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Following the rise of the biogenetic model of psychosis, psychiatric doctrine has held that the cluster of experiences so-encompassed – voices, visions, unusual beliefs, and other non-standard modes of perception – are little more than chemical noise, devoid of any real meaning or relationship to a person’s life. Many clinicians maintain that encouraging patients to talk or even think about the content of their psychosis feeds an illness that should be starved, constructing psychosis as a kind of malignancy that invades and cannibalizes the afflicted’s senses.1,2 But this explanation doesn’t always fit comfortably to the contours of lived experience. Since my own diagnosis, I have come to think of my psychosis (or, as I have sometimes preferred, “personal mythology”) not as a disease that hollowed out my capacity for self-knowledge, but as a strange and lovely cipher.

For me, the grain from which voices, visions, and unusual beliefs take root is typically an inner impulse that I am not yet able to address directly. I am confronted with a reality that is too threatening or confusing to assimilate into my conventional belief system, and the thematic kernel of it finds other ways to communicate itself. For instance, while reflecting on an instance of childhood abuse, I recently found myself wondering whether there was something inherently wrong with me that could have provoked it. Unable to sit still with the possibility that others chose to harm me of their own volition, my thoughts paced towards alternative explanations: perhaps, as a child, some kind of mind control beacon was implanted in my brain that caused people to mistreat me despite their best efforts? On its face, this is an impossible contortion of logic. But in that moment, it was the only way I could translate my feelings of self-blame and denial about the cruelty of other people into a tolerable narrative about my life. Once I calmed down, I was able to reassess this belief – but made note of the autobiographical information woven into it, in the threads of insecurity, shame, and betrayal.

Traumatologists maintain that a central characteristic of traumatic memory is that it is incompletely processed and integrated – more of a gallery of disjointed images than a coherent narrative.3 Accordingly, research suggests that traumatized people are less able to articulate our experiences verbally.4 If ordinary life events are remembered, it may be more appropriate to say that traumatic ones are dismembered. To draw again from personal experience: some months ago, I decided to start talking to others about an abusive relationship I had been in, spanning several years. I was stymied by the realization that I didn’t know where to start. There was no beginning or end to what I could remember, no backbone of “and this is why it all happened” to bind the story together. I found myself with only scattered vignettes that I struggled to gather into a legible shape, like crushed glass rendered from what must have once been an ornate cathedral window.

It wasn’t long before peculiar beliefs began their restless turning over in my skull. In the past, these beliefs – or delusions – had grown rampantly where they sprouted, elaborating into something vast and sprawling faster than I could prune them. This time, they merely flashed through me, like the spark of some secret metabolism. I’ve learned that this reflex to mythologize is how I come to tell my formless stories. Literary trauma theory has investigated the idea that both autobiographical and fictionalized life-writing are a way of synthesizing meaning from traumatic debris,5,6 and psychiatry itself has employed related clinical practices, particularly during its psychoanalytic heyday.7 Delusion, I would argue, behaves similarly. It pulls symbolic and exaggerated elements into the orbit of an essential truth in order to describe its gravity. In storytelling about my life – even or perhaps especially in this abstract, subconscious form – I am drawing maps between memories, across the black and foaming gulf that would strand them.

The emerging field of narrative therapy has similarly embraced the power of storytelling. Narrative therapy holds that the stories we internalize about ourselves inform how we interact with the world, and that exploring the origin and significance of these stories can guide us in establishing new ways of thinking.8 Likewise, cognitive psychology has suggested that memory is not a photographic but a constructive process, involving the incorporation of our preexisting ideas – or narratives – about the world, and that recounting events to others helps us to recall information about them later on.9 To me, this again demonstrates the importance of storytelling in organizing memory. Perhaps, for those of us who have never had the opportunity to tell our stories in our own words, who have become accustomed to the grisly work of dis-membering, the personal mythology of delusion offers a sanctuary: a domain in which we are free to speak about our injuries without the intrusion of outside perspectives. Society cannot or will not follow us into this magical-metaphoric thicket. Here, we are free to imagine and reimagine our experiences in ways that would otherwise be forbidden to us.

I think of the stories I told, glossolalic, through my psychosis. I think of how documenting this mythopoetic otherworld was, for me, a kind of testimony, laying claim to my role as author and narrator of my past. And I think of how psychiatry’s response of enforced silence and forgetting only intensified my need for meaning-making – how urgent it became to excavate the things I had interred. Psychologists have observed that the content of an individual’s psychosis is often related to past experiences,10 but I would take this conclusion a step further. My voices, visions and beliefs have been not only a distorted reflection of life, but their own vital truth, running parallel and symbiotic to my “sane” understanding of the world. I am re-membering the past, now, returning the red and beating soul to the sterile, lifeless history I had cleaved from it. I no longer hold the beliefs that characterized my psychosis as literal truth. But I have great respect for the stories I have told, and will continue to tell.

References

  1. McCabe, R., Heath, C., Burns, T., & Priebe, S. (2002). Engagement of patients with psychosis in the consultation: conversation analytic study. BMJ (Clinical research ed.)325(7373), 1148–1151. doi:10.1136/bmj.325.7373.1148
  2. Wang, E. W. (2015, October 1). Toward a Pathology of the Possessed. Retrieved from https://believermag.com/toward-a-pathology-of-the-possessed/
  3. Bessel A. van der Kolk, James W. Hopper & Janet E. Osterman (2001) Exploring the nature of traumatic memory. Journal of Aggression, Maltreatment & Trauma, 4:2, 9-31. doi: 10.1300/J146v04n02_02
  4. Miragoli, S., Camisasca, E., & Di Blasio, P. (2017). Narrative fragmentation in child sexual abuse: The role of age and post-traumatic stress disorder. Child Abuse & Neglect,73, 106-114. doi:10.1016/j.chiabu.2017.09.028
  5. Caruth, C. (1996). Unclaimed Experience: Trauma, Narrative, and History. Baltimore: The Johns Hopkins University Press.
  6. Henke, S. A. (2008). Shattered Subjects: Trauma and Testimony in Women’s Life-Writing. New York, NY: St. Martins Press.
  7. Polkinghorne, D. E. (1988). SUNY series in philosophy of the social sciences. Narrative knowing and the human sciences.Albany, NY, US: State University of New York Press.
  8. Morgan, A. (2002). What Is Narrative Therapy?: An Easy-to-Read Introduction. Adelaide, Australia: Dulwich Centre Publications.
  9. Pezdek, K. (2003). Event memory and autobiographical memory for the events of September 11, 2001. Applied Cognitive Psychology, 17(9), 1033–1045.doi:10.1002/acp.984
  10. McCarthy-Jones, S., & Longden, E. (2015). Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?. Frontiers in psychology6, 1071. doi:10.3389/fpsyg.2015.01071

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