Psychosis

When I went to a psychiatrist at fifteen and was given, alongside a diagnosis of Asperger’s Syndrome, “depression with mild psychosis”, it was the “psychosis” that most stung, and that I felt most ashamed of. Instead of admit to people at my school that I had “psychosis”, which has a terrible name, I feigned some kind of mysterious, verbose-sounding head injury (“occipital neuralgia”).

Depression and autism are both derided and misunderstood, but they both have slightly positive representations, even if those positive representations are inaccurate and often stupid. Sheldon Cooper eventually gets a girlfriend, while the “Black Dog” gave Winston Churchill the ultimately realistic outlook to defeat the Nazis.

While people with depression and autism struggle, it is psychosis that still remains totally maligned, misunderstood, and resolutely unsexy. Picture someone with psychosis and the first thought is that Alfred Hitchcock film, Psycho, or Jack Nicholson hacking a wall with an axe.

These prejudices pass to the psychiatric profession and to personal relationships. Mention to someone that you “hear voices”. Psychiatrists will often ask you “what the voices say” or “do the voices tell you to hurt people?” Girlfriends, and friends, meanwhile, will run a country mile, even if “depression” and “autism” can be cute, plushy signs of macholessness.

I hear voices. And, no, these voices do not tell me to ‘hurt people” or to hurtle an axe into a wall. Quite often, they don’t “tell me” anything. They are more like a malfunctioning computer, a high pitched sound emitted from a broken TV. Often, I will hear the voice of people I know, singing a note, while not actually singing any particular word. There is no message. Or I will hear bodies of water, rivers, oceans, running, that aren’t there. Or I will hear creatures that aren’t there.

Yet when I am tired also people’s voices will remold themselves into actual messages. These are usually negative, and deceptive, but still don’t involve commanding me to do anything. But they are fearful. When I was a teenager I would frequently hear a familiar voice saying, “I am coming to get you”.

But they can also be positive. They can be familiar tones of people I like heard at the creak of a door. There is a particular door that I open near my office and it reminds me, every time, of the distinct, imperceptible hum of someone that I like, a lot.

So saying “hearing voices” is a simplification. They are auditory hallucinations. They are a little like dreams, except your mind is carrying over concepts from dreams into reality, and asserting the rational part of your brain takes actual work. They are made worse by tiredness or hunger.

They are also a little like an imagination gone wild, or wrong. And imaginations are good, and necessary for writers, artists, and children, as well as everyone else.

So, in other words, “psychosis”, like depression or autism, can often be unpleasant, and undesirable. But there’s also a creative component to it. If it is well-managed, and the rational part of yourself is strong, it’s even possible to control it, to snap out of it.

This is something that medical professionals do not seem to understand. Nor do religious people, often. The religious response to saying you “hear voices” is often to declaim you as a fraud, or a madman, who needs the grace of God. Who needs healing. Not that you might, just might, have the fragments of an authentic, prophetic gift (while clearly not being the God, or the Messiah, etc.)

Our inability to take people who hear voices seriously leads them to the extremes of proclaiming themselves to be God.

So this is why I am writing this, here, now. Because I think that hearing voices needs to be less taboo. I think we need to be able to say, without societal derision or fear. I have had two points in my life where the hearing of voices has actually been an assault.

But in the last two years the condition has been well-managed. It will never fully go away. But part of helping “psychosis” not to be aggressive, or uncontrollable, is to actually take the content of what people with “psychosis” are actually saying seriously, and to have an awareness that hearing voices is something that a lot of the population report. Not just axe-murderers.

If psychotics are given the space and trust to share their visions, they will be better, and society will be better, able to incorporate the extreme creativity and originality they are able to showcase.  

People have only admitted to me that they hear voices under the most extreme promises of confidence. This should not be the case.