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The ‘Sign’, ‘Signified’ and “Psychosis’: The Intersection of Language and Psychosis

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There is no universal way to signify or capture the experience of psychosis. This article is a critical linguistic-praxis-based discussion of psychosis, language, and interpretation. The aim is to make new treatment approaches like Open Dialogue as an effective milieu to treat psychosis more understandable to implement from the ground up. Open Dialogue has seven basic underpinnings. These are:

  • immediate help
  • a social networks perspective,
  • flexibility and mobility,
  • responsibility
  • psychological continuity,
  • tolerance of uncertainty

In this blog I use a linguistic argument to highlight Open Dialogue’s underpinnings so clinicians, peers, and mental health stakeholders can be confident, and use research to target psychosis symptoms more effectively in their practice. 

My Lived Experience with Psychosis

In my last semester of college, my mental status went from slightly confused to floridly psychotic and admitted to a state psychiatric facility six months later. I was an English major with a concentration in critical theory. For three years, I was at work studying the English language. When I finally became psychotic, I was acutely aware of how the psychosis impacted how I understood and used language to communicate and connect with others.

My autobiographical memoir, University on Watch: Crisis in the Academy, takes a close look at my connection between language and my worsening condition: “The disconnect between what I thought I was doing and what was happening widened by the day, and by the semester’s end, I envisioned a new reality that was apparent to me alone” (University on Watch, J. PETERS).

Importance of Critical Reflection

People experiencing psychosis need to be critical in their reflection. I looked back on my memories while symptomatic all the time. I am no stranger to mental health blogging, writing, and other reflective practice. Like how I wrote and reflected in my memoir, linguistic self-study provides the teeth to begin a vast, retrospective psychological profile. Reflecting is also the point of departure for dialog between a therapist and patient to discuss and reflect on their experience

For those reflecting on their past experience’s psychotic, demystifying the taboo of psychosis and recasting belief in recovery is critical. Doing so rekindles social networks for people who might be isolated or ostracized and ushers in support and reassurance for someone in need of immediate help.

Interpretation Schema: Sign, Signifier, and Signified

 

The concept of signs has been around for a long time–classic philosophers such as Plato and Aristotle studied these terms. The terms are now associated with Semiotics. Derived from the Greek root seme, as in semiotics (an interpreter of signs), Saussure and American philosophers used the term through history, rhetoric, and communication.  

 Saussure created the terms signifier and signified to break down what a sign is, literally and metaphysically. The takeaway from Saussure’s scholarship was on the level of language: these signs make up people’s understanding and interpretation of the world. There is a direct relationship between an increase in psychotic symptoms and the speed at which sign interpretation goes through a transformation. However, the volume of change, how much or little people can tolerate/process varies from person to person. Some folks are more adaptive than others. 

After all, I am talking about completely restructuring a person’s interpretation system. As psychosis worsens, signs changing will impact a person’s language, oral expression, and how they interact with the world. Instead of painting the clinical picture in pathological colors, the person experiencing psychosis is humanized, allowing for him or her to take full responsibility and ownership of its impact in their life.

Now, instead of peers and clinicians spend so much conjecturing, arguing, and surmising what psychosis is out of fear in participating in stigma or the medicalization of the disorder, the wholesale commonalities between people’s extreme states can be readily embraced by consumers.  

Physiological Impact of Psychosis 

 

Coping with a loss is taxing and stressful. When superabundant, stress impacts people’s relationships with their worlds. Psychosis symptoms can be a healthy bodily response to radical and unsettling life adjustments. In doing so, the mind is coping with whatever is happening.

The body compensates and handles the change in brain function is, in essence, a method of coping and adapting to something altogether wrong for the body. The response can be healthy, creating a reality by changing or challenging a person’s interpretation. Sometimes, the mind must deal with the dysfunction of its regulation by systematically changing its signs. During initial psychotic symptoms, I fully believe the early moments of a person’s ‘break’ is more systematic, organic, and healthy than the toxic things people say about psychosis. The composition or nature of the ‘break’ is NOT disordered; but rather a natural bodily process best understood through Semiotics and Language.

 

Psychosis carries with them a constellation of related and altogether unique symptoms differently. At different times, psychosis symptoms exist in a dark harmony along a spectrum, sometimes feeding off one another and working in complete isolation. Before psychosis symptoms become too overwhelming, I suggest that they shift from more systematic sign change to more disruptive, arbitrary, and altogether difficult-to-follow changes within a person’s system of signification and interpretation of the world. 

As brain tissue becomes more damaged, neurons and their pathways become more misaligned, and signals become more chaotic and dysfunctional to and from the brain. Therapists can measure the rate of change before things get out of hand and introduce measures to worsening psychosis symptoms by charting and mapping the rate of change within the person’s signification system.

 

The Potential Clinical Significance  

 

 

The clinical significance of these claims has potential. If we assume my claims regarding the experience of psychosis can be measured, mapped out, and analyzed for degradation between a signifier’s linkages, this scheme’s usefulness becomes apparent. Further analysis will have to research the correlation between sign association and the experience of the individual who has psychosis.

Given all signs of change, the active disease process moves toward a higher degree of chaos and instability. Measuring distress tolerance to such changes will also be necessary for the research to add new meaning to understanding how everyone’s unique experience shares commonalities. 

Challenging Symptoms: Insight-Driven Self-Study

The current provision of clinical treatment is far too broad for the disorder’s individualistic impact. The otherworldly nature of psychosis can be settling. When first activating, there is a certain mystique to psychosis.

Indeed, psychosis does distort how we perceive reality and plays around with our level of attachment to the world. People in extreme situations, unusual situations, experiencing a new or recurrent crisis, and bizarre situations complicate our existence. We know I and introduce new angles or worldviews to cope.  While this may seem fascinating, and it can be hard for people experiencing this to pull out of a holding symptomatic pattern. The symptom’s impact on the individual may seem welcome, timely, and needed to experience a necessary change. In my own experience, my psychosis symptoms activated when I needed to experience a change and adjustment. Something was wrong; I needed to fix it. People that need to make a significant life change or radical course correction are more at risk of psychosis.

These patterns are maladaptive. It is the body coping with painting the world in more palatable colors. Psychosis serves to shift human perception enough to identify alternate or new solutions; psychosis can offer an answer to life’s problems by stepping outside your perspective. Job loss or unemployment, relationship changes, and significant life circumstance adjustments are complicated to tolerate. 

Periods of adjustment can sometimes be the pathway to more significant, complex issues if we let our problems go unresolved for long periods. The brain activates psychosis symptoms so the body can more easily tolerate the change without feeling or thinking about the situation as intensely and painlessly as possible.

There is a reason there are so many homeless people who experience psychosis. Most become psychotic after losing their homes. Their need to adjust to life on the streets is a major, overwhelmingly stressful event. 

 

Implementation: Risks to Clinical Application

 

Psychosis and how individuals are impacted by additional stressors, the symptoms worsen and become unmanageable. So, the gradual and welcome shift in perception will see and feel welcome for a while, but if the same stressors continue to aggravate, agitate, worsen, or persist, expect the detachment to increase and a sharp departure from reality your cards in the near-distant future. 

For the person adjusting to life on the streets or going through a tremendous loss, anything a person needs to do to cope with their reality will accommodate our minds during a crisis to make the change work. The mind doesn’t work the way it should. In the case of psychosis activating, it may seem to work for some time.

 

People often find solace and comfort in the initial stages of psychosis because their shift in perception is minor and more tolerable. This reality shift can be more comforting than distressing in cases like this. When psychosis becomes out of control, it can be overwhelming, like any other symptom. Life becomes too distant and unrecognizable to live without incident. 

I suggest that initially, some variance in our reality may seem appealing given a person’s life circumstances. Still, as the symptoms worsen and become more extreme, the interplay between the stressed situations and your body’s (coping) response to the stress is overwhelming. Overwhelmed and panicked is why psychosis is so disturbing and can be very scary to experience. 

 

No question exists that people prone to psychosis becoming active or reactive is linked to changes, or spikes, with stress and a person’s ability to cope. The mystique associated with the mind and bodily experience during a psychotic episode might have a deeper meaning to be forged from and not something to be discarded or forgotten because it’s so traumatic.

About the Author

J. Peters

Max Guttman is the owner of Recovery Now, a private mental health practice in New York City. Through his work as a Licensed Clinical Social Worker, therapist, and disability rights advocate, Max fights for those without a voice in various New York City care systems. He received a ‘2020 Bearcats of the Last Decade 10 Under 10’ award from the Binghamton University Alumni Association.

Guttman treats clients with anxiety and depression but specializes in issues related to psychosis or schizoaffective spectrum disorders. He frequently writes about his lived experiences with schizophrenia.

‘I knew my illness was so complex that I’d need a professional understanding of its treatment to gain any real momentum in recovery,’ Guttman says. ‘After undergraduate school and the onset of my illness, I evaluated different graduate programs that could serve as a career and mechanism to guide and direct my self-care. After experiencing the helping hand of my social worker and therapist right after my ‘break,’ I chose social work education because of its robust skill set and foundation of knowledge I needed to heal and help others.’

‘In a world of increasing tragedy, we should help people learn from our lived experiences. My experience brings humility, authenticity, and candidness to my practice. People genuinely appreciate candidness when it comes to their health and Recovery. Humility provides space for mistakes and appraisal of progress. I thank my lived experience for contributing a more egalitarian therapeutic experience for my clients.’

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