Rob Cook

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Psychosis and storytelling


One thing about psychosis that is hard for people to grasp, is how someone can come to believe things that are plainly not true. Psychosis is at heart a break with reality, not (as popular culture portrays) a predisposition to violence and unhinged mayhem. That latter description is befitting of comic book villains, not people who are dealing with a serious mental health experience.

What is the "reality" that a person having a psychotic experience looses touch with? It may seem obvious to any sane, rational person what constitutes reality. Take for example the statement "it's cold outside". If it is cold out, then clearly this is the expression of someone who is in tune with reality. What psychosis can help show you is that even such a simple statement as this isn't clear cut.

For a start "it's cold outside" is not a statement about the weather. It is instead a statement about your relationship to the weather. Cold is subjective. It is entirely possible for someone else to describe the same weather as "mild" or "warm", and still be relaying the truth. These statements can seem contradictory if you believe them to be objective observations of the weather.

In each case the person is telling themselves a story about the world around them. If enough people tell themselves a similar story, we call it reality. What about science I hear some ask. Could we not measure the temperature and, if below a certain threshold, we can confidently declare it cold outside? We could, but that's just the same mechanism applied in a different way. We are asking people to agree on numbers instead of direct perception - "it's 5 degrees, must be cold out". It would still require enough people agreeing to the "fact" that 5 degrees is cold. The threshold for cold would be arbitrary, dependent on time and place. As would the scale used to measure the temperature (and we cant even agree on that, both Celsius and Fahrenheit are in common usage).

Psychosis then is nothing more than a person starting to tell themselves a different set of stories than the people around them. You can call this a breakdown, or label it a fault in perception, or better yet just "different". Some insights from experiencing psychosis have the potential to be profound and life changing. Many others just leave you scared, confused, and unable to function in a way that society has come to expect of you.

Surely though the intricate stories of psychosis are nothing like the simple stories of day to day life? I'd argue they are more alike than different. For a start the "simple" stories of day to day life are anything but simple. Take our "it's cold outside" example. If the person next to you disagrees, many of us will instinctively see it as a contradiction that needs a resolution (or at the very least an argument). We embellish our story to account for the dissenting view - "he's a liar", "she doesn't feel the cold", "they must have lived somewhere hot". Many of these embellishments are unconfirmed with observations of the world, they are just convenient placebos and not so different from the layered stories of psychosis.

If further poof is necessary that we are capable of, and indeed actively engage in, spinning intricate imagined stories for ourselves, take a look at what our popular culture is currently like. TV shows spanning multiple series. Superhero stories that take place in a whole universe of films. Like the person experiencing psychosis, we find it very hard to let these stories go. It wasn't enough to have a tale of an Iron Man who becomes a hero. We wanted a trilogy of such stories which overlapped with stories of other characters, each embellished with their own trilogy. What is that if not an extended break with "reality"?

Life is inherently subjective. Perhaps instead of wilfully spending time escaping it, we go outside and find out how others experience the world around us. Unless it's cold outside.