from outside the human body without scanners to see within. This is why
the psychiatric understanding of psychotic disorders like manic
depression and schizophrenia is so poor.
They must be able to see inside but they can't. That's why psychiatric
solutions have been so poor. It's why diagnostic criteria are very shit.
It's all about external symptoms rather than truly attempting to
understand the internal experience.
The fact that language is so limited in describing our consciousness is
another great barrier to understanding.
But, perhaps most of all, the greatest barrier is the fact that
psychiatrists haven't been through these intense experiences. The lived
experience psychiatrist movement will bring hope to those affected by
these complicated internal experiences because they've lived through
these experiences. These experiences can not be understood from the
outside nor can they be understood by reading most of the books or
research papers psychiatrists read.
Calling it a voice in a head is a poor use of language but it'll do for
now. I mean specifically the voice or thought you respond to in your
stream of consciousness. Just listen to it comment now as you read these
words. You might hear the thoughts "i don't have a voice in my head" but
by hearing these thoughts you are having an experience similar to voice
hearing but without the advanced state of awareness to recognise these
thoughts as different from your sense of self, the thing which is
listening to the thoughts.
Psychosis itself can take many forms but what I'm talking about here as
the link between mania and psychosis (superficially the hearing voices
aspect, not the other things which make them different such as mood or
energy levels) is the experience of the voice or thoughts.
In my hypermanic phase I had a voice in my head - something which I
observed as different to my own sense of self. This was when I was 25
and first hospitalised. It was not an unpleasant experience and unlike
what I went through a few years ago which left me with a forearm of
scars from ym battle against this controlling force (which did other
things apart from show its power within my stream of consciousness).
During the hypermania the voice said positive things.
The positive voice drove my ego upwards. Whether it was cause or effect
I had very high energy levels at the same time. I was in a super-powered
human state (or at least that's how it felt to me). I listened to the
voice in my naivety and it drove me mad.
There have been other times where the voice or thoughts in my head have
been negative and I've listened to them. This was not the same as the
experience which left me with my arm of scars. This is other times in my
life where I was low and the voice inside would batter my ego with
negative words and sentiments.
I still live with this problem every day. I doubt it shows much on the
outside but so much of my pain rarely externalises. Occassional
uncontrollable crying or aggression, infrequent outbursts or other leaks
from the inner maelstrom are the only signs. Most of the time I keep
these away from the view of those close to me so all they see is the
person they want to see.
My coping mechanism - the one I've had to learn to manage this madness
as best as I can - is to dismiss the positive voices. The experience of
forced hospitalisation was a significant trauma. Both times were
because, or were at least associated with, listening to the positive
voice. The second hospitalisation was a direct result of a therapist
working on my self-esteem. He took down the protective barriers I'd
built and in so doing he took away the internal mental blocks I'd built
to stop my madness externalising.
This is why if you ever got to know me - truly know me emotionally naked
rather than as the mask I present (which exists for various reasons) -
you would find a very sad soul who doesn't think much of themselves. The
positive thoughts are almost always pushed away to protect my sanity.
Could you imagine what that feels like to live with? What I am
describing here is a bad coping mechanism but one that works better than
anything else I've found. It means I can survive but I don't thrive. It
doesn't mean I'm always unhappy. It just means that, for my education
standard and compared to my peers, my life outcomes have been far worse.
There are also the times where I have to deal with the negative
thoughts. I experience a lot of negative thoughts at certain times and
in certain situations. They're pretty hard to deal with at times.
Certainly in the past they've crippled me and in a sense they still do
in the present. I don't thrive much.
Though I dismiss the positive thoughts to stay away from states of mind
which end me up sectioned I accept the negative thoughts. The way I
survive accepting the negative thoughts and rejecting the positive ones
is to side step the impact of negativity. It's very hard and I don't
always get it right but it's how I get by in this shit of a world. Call
it resilience if you will. I accept the negativity and just get on with
whatever life has to throw at me when I have the inner strength. It is
the feeling of feeling worthless but acting as 'normal' regardless of
the shitty feeling. It is feeling low but smiling on the outside. It is
feeling like a failure but never showing it in deed or action. It is
gripping the idea of just getting on with it regardless of how shit I
am. This doesn't always work of course and there are times when I lose
strength - on both counts of forcing away the positive thoughts and
accepting the negative ones.
There are times when I balance the two but these are rare. It is
evidence which allows me to accept any sense of positivity but I'm
discriminatory about accepting evidence. The important thing - to
society and external reality - is what I do on the outside. I don't
think the system gives a shit about inner pain. Just what externalises
and what people who work in mental health an recognise. (For example I
woke up today with crusty eyes. It might be hayfever or it might be me
crying in my sleep. That doesn't matter to the people around me as long
as I don't show it. Only if I couldn't hold back the tears in front of
another would they wonder if I was unhappy or depressed or whatever.
Such is the burden of carrying a mask.)
I still show arrogance and this is clear on my blog. This may be a
compensating thingie because of my inner negativity. It may also be
driven by the fact that I do value my analysis even if others don't. I
spend a lot of time working on my work, far more than most. In fact I
might be a bit slow in some ways but I compensate by putting insane
amounts of work in. I rarely rely on intuition if at all. I work bloody
hard to come to a solid conclusion.
So my conclusion to this poorly written piece with lots of mistakes I
can't be arsed to correct is that mania and schizophrenia are related
because the voice/thoughts inside are often involved. This is, perhaps,
in relation to ego. It can be where the external symptoms come from.
Though the external symptoms are different the cause is, for me, often
rooted in those thoughts which I chose to listen to or dismiss.
I assume this is what CBT for psychosis tries to deal with. I assume the
therapeutic model bases itself on controlling the inner voice and
reactions to the inner voice. I assume treatment is based on this sort
of thing and measured by success in dealing with this sort of thing
rather than focusing on external symptoms. I assume this because this is
what a good system would be doing as a form of treatment.
I assume wrongly....or do I?
Admittedly there are times I do rely on intuition. Sometimes this means
I get it totally spot on. Other times it means I totally get it wrong.
Theere are links between this idea of intuition and the voice or
thoughts other than our self, our "I", within our stream of consciousness.
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