16 Comments

Soon after I started reading this I thought "oh it's another one of THOSE, supremely privileged people from highly educated and very affluent backgrounds making pronouncements that have no relationship to the situation of the vast majority of humans struggling with mental illness, especially psychosis". But I kept reading, and found an interesting, informative and self and society aware account, and was reminded of a need for open approach to others' accounts and withholding judgement. Ok, fencing coach almost threw me off that path of humility, but only briefly. Thank you for this text.

As to the main point (not a psychiatrist) I think working on the metacognition level is important and can be helpful with all care and recovery, physical and mental, because humans are creatures of meaning; even if it might be more challenging in psychosis.

[I'm not sure of I have any followers interested in those topics here, but highly recommended a read]

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Jun 7Liked by Awais Aftab

Hi, author (Sarah) here. I laughed, appreciating at your comment. I admittedly can be very privileged but I try to listen to people of all backgrounds, keeping in mind that we do come with our own biases. It's comments like yours that keep us grounded and aware of our perspectives! Thanks for reading, and I'm really glad you got something out of it.

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Thanks for this wonderful piece. It is interesting how similar psychosis is to the structural dissociation I have, though, of course, also different. The difficulty finding someone who can understand and help is similar. “Psychotherapists specializing in psychosis were hard to come by, and without a trained clinician addressing these issues, metacognitive insight was difficult for me to acquire.” It may be that even fewer clinicians know how to work with dissociation. At least clinicians believe in psychosis; many don’t believe in dissociation.

In particular, this: “schizophrenia is a distinct loss and breakdown of the self. One of those potential losses is the ability to have a narrative that aligns with reality. One could argue that to restore sanity, one would need to bring back that ability to self-narrate in a way that also matches up to others’ observations”

Dissociative amnesia is also a breakage of the self. Without memories of critical events of my past, and continuing to dissociate/forget as an adult, I was unable to form “a narrative that aligns with reality.” And my recovery has required building a self-narrative that aligns with what happened to me, and who people really are, and who I am and might be.

Also, thanks for sharing the insights on movement; I will try them out.

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Thank you for sharing this. It seems to me that the single most important step to recovery is the notion that it is possible and I think thats a big part of what society in general really struggles with

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Enjoyed this post. A patient with agency. Provides context to our long-form conversation around lived experience for me.

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Jun 8Liked by Awais Aftab

Loved your article collab!! Thanks for reading!

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Thank you. I felt there was a great need for this conversation. I am sure you probably understand why given my views. Please feel free to restack!

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Wonderful insight into your journey, thanks so much for sharing. A couple points stood out, one was that in adolescence, you had PTSD. The role of psychological injuries in contributing to psychosis needs to be acknowledged, rather than the dominant biomedical paradigm. Another crucial point is that "I felt heard and understood by my psychiatrist." The therapeutic alliance is so powerful in healing, yet it is very rarely measured and discussed between treatment provider and client. If this practice was seen as standard of care, then outcomes would improved markedly.

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Jun 7Liked by Awais Aftab

Just started listening to this. So much to love here. Thank you. I have had a family member suffer. It is terrible to witness when you cannot help. And there is so much stigma out there.

Just. Love. This.

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Schizoaffective is what my family member had as well. It was always super confusing what was different b/n the two.

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Jun 7Liked by Awais Aftab

Thank you for sharing your insights! I'm curious what first person narratives dealing with psychosis you would recommend.

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Jun 7Liked by Awais Aftab

There aren't many out there! The two most popular ones are The Center Cannot Hold by Elyn Saks and The Collected Schizophrenias by Esmé Weijun Wang.

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Jun 8Liked by Awais Aftab

I’d recommend Lauren of the YouTube channel “Living Well With Schizophrenia”. I believe she also has schizoaffective disorder. She shares her real life experiences to raise awareness. She recently started to post discussions with researchers and other voices in psychology particularly discussing lived experience.

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Great... thank you!

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this is a very powerful testimony, thank you for sharing it

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Jun 7Liked by Awais Aftab

What a great read, thanks for sharing.

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