Saturday, July 5, 2008

--After Psychosis--

Reentry into the real world is probably the most difficult aspect of treatment for the psychotic patient to master. Recovery from acute psychosis and chronic psychosis are different. The fulminating energy, the high expressed emotion, and the need for quick relief from the terrifying pain cause the patient to seek any available object to attach themselves to. A protective environment, a sympathetic understanding therapist, or medication all can give immediate relief.
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The struggle to overcome chronic mental illness is a much more tedious process. With chronic psychosis the patient has settled into a different life style. They have given up control of their mind to a different entity and have applied life to this entity as if it is real.
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Hallucinations give directions to the patient. Based on false premises, all reasoning that follows is therefore delusional. The patient, fearful of change, and more entrenched as the process continues first into months and then years without relief, becomes like an immovable stone. In the most formidable cases, it seems as if only an explosion from within, with it’s scrambling of emotions, might be necessary.
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Fortunately most cases give the therapist more to work with. As the dust clears, it becomes obvious that the precipitating factor in chronicity is a failure to bridge intimacy. Most psychotic breakdowns occur in adolescents. The chronic psychosis may not completely disappear until an intimate relationship forms with another human.
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Bluntly, until the patient falls in love. A good relationship with a therapist is usually necessary as a teaching process. Sometimes the patient must learn or relearn the language of speech and the basic communication of emotions as stepping stones to understand the world around. The process of recovery is slow, repetitive, and sometimes boring. This process includes direct intrusion and support. It can take up to twenty years in some cases. It is important for the therapist and patient to remain hopeful and positive in the moments of adversity that will always occur.
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