If madness, or psychosis, is just a result of a physical defect in the brain, then it makes sense to devote little effort to understanding the experiences of mad people, and to focus instead on suppressing such experiences as much as possible. That’s what our vast “mental health” industry has been doing for decades, without success. In his book, Rethinking Madness: Towards a Paradigm Shift In Our Understanding and Treatment of Psychosis, psychologist Paris Williams outlines a very different approach — one that prioritizes understanding and the valuing of personal experiences.
Before writing this book, Williams spent time as a hang glider pilot, winning one world championship and several national awards. Then, he tells us, he experienced a mental crisis that could have been labeled psychosis, but avoided getting diagnosed or “helped” by psychiatry. Instead, he says, he worked through his experiences on his own. This caused him to become interested in helping others, and he became a psychologist and researcher focused on the detailed exploration of the experiences of people who have undergone psychosis and then full recovery.
One of the key ideas Williams sets forth is that psychosis, in the presence of the right conditions, can be expected to most commonly result in a positive outcome: an outcome that is better than the state that existed before the psychosis. This assertion flies in the face of most of what our culture thinks it “knows” about psychosis, but the author documents the argument well.
Still, the perspective should not be confused with some romantic notion that psychosis is always a good thing — Williams is clear that it is hazardous under the best of conditions, and likely to lead to major ongoing life difficulties when the focus is just on attempts to suppress the process, as usually happens in developed countries today. What is critical to note, he tells us, is that these poor outcomes are typically due to poor handling of the experience, and not the nature of the experience itself.
Another major point Williams makes is that the core issues in madness are not a struggle with an “illness” experienced only by some, but rather a struggle with the existential issues that we all face, such as being caught between a fear of being separate and a fear of being overwhelmed or engulfed by connection. He outlines how the ability to regulate one’s approach to such dilemmas is lost in psychosis, usually in response to a number of stressful experiences—but also how the loss of one’s prior approach has the potential to lead to the emergence of new and healthier ways of being organized. He discusses these ideas first theoretically, then by clear descriptions of how these issues played out for the individuals he has researched, as they went through psychosis and then recovery.
The author argues that psychotic experiences typically occur as part of a process of experimentation at a deep level of the mind, a risky process of profound disorganization and then reorganization. He illustrates how the current mental-healthcare system interferes with rather than safely facilitates this process, and how recovery seems to only be possible when people manage to break away from the system to at least some degree. He then sketches out the possibility of a very different system of care that would recognize the meaningfulness and positive potential in psychotic breakdown.
Unusual as his ideas may seem, Williams convincingly demonstrates a very extensive knowledge of psychosis. In fact, his book may be among the best types of “preventive” measures — preventing one from entering the black hole of biomedical psychiatry, that is.
Rethinking Madness: Towards a Paradigm Shift In Our Understanding and Treatment of Psychosis
Sky’s Edge Publishing, April, 2012
Paperback, 398 pages