This is the second part of MIA’s coverage of the British Psychological Society’s recent report challenging the current paradigm for the diagnosis and treatment of psychosis.
The authors of the report expand upon the traumatic and sociopolitical factors underlying presentations of psychosis and “schizophrenia” and call for new ways of understanding these experiences.
The authors warn against conceptualizing voice hearing and other “unusual” experiences as indications of an unwanted “brain disease.” Most notably because this view uniformly pathologizes an otherwise heterogeneous experience that some find non-distressing and conducive to their lifestyle. Furthermore, they argue that these approaches privilege internal explanations for distress in a way that conceals the effects of trauma and structural violence.
They cite compelling evidence that mental health problems, and distressing experiences often labeled as “psychosis,” can be reactions to stressful life events, such as poverty, abuse, and different forms of trauma. Survivors of child abuse, for example, may hear voices resembling their former abuser. One review found that between one-half to three-quarters of individuals in psychiatric inpatient units were victims of childhood physical or sexual abuse.
Alongside flashbacks, intrusive images, and dissociation, hearing voices might similarly arise as a natural response in the aftermath of trauma. Refugees, for example, may hear voices or have visions related to personal experiences. The authors write: