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Recent Advances
in Psychological Understanding of Psychotic Experiences
April
23, 2001
by Anne Cooke,
clinical psychologist at the Salomons Centre, London.
.....
A report –
Recent Advances in Psychological Understanding of Psychotic Experiences
– has been produced by 14 professionals working under the auspices
of The British Psychological Society’s Division of Clinical
Psychology.
It was written
to inform service users and journalists - as well as psychologists
- about the considerable body of research from the last 10 years
which challenges conventional ideas about “mental illness”.
This conventional
wisdom can be paraphrased as: “A person who has psychotic experiences
is different from normal people… Because his brain is damaged
or different, probably because of his genes. He is A SCHIZOPHRENIC,
who is not understandable, is dangerous, has no legitimate voice
and requires control through drugs, which are the only treatment.
“Oh and
incidentally the drugs work for anybody who can be forced to take
them, have no adverse effects, and actually target the brain disorders
that we all know are really responsible.”
By contrast,
evidence presented in the report suggests that:
- There is a
continuum between mental health and “mental illness”.
Given the right circumstances, most of us would be likely to experience
“psychotic symptoms” such as hearing voices. “Delusional”
beliefs have much in common with other beliefs or prejudices.
- There is little
evidence that psychiatric diagnoses such as “schizophrenia”
are really very meaningful or, for many people, useful.
- Many of what
have traditionally been considered symptoms of “illnesses”
such as schizophrenia with a presumed organic cause, are actually
understandable in terms of normal psychological processes. For example,
recent research on unusual beliefs (“delusions”) and experiences
(“hallucinations”) provides compelling evidence of the
role played by normal processes such as the effects of threat on
information processing.
- Many people
who have psychotic experiences have experienced abuse or trauma.
Very few are ever violent, but they are more likely than others
to be victims of violence.
- As with other
human experiences, the causes of “psychotic” experiences
are complex and the precise combination is likely to be different
for each individual. The person him or herself is therefore the
best expert on their experiences.
- Although psychotic
experiences involve brain events and can be influenced by biological
processes, this is also the case for every single thought that we
have.
- The content
of “psychotic” experiences is often personally meaningful
and it is can be helpful to explore this meaning.
- It is vital
that people who have distressing psychotic experiences have the
opportunity to talk and think about them in a calm, supportive and
non-judgmental atmosphere. There is good evidence that psychological
therapy can be very helpful for many people.
The report has
been well received not only within the profession and by service
users but also by psychiatrists.
Professor Graham
Thornicroft stated that it should be required reading for psychiatrists.
Professor Paul
Bebbington commented that: “scientific opinions on schizophrenia
and other psychoses are currently in flux to an extent that presages
radical revision”.
There has been
some debate about specific aspects: for example some have felt that
cognitive behavioural approaches are emphasised at the expense of
other psychological approaches.
However, as
members of the report’s working party pointed out at a symposium
at the British Psychological Society’s recent annual conference,
our differences fade into insignificance compared to the need to
challenge the outdated and inaccurate information and assumptions
which have more usually characterised debate in this area.
Reference
British Psychological
Society Division of Clinical Psychology (2000) - Recent Advances
in Understanding Mental Illness and Psychotic Experiences. Leicester:
British Psychological Society. Downloadable from www.understandingpsychosis.com.
Copyright
Psychminded, 2001
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