Psychosis Part Two: The Other Side of Reality

So I'm gonna revisit a topic that I did not too long ago, um, psychoticism, psychosis, uh, 'cause I've had a lot of questions coming in from people that if I could, um, expand in more detail because there's just, um, a lot of misconceptions about what psychosis actually is.

And a few misconceptions I think that are important to, to clear up is, is psychosis does not automatically mean schizophrenia, schizoaffective disorder.

It does not automatically equate with being dangerous, and it doesn't mean that someone has permanently lost their mind.

So, so think of psychosis or psychoticism a, as, as a better understanding would be it's, i- it is, is a sy- is a syndrome or a symptom state which really involves impaired reality testing.

So, you know, i- i- it, you know, uh, someone's ability to underst- uh, you know, distinguish, you know, what's happening internally, externally, what's objectively occurring, what they believe is occurring, and that, that becomes significantly disrupted.

And depending on the individual, this can involve, uh, hallucinations, auditory, visual, tactile, gustatorial, factory, um, delusions, disorganized thinking, uh, disorganized behavior, paranoia, uh, definitely severe disturbances in judgment, and many times reduced insight.

And what's interesting is, is, is some people who experience psychosis, they can look remarkably organized.

They, they can, they can dress normally, drive, go to work, have, have a conversation, appear calm, and then they tell you may, uh, it may be a conversation at work or in some other format that the FBI is moni- monitoring them, that their, their television has, you know, secretly encoded messages.

Uh, somebody p- placed a device in their body.

Um, so it's really not always, I think, the dramatic Hollywood picture of someone yelling at invisible people or, you know, Jack Nicholson in, you know, the, "The Shining." Um, uh, so if you think, like, what, what psychosis really is, it-- uh, think about reality testing.

And I think a lot of us, just individuals in general, we, we check our, I would say, internal in- interpretations against external information.

So, uh, you think somebody looked angry, then you think, "Well, maybe they were tired.

Maybe they weren't looking at me.

Maybe, um, I'm interpreting it incorrectly." And the important distinction is the ability to generate alternatives is part of intact reality testing.

And the difference with psychosis is the interpretation essentially becomes rigid.

The person says, "Well, he looked at me because he knew what I was thinking." And, um, evidence against the belief generally doesn't weaken it, and sometimes there-- the contradictory evidence actually becomes incorporated into the distorted belief.

Um, so say, um, somebody believes that the police are, like, secretly following them, and you, you basically, uh, "Oh, look.

There's, there's, there's a, there's a police car outside." And what the person says, "Exactly.

They're hiding because, because I know I'm onto them." Um, so from a, I think, a longitudinal or hi- historical context, um, it's interesting because h- humans have, I think, experienced hallucinations and delusional states throughout history.

And historically, these experience were often interpreted through whatever belief system was dominating the culture at the time.

So for example, um, a person may have considered, been considered to be, uh, possessed, uh, cursed, like spiritually chosen, touched by God, morally corrupt, bewitched.

And as science and psychiatry and psychology developed, um, mental disturbances, I think they gradually became conceptualized as illnesses involving the body and the brain.

So, uh, Emil Kraepelin, um, he was a pr- I'm sure he was a pr- a German psychiatrist.

This was back in the, in the later 1800s.

He wanted to-- attempted to kinda classify severe mental illnesses, and he basically would focus on, like, their symptoms, the course, their outcome.