Psychotherapy Services in South West London

The paradox of psychosis

There are few who have not on occasion felt the press of irrational thought, been tempted into unwarranted belief, or experienced the highs and lows of inexplicable mood. However, it is when these experiences pass beyond some threshold of acceptability, both for the person and for others, that the individual is recognised as suffering in a state of psychotic disorder. Psychiatric classification leaves much to be desired, for example in its inability to distinguish clearly between different varieties of psychosis or draw sharp boundaries between the manifestly and the marginally insane. There is at least reasonable consensus about the meaning of “psychotic”. Psychotic refers to an abnormality of experience and behaviour in which the individual lose control of his or her feelings, perceptions, and ideas and may develop delusional beliefs that have no basis in reality and intermittently lacks insight into the fact that anything is wrong. Experienced subjectively the state may range, depending on the degree of insight form great perplexity and distress to arrogant certainty. Observed objectively the behaviour seems grotesque and incomprehensible. Such deficit is a primary, intrinsic feature of those diseases and usually having a progressive course. Functional psychosis on the other hand is radically different. It is true that during bouts of acute psychotic illness there may be impaired social and intellectual functioning, but this has more the appearance of a secondary consequence and, in any case, is by no means seen in all individuals. More significantly functional psychosis also contains within itself a potential for the very opposite of deficit: the occasional capacity for superlative functioning and high achievement, this is the paradox.

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