Its Been 10 Years Since...
How Psychosis Actually Wound Up Saving My Life
This is what a symptom is: body and life falling together as if by accident.
- Thomas Moore, Care of the Soul
Psychosis both broke me and saved my life. I mean that literally, as in I would not be here otherwise. Psychosis was the lever that violently steered the trajectory of my life off course. Yet, in a strange twist of the typical narrative, it forced me to see all the ways in which I was already literally and figuratively dying. I realize that few get to speak about psychosis in past-tense, but having worked with survivors in the 10 years since, I know this has more to do with how we treat and understand psychosis societally, than anything about the experience itself.
The Fractured Mirror or Sharp Looking Glass?
Old literary and psychological references of psychosis describe it as a “fracturing” of the psyche, a divided mind, or a dual and distorted reality. In The Divided Self, critical psychiatrist, R.D. Laing, remarks on the use of the term ‘schizoid’ as “an individual the totality of whose experience is split in two main ways: in the first place, there is a rent in his relation with his world and, in the second, there is a disruption of his relation with himself. Such a person is not able to experience himself ‘together with’ others or ‘at home in’ the world, but, on the contrary, he experiences himself in despairing aloneness and isolation.1” Taking the metaphor to an extreme, Elyn Saks, a survivor of psychosis writes in The Center Cannot Hold, “the schizophrenic mind is not so much split as shattered.2” The experience of self-alienation, holding multiple realities, and finding yourself estranged from an unfamiliar world do indeed seem to be hallmarks of this experience (ones that I too experienced). However, the emphasis on psychosis as a fracturing steals focus from what exactly it is that’s broken.
In hindsight, it was not my mind, but rather the life that I was living that was fractured and broken. It was unsustainable, to say the least. For me, the psychosis was not the true distortion or the fractured mirror, it was a sharp clear looking glass, through which I could see all that was already destroyed. Psychosis was not the fantasy distorting my reality, but rather the truth serum, a forced reckoning, my body’s way of revealing what had made me sick, trapped, and withering away in the first place. The altered states, hallucinations and delusions, were confusing, dizzying, and terrifying, and yet each seemed to pull my attention to something that I had much preferred to keep hidden. Psychosis was not the illness as such; it was a part of a bigger process of finally getting well.
“We understand illness to be holistic in its creation and manifestation — it is a part of body, mind, and spirit imbalance. Illness, in Indigenous worldviews, is a way that the body communicates about what is happening and what it needs.”
- Thabiso Mthimkhulu, Sangoma3
Get It Out of Me
Here’s how it started.
It was my birthday, 2015, a day that annually stirred up a lot: flashback memories of childhood abuse, anger, isolation, feeling trapped with nowhere to run or hide from the pain. I escaped to the Williamsburg Bridge, the Pepto Bismol colored metal passage from the lower east side in Manhattan to Williamsburg, Brooklyn. Trying to breathe and focus on the graffiti, I stopped and slid my legs between the iron bars in the center isle where I could see the L train rumble on below. Too polite to let the scream in me erupt, I turned my head to the sky and asked some higher power to please get this darkness out of me. When I closed my eyes, I could see myself desperately trying to pull this heavy molasses sludge out of my gut in fist fulls. I begged the universe to get it out at any cost.
By “it” I meant the trauma, pain, shame, and rage of being an incest survivor. I meant the weight of that burden on my whole body, the way it seemed to shape how I live and think and act. After 20 years of swallowing the pain and 4 years of intensive trauma therapy, I was desperate to put it down. I was also carrying immense responsibility as a crisis counselor, working in the public mental health system, seeing clients with just as weighty trauma histories. These clients were told they had some type of mental illness and simply needed to take their medication and listen to their doctors, often coerced into treatment, the roots of their pain erased. I felt both complicit and responsible—a dangerous combination. I slept very little most days, but not because of my work. It was insomnia, stomach ulcers, being chronically sick with something or other, overworking, and just trying to survive.
At some point in the days or weeks after the bridge prayer, something erupted in me, unwilling to stay contained. If the universe heard my prayer that day, my body seemed to hear it ten-fold.
Late one evening, alone in my shared apartment, I felt a pang of sudden dread, the most intense foreboding. Something was coming. I thought maybe it was a catatonic episode which I had become accustomed to with C-PTSD, or maybe something I ate. But this time was different. I knew it the minute I saw 3 shadowy figures emerge in the dark, dementor-like, no faces, coming to suck out my soul.
There is this concept in psychosis literature called “double bookkeeping” in which a person can be trapped in a dual reality, sometimes even knowing that what they see and hear is not “real” yet they can’t avoid acting as if it were. I knew I was hallucinating, yet still I ran into my humble Brooklyn backyard and tried to bury myself in the ground. I figured I must be dead and need to be buried. When that didn’t work, I ran to the shower to cleanse myself, inciting incantations to try to banish the demons to no avail. My roommate and friend found me, dried me off, and dragged me back into this world. In an instant, I knew nothing would be the same again.
Psychotic episodes are like fever: it’s not the thing that makes you sick, but the thing that stops you from getting sicker” - Justin Garson4
The Unorthodox Route
For most of us in the Western world, an experience of psychosis becomes a medically treated disease. It then often morphs into a life-long condition, typically with numerous hospital stays and various psychiatric treatments. For some, mostly marginalized people, this experience forcibly intersects with multiple systems, feeding into and out of experiences of incarceration and/or being unhoused. To be sure, psychosis can become an early death sentence56.
The orthodox narrative around psychosis and schizophrenia is that it is a degenerative disease, but the much more complex reality is that the very treatments and systems that aim to support those with psychosis and schizophrenia, often wind up making people sicker, reducing agency, and eliminating choice. This is particularly true for coercive or forced psychiatric treatment, which studies show can actually increase one’s risk of suicide7.
I owe my survival and ability to come out the other side of psychosis nearly entirely to 3 things:
I was never psychiatrically hospitalized.
My only touchpoint with psychiatry was once at 17, when I left an appointment with 3 diagnoses and 1 prescription for an antipsychotic which I only took for a month. That experience shaped forever how I would come to understand psychiatry and the mental health system. Yet, I left with my agency in tact.I had a robust community.
While I was estranged from my family and had no safety net, I did have a community of friends, peers, healers, and therefore, the ability to heal relatively unmarred by systems.My symptoms were explored and medicalized appropriately.
Instead of getting a blanket diagnosis like schizophrenia, which would halt all exploration into root causes, I was able to research and advocate (not without many roadblocks) for other testing and eventually was treated for autoimmunity which helped immensely.
I’m asked quite often how I “decided” to go the unorthodox route. It wasn’t so much a decision as a resignation. The vast majority of people never get to choose how they want to navigate such a crisis. Orthodox psychiatry is so deeply embedded in Western culture, most people don’t know that there’s anything else available. Even when they want to try something else, there’s very few services that are well-resourced, affordable and accessible. Even as someone who had insider knowledge as a crisis worker, I rode the subway past Woodhull hospital every single day and considered checking myself in because this was simply “what one does” when things get this bad. It would have been a relief to have experts attending to me and telling me what was wrong and what to do next. In a crisis, uncertainty feels dangerous. But I also knew that the moment you enter the system as it stands now, you give up your right to own your story and experience (not to mention your very basic human rights).
The main reason I decided (if we can even ascribe that much intentionality to me at the time) to try a different way is due to this tiny whisper in me that said “This is a necessary process.” I wondered if all the trauma and pain and anguish was coming up and out so I could finally grapple with it. It didn’t exactly seem worth it, but I was in so much pain, I had been considering leaving this world anyways, I figured, what was one more leap of faith? There are moments in life when a leap of faith is all there is. There’s no other viable path. That whisper won out and I gave myself over to this process that I somehow trusted was not an annihilation, a disease, or decompensation, but rather a way to get right with myself and course-correct.
I used to think psychosis itself was some bigger transformative process. Now I think of it more like one possible manifestation, or signal, in a broader attempt of my body to reveal its truth to me. I think this is true for a lot of experiences that get called mental illness — depression, anxiety, mania, obsessions, dissociation. The body-mind moves through the world trying to make sense of this life, world and context. It has a history and lived reality, needs that go unmet for years, sometimes without us noticing. Problems stack up in all domains, the physiological, interpersonal, cultural, existential, and compound until, slowly or quickly, something goes very very awry. Pain manifests in ways that are deeply connected to life, mind, body, and world. It makes little sense to see one manifestation of pain as solely a biochemical problem, and another as solely an interpersonal one. Sure, there are cases at extreme ends of the spectrum, but something like psychosis doesn’t come out of nowhere, it has a history.
My psychosis is not the same as someone’s whose experience is substance induced or dementia-related, or a result of sleep deprivation, or autoimmune encephalitis, or brought on by a loss of stability, or refugee status (not that these are simple nor exemplary cases). Psychosis is both a symptom with many possible causes all converging, and also can be a cause of other issues.
In my case, I came to understand 5 main roots: interpersonal trauma, ancestral/intergenerational trauma, autoimmunity, structural inequity, and a spiritual crisis. To me, psychosis was my body-mind reckoning with the past and forcing me to deal with the consequences of these life-long hits to my whole system.
Course-Correction
Psychosis saved my life because it was a course-correction—an abrupt rupture with a clear before and after. Every part of my life at the time was unsustainable and wrecking my mind and body. My physical and mental integrity was eroding. I was working in a job that was part of carceral and coercive systems, trauma was eating me up inside and out. I was surviving on little sleep and nutrients, living in a city that expected us to run on pure adrenaline. If anything, psychosis was the final warning; keep going like this and you’ll die.
As I wrote in my chapter of the Mad Studies Reader “Making the case for Multiplicity,” suffering leaves clues, and “by remaining open to such an experience, even impossibly painful ones, we can begin to unravel the breadcrumb messages left behind in metaphor and symbols – or, as Thomas Moore (1992) describes it, “the necessary changes requested” by disruptive feelings and extreme states (p. 6).8”
Psychosis requested massive changes, and it wasn’t quick or simple. We don’t always have the capacity or resources to make the “necessary changes” to save our own lives or drag ourselves out of the fire. For example, at the time I was recently unemployed after quitting my job in the mental health system, had no financial security, familial support, or backup plan. I could not immediately change my circumstances, even as a relatively privileged person who had not been institutionalized. However, there were small things I did have control over which turned into bigger things with profound effects.
Life in the After
The first 2-3 years after psychosis were tough in unexpected ways. I tell my clients all the time that sometimes the re-integration-with-life part was even harder than the acute psychosis phase. It requires so much of you. With a total destruction of the old “self,” or selfhood at all, how are you supposed to answer basic questions like “how are you?” or “who are you?” I felt like a pink skinned new born baby feeling the raw, harsh too-muchness of the world. It was sensory overwhelm. I wondered if I would always feel like this.
Also, life doesn’t stop, trauma isn’t just erased. Trying to make pieces of your life fit together again is like trying to squeeze the very last drop of toothpaste out of the tube — frustrating and not really worth it. You have to do all of this life stuff after having your insides turned wrongside out and feeling like a floating blob of nothingness. Plus, the body is not simply ‘fine’ afterwards, especially if psychosis was related to physiological issues.
I had other chronic illness that needed attention: Lyme, SIBO, a hiatal hernia, plus the wreckage of undiagnosed autoimmune disease. I was angry I had a fourth of the capacity to do things I had before. I had trouble building relationships and was suddenly socially anxious in a way I hadn’t been before. That’s only the surface level.
Yet, I never had another episode and surprisingly, I wasn’t afraid it would come back. Something in me felt like it had run its course. I leaned on the small bits of stability that were in my life. I learned what was helpful and not when I felt a little shaky, and found other safe ways of entering altered states of consciousness that were helpful for my healing. I grew confident that psychosis was not some plague I’d have to keep fighting off. It was the deeper story of how I was relating to myself, my body, and the world which was shifting.
Learning The Language
While initially leaving me distrusting of my body and mind, the fact that I did experience such a crisis was a sign that my very being would not let me get away with anything other than full integrity of body mind and spirit. Some call it a weakness that some of us are so sensitive or impacted. Some of us have low tolerance for overriding basic needs, inauthenticity, toxins — literal and figurative, psychic baggage, or unsustainable environments. Some of us can’t tolerate living in societies that weren’t built for our survival, let alone for thriving. Modern life, even with its achievements, has in some ways brought us farther away from the very basic things that allow us to live well. And some of us feel it much more than others.
I wouldn’t say psychosis itself is a gift. However, the warning signals in my body, the interception that makes it possible for me to feel when I am living well and when I am not, the fact that my being will always let me know and give me the opportunity to course-correct, to shed pain, old beliefs, and find another path — this is the true gift. There is no greater trust than what I now have for my body. Like the friend who won’t tell you what you want to hear but what you need to hear, shake you awake, and make sure you don’t sleep through the tough lessons. This is the relationship I’ve come to build with my body.
In the 10 years since my psychotic break, I have no linear narrative to share or nicely summed up reflection, but this is as it should be. Because the journey of living through an experience like psychosis isn’t so distinct from all the intricacies and tumult of life. Symptom, body and life falling together; it is no accident. And what is revealed through the state of our body-minds is some of the most important information we have about the state of our personal and collective realities.
There is one thing I know for sure: The body-mind has it’s own lived reality. Sometimes we are attuned to it and sometimes not. Regardless, the body speaks—in symbols, symptoms, signals, subtle cues. It has been my greatest journey to learn to speak this language again.
The Divided Self by R.D. Laing (1960)
The Center Cannot Hold by Elyn Saks (2007)
See Instagram post from Thabiso Mthimkhulu:
& Russell, J. (Host). (2023, March 3). Redefining “Crazy” & The Initiation Process with Swaziland Healer Thabiso Mthimkhulu (No. 35) [Audio podcast episode]. In DEPTH Work: A Holistic Mental Health Podcast. https://www.jazminerussell.com/blog/redefining-crazy-the-initiation-process-with-swaziland-healer-thabiso-mthimkhulu
Garson, J. (2024, May 9). Evidence grows that mental illness is more than dysfunction | Aeon Essays. Aeon. https://aeon.co/essays/evidence-grows-that-mental-illness-is-more-than-dysfunction
Correll CU, Solmi M, Croatto G, Schneider LK, Rohani-Montez SC, Fairley L, Smith N, Bitter I, Gorwood P, Taipale H, Tiihonen J. Mortality in people with schizophrenia: a systematic review and meta-analysis of relative risk and aggravating or attenuating factors. World Psychiatry. 2022 Jun;21(2):248-271. doi: 10.1002/wps.20994. PMID: 35524619; PMCID: PMC9077617.
Sharifi, V., Eaton, W. W., Wu, L. T., Roth, K. B., Burchett, B. M., & Mojtabai, R. (2015). Psychotic experiences and risk of death in the general population: 24–27 year follow-up of the Epidemiologic Catchment Area study. The British Journal of Psychiatry, 207(1), 30-36.
The Mad Studies Reader: Interdisciplinary Innovations in Mental Health. Edited By Bradley Lewis, Alisha Ali, Jazmine Russell https://www.taylorfrancis.com/books/edit/10.4324/9781003148456/mad-studies-reader-bradley-lewis-alisha-ali-jazmine-russell
"Like the friend who won’t tell you what you want to hear but what you need to hear, shake you awake, and make sure you don’t sleep through the tough lessons. This is the relationship I’ve come to build with my body." This is a beautiful piece, Jazmine. Thank you for writing it.