The Anxiety Vortex

Very understandably, whizziness can make people anxious. When it makes carers anxious, the carer’s anxiety can make the whizzy person anxious, because it sends the message that this experience isn’t something that can be coped with. Either tacitly or overtly, the whizzy person is often asking the carer “am I out of control?”. If the carer responds in a way which conveys “um, I don’t know, maybe you are!!” then everyone starts to panic.

Before you know it, an Anxiety Vortex starts to swirl, whipping up both the whizzy person and everyone around them into an escalating state of alarm. This, of course, is counterproductive to the whizzy person becoming less whizzy and more grounded. The vortex gains more and more momentum, as anxiety begets anxiety. A gulf opens up between the carer and the whizzy person, which the carer interprets as evidence that the whizzy person is becoming seriously unwell. The whizzy person then feels irritated and resentful that the carer is framing their anxiety as proof of the whizzy person’s illness, rather than the carer taking responsibility for their own anxious feelings themselves. They rebuff the carer’s interventions, which only serves to make the carer more anxious still!

Not knowing what else to do, the carer escalates the situation by reaching out to services. If you can’t access a GP whilst in crisis you will probably have go to an A&E department – environments which are hardly known for their relaxed and chilled-out atmosphere. Services, of course, have their own modality for anxiety: risk assessment. When a whizzy person presents to primary care and then gets referred higher up the system, it can feel like an institutional version of asking the carer “am I out of control?”, where the system responds “um, I don’t know, maybe you are!!”.

Clinical decisions do not only reflect the levels of distress experienced by the patient: they are also a function of the risk appetite, modalities of judgement and accountability systems within which health professionals operate. Professionals are trained to err on the side of caution, and their accreditation depends on making real-world judgements which align with whatever has been delineated as the professional standard. This is usually a good thing, but it’s not something that health practitioners always acknowledge explicitly to patients. Doing so would frame their authority as contingent and this is widely seen as undermining, especially in situations where persuading patients to accept treatment is a life-or-death matter. It takes a confident, reflective health practitioner to acknowledge what’s going on in the round.

When health practitioners frame their decisions as solely delineated by the condition of the patient (as if this exists in a petri-dish with no social context), an even more pernicious Anxiety Vortex can swirl. Patients contemptuously resist a system which frames them as “the problem” and fails to acknowledge how risk assessment – a formal framework for mediating professional anxiety – plays into treatment decisions. They may feel insulted at being pathologized when a wider context (for example, family dynamics, trauma or societal injustice) is at the root of their suffering. Their resistance makes health professionals even more worried and this is seen to necessitate more coercive and restrictive treatment. Such coercion alienates patients further. As trust breaks down, patients spiral in the Anxiety Vortex and become increasingly powerless, uncooperative, angry and unwell.

It’s a tragic situation that nobody wants. It would clearly be much better for all concerned to de-escalate the Anxiety Vortex, stop it from spiralling – and stem it from developing in the first place.

To that end, I’d like to offer a suggestion for how we might make sense of whizziness and understand it a bit better.

Making sense of whizziness

When you’ve been whizzy for a while – living at high speed for days without eating and sleeping – you develop a sensitivity which makes the world challenging to interpret. It’s like an extreme version of what in normal life we call feeling ‘spacey’: a sort of lunar time where the world is bathed in eerie moonlight, rather than normal daylight – which is perhaps where the term ‘loony’ comes from. It’s common to have little glimpses of this headspace as a neurotypical person – you might feel a gentle version on the Sunday morning of a music festival, when coming down off strong painkillers, or in the days after giving birth.

When you’re in the full banana version of this headspace, however, it can get quite confusing. Some people report that they are able to read minds, make people do things and predict the future; or think that other people can read their minds, make them do things or set them on a path. They sometimes think that the world is fake; that everything has been pre-arranged; that they are dead; or that everyone is an actor and they are living in a play.

I agree with the neurotypical view that these beliefs are mistaken – that is, that whizzy people dip into psychosis as they stop being able to process the ‘noise’ of multi-sensory data from the world into the ‘signal’ of reliable information about what’s going on. But I also think these misunderstandings are relatable and interesting.

Here’s my theory about it:

When you are whizzy you become acutely aware of the social cues for connection and disconnection that are usually read tacitly. In social interactions, people are always giving each other signals that they want to connect (aka “bids for attention” [1]) or signals that they want to break away from the interaction. Often, people are breaking away from a social interaction because they are called to attention by a thought in their own heads, or a feeling in their own bodies.

The signals to connect or disconnect function like “advance!”/“retreat!” commands, which we read in other people without thinking about it consciously. We read each other not only through what is said overtly, but also through body language, tone of voice, and myriad other subtle cues. We use thousands of muscles in our faces, especially around the eyes, to send out “advance!” versus “retreat” messages to others. We usually don’t do this deliberately – we do it unconsciously, without realising it. Because when you are whizzy you are operating so quickly, you stop doing this automatically. Your perception becomes so fast that it’s like being able to see all the different still-image pictures that make up a movie film: usually the movement looks smooth, but suddenly you can see all the pictures.

When you correctly interpret whether someone is giving you an “advance!” or a “retreat!” signal in normal life, you create a delicate social dance with the other person and send your own signals for them to interpret in turn. If all goes well, you complete a social exchange of some kind – communicating a message to someone else, and receiving one in turn. Completing a social exchange of messages is what we do when we deal with one another. Doing this unconsciously is an important part of what makes the dance go smoothly. Things get awkward if people become self-conscious – that is, if they start thinking explicitly in their own minds about what they are doing when they are dealing with someone else.

Whizzy people’s sensitivity emerges as things that are usually part of our unconscious lives start to intrude into our waking consciousness. It makes sense that this would happen. If you haven’t slept for a long time, it figures that eventually unconscious stuff – that usually surfaces when you are dreaming at night – will start to come through anyway. Whether you like it or not, you become aware of things that belong to an unconscious realm.

Because we are used to navigating each other’s other people’s “advance!” versus “retreat!” signals automatically and without thinking about it, it can feel very frightening to a sensitive whizzy person when these become blindingly, screamingly obvious. It messes up the dance. It makes things so awkward that awkward isn’t even the right word anymore – it makes things feel false; strange and uncanny. Not being able to socially dance with others means that exchanges of communication start to falter. That is to say: you lose your ability to deal with other people, and other people lose their ability to deal with you.

When you can’t deal with things

It’s even more scary when you start to notice the “advance!”/“retreat!” commands in social interactions that don’t involve you – and those which involve things (objects, images, lyrics, concepts or material stuff in the world) not only people. There’s no turning the sensitivity off without sleep or drugs, so you have no option but to watch the multitude of dances which happen everywhere you look. The fact that you can’t stop seeing the “advance!”/“retreat!” commands is exhausting. It’s lonely to be constantly confronted by a phenomenon that nobody else seems to be paying attention to – especially when pointing out what’s going on only makes things worse.

For example, I remember once sitting in the bath and hoping that the hot water would provide some relief from my whizzy headspace and help me connect with my body. My husband and I had lost the rhythm of our dance at the time, so I was watching Match of The Day as a proxy for him.

Terrifyingly, Ian Wright and Alan Shearer chatted about the football. Ian had some beige trousers on. A young man glanced upwards before answering a journalist’s questions about why his team had underperformed. A swishy sound effect accompanied a camera shot as it rapidly zoomed in, like the outbreath of a boxer. Two pundits accelerated their verbal capoeira into a punchy staccato as they argued about the strategic errors that had led to a defeat. There was a faint sense of disconnection in Gary Lineker’s voice as he read some of the scores, but this strengthened as he touched the table. I noticed that the children’s song “thou shalt have a fishy on a little dishy” popped into my head as a bald referee blew his final whistle. It was all too much!!

It was like watching a dance rehearsal with the music turned off and the instructions spoken aloud: “One, two, step-ball-change” became “in-breath, eye-flicker, comment on the penalty”. It was very clear that things – the trousers, the sound effect, the football scores, the bald head, the whistle – were part of the dance, and that there was more to the movement than just people. Everyone on screen seemed to be effortlessly moving to the music, but to me the choreography was painfully conspicuous. There was a performance going on. Was this real life? Was everyone pretending?

Worst of all, the graphic boxes which the Match of The Day team had chosen to frame clips of the highlights were electric pink. Why pink?! Were they always pink?! Pink is associated with women and girls in British twenty-first century culture. Electric pink is a colour of energy. Was this a bid for my attention from Match of The Day? Had the producers of Match of The Day somehow known that I would be in the bath in a state of high energy, attempting to obliquely connect with my husband by watching the football? Were they reading my mind?!?!

Reflecting back now I would say that the answer to this is, kind of, in a way, yes. The graphics designers who decide on the colour palette for Match of The Day would probably have been influenced by the cultural associations of an electric pink colour. They’d probably have a sense that it would be boring if a programme with a mostly male audience limited itself to a stereotypical masculine colour palette. The producers no doubt have an eye to ensuring Match of The Day is welcoming and inclusive to women and girls, and pink is a low-key way of signalling this. It probably was to do with building bridges between men and women, at least partly. Electric pink is an exciting colour, which matches the emotional tone of the football highlights.

Crucially though, the Match of The Day producers wouldn’t have been directing their electric pink graphic boxes solely at me. There’s no disputing that the colour was indeed a bid for attention. And it was absolutely a bid for my attention – because I was an audience member. It was an “Advance!” command, beckoning the audience’s attention towards it. But it was a bid for everyone else’s attention, too. The fact that it represented outreach across traditional gender territory was synchronicity: a meaningful coincidence. It was not a secret plot to bring my husband and I closer together.

But it is very challenging, in a state of extended whizziness and sleep deprivation, to interpret all this in a way that is congruent with the anchors of reality that other people share. It’s difficult to bounce your interpretations around with other people without making things worse: Asking whether Match of The Day is sending a special message to you through its graphic design is no way to de-escalate an Anxiety Vortex!

So it’s hardly surprising that whizzy people draw inaccurate conclusions from their experiences. When you are flooded with material from the unconscious, you are dealing with a very noisy multi-sensory data set. In my view, if we conclude that the world is fake – that we’re able to read minds, make people do things, predict the future etc – it’s because we’ve misunderstood what’s happening with the “advance!”/“retreat!” dance, which is part of social life all the time. But we’ve had a decent stab at making sense of some extremely challenging experiential material.

Are these interpretations wrong? Yes.

Are they reasonable? Definitely.

The social life of things

In my view there is nothing wrong with the fundamental observation that whizzy people grapple with: that the world is filled to the brim with meaning.

In my training as a social anthropologist, I explored evidence from every corner of the world of how human societies infuse relationships and the world around them with meaning; and make sense of meaning that they find to be already there. From an ethnographic point of view, there is no a priori limit to the ways in which our social world can be found, and made to be, meaningful – it is as boundless as human imagination.

The interpretation of whizziness that I’ve outlined above is in conversation with social theory that has done the rounds in my discipline for generations.

In 1925, one of the big granddaddies of anthropology, Marcel Mauss, wrote a classic ethnography which explored how gift exchanges build bonds of reciprocity between people, strengthening not just personal relationships but social solidarity [2]. He described how gift exchanges in Māori societies are subject to strict customs and unwritten laws, which aren’t made explicit but function as the ‘glue’ which binds the community together. His work sparked a canon of scholarship about how gift exchanges function to build society, in contexts all over the world.

We can think of communication as an exchange of messages, where words are offered as gifts for the other people to receive and reciprocate in turn. This is reflected in colloquial language such as “do you get me?” – added after someone has sent a message to check that the other person has accepted it; or in walkie-talkie lingo, “are you receiving me?”. When whizziness speeds up the rhythm of an exchange of words, violating its tacit terms, it contravenes the unwritten laws which govern how people make deals with each other in conversation. As the glue of this gift exchange starts to break, it’s no wonder that whizzy people feel that they have fallen out of society.

The idea that we follow “advance!”/“retreat!” commands to create a dance of social life is an extension of a famous analysis by Ervin Goffman. Back in 1956, he used imagery from theatre to create a sociological version of Shakespeare’s “all the world’s a stage” idea. Goffman explored how people read cues from one another in social situations to avoid embarrassing one another, and to play out roles that they perform within a particular social setting. There is a ‘front’ where people present themselves carefully so as to maintain a positive impression in front of their audience, and also a ‘backstage’ area where they set their performing mask down and relax. For example, a team of waiters will perform graceful and deferent service when dealing with customers at tables, but slip out of role and bitch to colleagues when they are backstage in the kitchen. People use props (objects), costumes (clothes) and sets (their environment) to perform their roles and make them convincing. These material things and surroundings give people cues which tell them what kind of performance is expected of them, but the performance is created by people themselves. Goffman’s theory therefore offered a bridge between what social scientists call ‘structure’ (stable, established patterns in society that individuals can’t easily change) and ‘agency’ (the choices that individuals can make independently).

In my Match of the Day example, Ian Wright’s trousers were – like all trousers – part of a costume. The swooshy sound effect helped set the scene. The young man glancing upwards before he answered the journalist’s difficult question was, we might imagine, a moment of retreat into his back-stage to gather strength before a challenging part of his performance. Something had thrown off Gary Lineker in his role as reader of the football scores, but had an internal team member – a little voice in his head – helped him get back on track? Usually, in order to perform in our own in social lives, we don’t pay conscious attention to these things – we play our parts quite automatically. A dramatic performance falls apart if you make a big deal of responding to the cues, or if you explicitly point out the cues that other people are following. So it makes sense that suddenly becoming very aware of social cues is terrifying: it threatens to bring the curtain down.

There’s a perennial debate in social science about structure versus agency – i.e. how much our lives are pre-determined and delimited; and how much we can influence ourselves. In terms of Goffman’s analysis, are we like characters in a play that is scripted? Is this an improv performance where we’re making it up together? Or are we the actor-directors of our own show? For me, whizzy misunderstandings about the fakeness of the world or mind-reading are akin to sociological interpretations at the extreme end of ‘structural determinism’. This theoretical perspective isn’t my bag, but in a social science context it’s not particularly wacky or weird.

After Goffman showed how people are actors in their social worlds, social scientists then explored how things can be actors too. Arjan Appadurai’s classic 1986 collection, The Social Life of Things, described how the things that people exchange do not just have economic value, but political value too [3]. The production of material things, ideas, words or images is a cultural and cognitive process – where things are not only brought into the world on a practical level, but imbued with significance within their social context. When things are significant, they mean something: they have power which is about more than financial value. To translate this in terms of my Match of the Day example, the referee’s whistle was not just a way of making noise, but a conduit for authority, justice and a truth-claim about who had won the football match. The whizzy sound effect was an assertion of power – which signified that the camera shot was important and worthy of special attention from the viewers.

In the 90s, scholars such as Daniel Miller described a rich world of material culture, where things were not just passive objects carrying messages ascribed to them by human beings, but active agents of social relationships themselves. Miller’s Theory of Shopping showed how everyday purchases in North London not only illuminated love within families, but actively fostered and shaped those relationships [4]. Buying things for family members was a love language which not only articulated relationships, but made them develop and grow.

Bruno Latour, an anthropologist/philosopher/rock-star, then smashed open the scholarly conversation like a seagull smashes open a shellfish – by dropping the ideas from a great height. In the Parliament of Things he asserted the autonomy, agency and rights of objects [5]. He contested the subject/object dualism of traditional scientific inquiry, which positions power as the sole privilege of the former (take that, Cartesians!). Latour described how both humans and non-humans constellate networks, arguing that we make sense of social life by tracing the nodal points of these networks – joining the dots, if you like. This happens in a fragile and ever-shifting way, where the positioning of humans and non-humans can emanate powerful meaning whilst in a certain constellation, but which slips away in the next moment.

To apply Latour’s theory to my Match of the Day example, Ian Wright’s beige trousers may indeed have been highly significant, whilst held momentarily in a network with myself, himself and the groin covering archetype of trousers in general. The fact this power came and went, unbeknownst to other Match of the Day viewers, has no bearing on whether we might believe that the mind-blowing power of the trousers had once existed. There’s no reason to think it wasn’t there, just because nobody else could see it.

From the turn of the 21st century, anthropologists went still further. In a 2007 break-out collection, Thinking Through Things, Henare et al. proposed taking ethnographic informants seriously when they told anthropologists about meaningful, powerful and significant things in their lives [6]. These scholars had gathered field data from a range of societies which contrast markedly with our own. Holbraad had studied divination in Cuba, and been told by his informants that a particular kind of red powder was power: Not that the powder was a representation of power, but that it actually was power. Pedersen had worked in Mongolia where shaman had described to him how, by wearing a particular costume, they could be transported to a spiritual world where a different type of vision was possible. In a Papua New Guinea prison, Reed’s informants showed him how cigarettes kill memory and change the nature of time.

Rather than take this to be evidence of be different world-views (i.e. cultural perspectives or beliefs, where informants impose their interpretations onto a reality that we all share) Henare et al. argued that these things actually created a different reality. It wasn’t the case that these informants were imbuing things with meaning – looking at the world from a different angle and seeing different things in it. Instead they argued, “things create a plurality of ontologies” [7] – that is, these seemingly magical things were actually real.

Mic drop!! Henare et al were questioning the very fabric of reality. They were asserting that all manner of ‘strange beliefs’ were not just differences in perspective, but actually true. But this collection of essays was not taken as evidence of a collective academic psychosis. On the contrary, the authors became like academic versions of the Young British Artists, who ended up with some of the most prestigious jobs in the discipline.

*

Now, I don’t recommend opening up a can of social theory on your local community mental health team the next time you are struggling to access appropriate care. Even at the best of times, many people mistake social science for inflated beliefs (I can’t imagine where they get that from). But, quite honestly, you could close your eyes and throw a dart in an anthropology library to find evidence calling conventional mainstream psychiatry into question.

This isn’t a problem in itself, as any academic discipline worth its salt loves to be questioned. As someone who has had their life saved by psychiatric drugs, I’d be the last person to dismiss psychiatric expertise wholesale. However, I’d argue that psychiatry as commonly practiced in Britain today requires two crucial steers:

1. Drop the disorder

Psychiatry would never call mental health conditions ‘disorders’ if it was concerned with asking if these psychic experiences in fact reflect a different kind of order which we just don’t understand. As a discipline, psychiatry isn’t really designed to consider whether this might be the case – anthropology, philosophy and other humanities disciplines have better methodological tools for looking into these questions. That’s fine, because scholarship is a team sport and you can’t do everything. But by using the term ‘disorder’, psychiatrists obstruct curiosity and foreclose the possibility that there is an order to these experiences which is simply difficult to grasp. It stops people even asking the questions. Psychiatry should hold open the space for empirical enquiry by those with the tools for the job, and flag the knowledge gap for them to step into.

Rather than saying ‘bipolar disorder’, just say ‘bipolar’. The place for describing the texture, normativity and context of a condition is in the adjectives that describe it, not within its defining noun. There is no medical need to referring to patients as disordered – in my view, nobody in the mental health space should be using this terminology.

2. Check your hubris

There’s no justification for the common practice of saying the perceptions of a patient are ‘subjective’, but the perceptions of carers and health professionals are ‘objective’. It’s not only rude – it’s an inaccurate use of the terms which stops people being reflective.

Better to recognise the power relationships here: the perceptions of carers and health professionals are hegemonic. That doesn’t mean their views are necessarily right or wrong – it means these perspectives can ultimately be enforced because they belong to the people who hold the most power. Do not mistake having power for having knowledge – there may well be something going on that you simply don’t understand.

Psychosis shouldn’t be defined as “losing contact with reality”, because “what is reality?” is a perfectly valid ontological question that has been at the heart of the human condition for thousands of years. It’s more empirical to define psychosis as being out of touch with the anchors of reality that other people share.

This doesn’t mean that people in psychosis might not be mistaken. It means they might be dealing with their own truth.

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Not ‘real’ life; but inner life

Psychosis can be truly awful. You might think that cockroaches are crawling over every inch of your body; that you are surrounded by MI5 agents who are spying on you; that a car wouldn’t kill you if it ran you over; that you are compelled to perform miracles as the embodiment of Jesus Christ; or that you have to do something terrible in order to make your ordeal stop. If you believe that this kind of thing to be happening, it’s possible you will do dangerous things. In order to fulfil some kind of mission or get yourself out of a horrible situation, you might find yourself resorting to some pretty desperate measures.

It is more common for people in psychosis to frighten themselves, and those around them, with these beliefs than for the worst possibilities to be realised – but clearly this is a time when people need looking after. We know that the presence of psychotic beliefs has a statistical positive correlation with people doing dangerous things, and that, left unchecked, the beliefs may ramp up and become more and more detached from the anchors of reality that other people share. Quite apart from where it might lead, psychosis is usually a terrifying and traumatic experience in and of itself. Of course, we want it to stop.

But it lacks curiosity to say these experiences simply aren’t true. I think there is an alternative to disregarding psychotic beliefs as delusional, which involves taking whizzy people seriously, but not literally.

Let’s remember that the context in which whizzy people become psychotic is that they usually haven’t slept for a long time. In my opinion, we are effectively dreaming. The beliefs and altered perception that comes through during psychosis are more or less a waking dream, where subconscious material rises up, floods our waking life, and gets muddled up with what we usually perceive consciously.

A dream is not real life, but dismissing it as ‘just a dream’ is to miss out on some of life’s most fascinating dimensions. I favour Carl Jung’s framework for dream interpretation, which explored how the images in dreams are symbols which reveal our inner lives to us each night. Dreaming is universal in human beings, whether we remember them or not. There are methodologies which ordinary people can use to interpret their dreams – and these can be useful tools for understanding our inner lives, whether you’ve experienced mental illness or not [8].

Dreams can be frightening and they can be beautiful. In a dream you might be able to fly or find yourself falling from a great height; find rats dripping from your kitchen ceiling or be chased by a dead dog whose body is rotting away in cling film. You might leap off a cliff with your dress popping out like a parachute; or whizz across water like a motorboat with your arms outstretched. You might find your childhood home transformed into a labyrinth, or wrestle a film star to the ground before eating him.

Stuff that happens in psychosis – especially inflation and persecution – is ubiquitous in dreams. It’s normal for illogical things to happen. But just because dreams are illogical it doesn’t mean that they are meaningless. In Jungian work, you analyse dreams in terms of their symbolism; considering the images and narratives to explore what kind of message might have been offered by the psyche. I’d suggest you can analyse whizzy perception in the same way.

For example, if the Match of the Day example was my dream, I’d notice the resemblance between Ian Wright and a schoolteacher I once idolised. I’d recall once watching a documentary about Ian Wright’s tearful reunion with the schoolteacher he himself had once idolised, and his painful wait for a pair of trousers. I’d speculate that Ian represented a symbol of circularity in my dream, where every idol has a teacher whom they idolise themselves.

If this was my dream, I’d notice the table which Gary Lineker touched just before his voice strengthened. A table is space on which you deal with things. Perhaps this image represented the idea that, by finding space to deal with things, I might find strength. Or perhaps [cue spooky sound effect] Gary Lineker had actually gained strength by touching the table and tacitly absorbing this idea himself. Wooooo!!

If this was my dream, I’d wonder if the image of the electric pink graphic frames for the highlight clips represented my experience of whizziness itself. A frame is something you see the world through – it delimits what you are looking at and establishes the context for what you will see. With their high voltage colour-palette, perhaps the electric pink graphic frames were an image of my own change of perception, which had caught my eye precisely because they represented a shift in consciousness that was frightening me.

If this was my dream, I’d notice that the second stanza to the “thou shalt have a fishy” children’s song is “dance to your daddy; sing to your mummy”. I’d consider that perhaps the referee – as a character representing authority – had triggered my father complex as he blew his whistle, which was why the song had popped into my head. If the lysis (or outcome) of the dream was to dance to your daddy, sing to your mummy, then perhaps there was a message in the dream about treating authority with greater lightness – singing and dancing, with assurance that the boat will indeed come in.

If this was my dream, perhaps the overall message I’d take from it would be to hang in there and keep faith. I would find this interesting, given that the feeling tone of the dream was abject terror.

*

In Jungian analysis, dreams are to be taken seriously, but not literally. The images should be understood as symbols or metaphors, which tell us something we don’t already know but are not direct reflections of reality. Scary or disgusting bits in a dream might interpreted as symbols of our shadow – the bits of ourselves that we hate to acknowledge; but which show us our depth as whole human beings when we learn to face them.

If you had a dream about cockroaches crawling over every inch of your body, you might consider it as a shadow image of infestation – being invaded by something. You might reflect about whether something in your past or present felt like an infestation; creeping everywhere and carrying the threat of disease. If you had a dream about being surrounded by MI5 agents, you might wonder whether this was a shadow image of surveillance – something in your past or present that represented the feeling of being watched.

Jungians might also consider frightening dream images to represent the dark divine – awful because they are an awe-full experience: an encounter with the Gods. Read in this way, to be in psychosis is to be swept up in something bigger than you – flooded, possessed and overwhelmed by a power beyond your conscious ego.

Before I discovered Jung’s writing, I’d come back from several psychological fieldtrips with scrappy notes which, vaguely but repeatedly, described the feeling of having encountered something ancient. The sense that the experience was not only to do with ‘personal’ truth that was unique to me, but a kind of truth that was eternal and universal. It felt like the closer these experiences brought me to death – that is, to the finite – the more they seemed to put me in touch the infinite. I wondered if the images I was encountering were not only reflective of my individual psychology but of everyone and everything that has already died; whose souls live eternally through all of us.

This all felt very woo, I thought. The word ‘woo’ caught my eye. Woooo! I wondered if it was something to do with the sounds of ghosts; or whether maybe that the dismissiveness of that word revealed it to be a defence against mortal fear.

I felt a pang of shame to find myself going down this analytic path, and took it as evidence of the inflation that is a bipolar symptom – nothing more than an indicator of serious illness. I’m still unsure what conclusions to draw from these thoughts. But I’ve been pleased to discover Jung’s writing about the collective unconscious which turns on similar themes. Jung’s spiritual interpretation of dreams argued that, at times, the dreamer may be taken over by a transpersonal phenomenon which is less to do with our individual psyches than it is to do with the cumulative psychological experiences of our ancestors. We may encounter an ancient and numinous power which humbles human beings and makes us quake with fear. In this reading, psychosis puts the fear of God into us because to encounter the divine is truly terrifying. The divine goes beyond you and is inherently mysterious. To claim that you’ve fully understood it is to prove that you’ve missed the point.

From this perspective, whizzy people who have fallen into psychosis are not really being swarmed by cockroaches or followed by MI5 – but we really are in the grip of the darkest parts of the human psyche and the most profound challenges faced by human soul. We are wrestling with demons, not so much in the figurative sense but through what is genuinely a living nightmare.

Understood like this, psychosis is a delusion, but it is not just a delusion. It is inner life – time spent in the fires of life itself – and that is real.

You’re not supposed to ‘get’ it

There is room to be much, much more imaginative about mental illness and what it might mean. There will often be times when someone who is whizzy or in the depths of psychosis believes or does stuff that seems illogical, irrational and unfathomable. But in many instances, experiences relating to supposed ‘disorders’ may well have an order which is just challenging to grasp. It is well worth keeping an open mind and imagining what might be going on from a range of angles, because offering the message “that’s understandable” usually gives great comfort to those in crisis [9]. Of course, you can sincerely assure someone that their experience is understandable, in principle, without claiming to fully understand it yourself.

But not being able to see the reason for someone’s beliefs or perceptions doesn’t have to be a big deal. You aren’t supposed to ‘get’ someone else’s dreams; you are supposed to be curious about the material and let the dreamer consider the meaning for themselves. As the dreamer, you’re not supposed to be in control of the dream’s message; you’re supposed to respect the independence of your subconscious. Mystery is normal and it’s what makes the whole thing work.

*

So, maybe the Joker was right when he said “you wouldn’t get it”. If only the dreamer can discern what a dream means, and psychosis is a waking dream, then people in psychosis have a distinctive vantage point. Like every unique individual and human being on earth, we can see depths and dimensions to the world that are unavailable to other people, because we singularly experience our inner life and outer life interweaving. It’s not so much that our experiences aren’t real life; it’s more that we’re experiencing a bit of life that can’t be verified by external sources.

Could we therefore conclude that, in fact, whizziness and psychosis are reasonable in their own way? Could we repeal the banishment of people with mental illness by expanding our definition of what ‘reasonableness’ looks like? I think to some extent we can, and this would be a very good thing.

But it won’t be enough. It’s a big ask of 21st century British culture to expand the concept of ‘reason’ to include stuff that nobody else can understand or check. It messes up accountability and the balance of powers, which from an Enlightenment standpoint was the point of having ‘reason’ in the first place. We could potentially add ‘mad’ (in the sense of irrational) to the list of politically incorrect words – but this would be a skin-deep victory if we didn’t also start appreciating the non-rational dimensions of being alive. Whizziness brings these to the table in spades, and in my view they are an undervalued part of everyone’s day-to-day life.

Arguing that psychosis shouldn’t be banished because it is simply rational in an unusual way is, then, to shoe-horn this experience into an Enlightenment box. It does violence to the mystery of the unconscious to think it is only valuable when it is knowable – something you can ‘get’, package up, preserve and share. To respect profound, awful and awe-inspiring forces that go beyond our Ego, we must give their essential unintelligibility some breathing room.

And anyway, frankly, it doesn’t matter. What matters is treating people as human beings, and if this is your goal then asking “does this make sense?” is asking the wrong question.

There is more to being a human being than that.

 


[1] The psychologist, John Gottman, popularized research on how bids of attention are important in relationships. See Gottman, J. (1976) Couples Guide to Communication. Research Press Publishers.

[2] Mauss, Marcel. The Gift: Forms and Functions of Exchange in Archaic Societies. London: Cohen & West, 1966 [1925].

[3] Appardurai, A (1986) The Social Life of Things. Cambridge: Cambridge University Press.

[4] Miller, D (1998) A Theory of Shopping. Ithaca: Cornell University Press.  

[5] Latour, B (1991) We Have Never Been Modern. Cambridge: Harvard University Press.

[6] Henare, Holbraad, Wastell et al (2007) Thinking Through Things: Theorising Artefacts Ethnographically. Oxon: Routledge

[7] Ibid, page 7.

[8] I learnt to interpret dreams using the methodology of the This Jungian Life educational programme, Dream School.

[9] I’d be interested to know the extent to which this is true cross-culturally. It might be that “that’s understandable” is particularly comforting in societies where there are strong Enlightenment values.


These pieces are part of our writer in residence programme, and are the writer's personal views.

Last modified
18/11/2021 - 17:21

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