So there I was, some 16 years or so since I last heard voices labelled as psychosis, and then I had another experience. I heard my name being called out from a street cafe...I couldn't see anyone attached to the voice.
Having had a look around, from where I was standing, I slowly took a few steps backwards towards the cafe, just to see who it was that had called my name. Alas, I could not see who it was. What I did notice is that all the people in the cafe had appeared not to notice my name being called out. Fortunately, I was not overly concerned but perhaps a little surprised by this clear and concise calling of my name.
As I walked on, I heard the voice again. The voice was familiar and this time I was able to put a name to the voice. When I realised who the voice was I became unconcerned by the voice being present and continued on my way.
The explanation for hearing the voice last week outside the cafe is quite straight forward and does not represent anything unusual or concerning. I had been awake for 36 hours and had spent the past 12 hours in a highly significant, humbling and deeply humane relational and emotional reality. But what if I had not been able to make sense of such an experience? What if I could not make sense of the experience of hearing the voice ( especially as the voices was actually comforting given the previous few days and weeks)? And, what was the relationship between the voice I heard this week and the voices I heard all those years ago...if any?
The reason this experience interested me so much has a number of factors, not least the journey of working in mental health environments that have the biomedical stamp all over them. Choosing to stand up and speak out with alternatives to the dominant discourse has come with considerable attack, allegation, agitation and threat. Statements about a lack of understanding, my actions increasing risk, non sense about being 'anti psychiatry', non sense about being 'anti medication'...the list goes on. This kind of vulnerability is of course not a knew experiences for people that have spoken out before me. But it is unfounded and rather unpleasant for me and sadly speaks to a dominant discourse that is not founded in science, compassion, humanity or dignity, but using power as an apparent 'truth'. The fact that I have a lived experience is given broad acceptance. The sad reality: the prejudice and stereotyping that lies dormant, except for the odd occasion when people cannot contain the exposure of their underlying views, that a person who has previously been psychotic might just not really be okay. And as a health professional these stereotypes do inform the views of workers. More concerning is the potential justification of the stereotypes if I returned to being the objectified voice hearer once again.
So, is my past experience of being diagnosed, 'treated' and then moving on a concern? Perhaps it is if we take the reductionist, bizarre, often disempowering, and offensive position that we actually know why any person becomes psychotic( without any genuine evidence ), and even worse that we can actually cure the so called illness. In this milieu my past experiences almost certainly contributes to and informs the lazy assumptions made by professionals as they comment and inform their often unfounded utterances to colleagues in response to the recovery orientated and trauma informed views I express. And of course my voice hearing experience last week can easily and comfortably contribute to the unfounded reductionist position as an example of my 'vulnerability' as a formerly psychotic person.
But some evidence at least can give us another clue. I could be considered more healthily to be 'anti' over prescribing and drugging human beings that are experiencing a state that is contrary to the 'normal or healthy' that is accepted by the custodians and collaborators of the dominant discourse. I could also be considered to be 'anti' psychiatry if speaking out against oppression and 'treatment' of individuals without giving honest, clear and at least partially scientific explanations for 'treatments' and diagnosis, that can in them self cause significant harm and distress. I could be considered 'anti' something or other when I raise concern about the '80%-90% success rate' of ECT that has often been reported to individuals and families on numerous occasions as part convincing them to concent to ECT, or for speaking out against CTO's that have no validity in adressing the intended purpose... but do remove certain human rights and disempower the choices of an individual (Burns et al, 2013 - http://dx.doi.org/10.1016/S0140-6736(13)60107-5 ).
I could be 'anti' something because I raise concerns over the use of poly pharmacy and high doses of drugs that are at best useful for some people and at worst contribute to physical health problems and early death - For many people who are prescribed anti psychotics the drugs have a significantly harmful impact on their quality of life. And I could most defintately be considered 'anti' the 3 monthly injections of anti psychotics or even the proposed Aripiprazole tablets that contain a sensor so that professionals can monitor 'adherence' to medication(http://www.tandfonline.com/doi/full/10.1080/14737175.2017.1287566).Finally I could be considered 'anti' for being aghast to read the anti psychotic prescribing rates in the and around the community in which I live. In Adelaide the the prescribing rates for anti psychotic medication was recorded by the Australian Commission on Safety amd Quality in Health Care (https://www.safetyandquality.gov.au/atlas/atlas-2015/) as being around 30,000 prescriptions per 100,000 population. To be dispensing anti psychotic medication at a rate of 30,000/100,00 is a concern. Either a third of the population is on anti psychotics or there is too many people taking a lot of these drugs - neither of which is safe or justified...unless of course there is nobody left with 'psychotic' realities in Adelaide. Which is clearly not true. I know this because I heard a voice talking to me at a cafe the other day...
So, when I reflect on the experiences of hearing a voice call out to me, in the context of recent and current events, I do wonder what on earth we might mean by the generic and broad term psychosis that we apply to the legitimate and real human experience that is felt, and lived by so many people.
When I heard a voice speak to me last perhaps I was experiencing a response to significant events, a way for my mind to intentionally contain a confusing personal event or experience. With that in mind I am confused how the use of the term psychosis would be of any value. Of course in this instance I would not tell the story of my reality to a person that would label it as psychotic (unless they are reading this!), and for many the brief experience I describe would not constitute psychosis. But even that is fairly arbitrary and undermines much of the apparent specialist knowledge of those in the mental health field that talk with certainty and coercion when asserting their perhaps well intentioned but incredibly unsubstantiated description of a persons reality. And one that may well lead to well intentioned but potentially harmful 'treatment'.
And finally, I reflect on the joy of hearing that voice, the comfort of whom the voice represented and where i was when i heard the voice. I reflect on the value to me of hearing that voice. But most of all I reflect on the difficulty and challenges that may have arisen if I was not comfortable and confident in accepting the common human reality of hearing a voice following a stressful, emotionally and life changing experience.
This reflection does not feel 'anti' anything despite pointing out certain aspects of peoples experiences that I find difficult to accept and questioned the humane conscience of enforcing or over 'treating' people who could well be experiencing voices or other alternative realities as a meaningful and valuable message or metaphor related to significant life events.
Fortunately I was able to find gratitude to that part of me, or the emotion within me, that offered me comfort and connection in providing a voice to represent the significance of an experience, and in doing so allowed me to have a final moment with a wonderful friend who had just passed away.
Many years after battling a way through the challenges of being a psychiatric patient who first heard voices and later celebrated voices not being present, last week I found my self feeling whole and grounded in the common human reality of hearing voices and the connection the voices offered to understanding how much a event and a person meant to me. What my reflections have crystalised for me is the imperative to create safe and compassionate spaces and relationships to accept and explore voices and other common human realities. These spaces could be intrapersonal or interpersonal, spiritual or other relational realities of healing and safety. So, I find myself embracing the voice I heard last week with gratitude and taking inspiration towards creating humane and compassionate spaces inside me, to explore and make sense of important and powerful experiences as a legitimate human reality. As a professional I am grateful for the powerful reminder that hearing voices is something to embrace and support a person to accept and make sense of, which includes identifying and putting aside my own 'unknown' prejudices and stereotypes in embracing the person as a unique and equal citizen in the world and a renewed commitment to facilitating safe and compassionate relationship.
I used to be psychotic and then I heard a voice again...and it helped me a lot.