[tananan]

If this treatment is “surprising”, it might point to a unskilful way of conceptualizing the disease in the first place.

I wonder how many people make things worse for themselves by worrying that they’re going crazy, which ends up feeding the cycle.

As opposed to “What can I do with this/How can I work around it?”

Giving people agency and making them know that they don’t need to own every random voice that comes into their head is nice. Even for non-psychotic folks.

[FollowingTheDao]

In my deeper psychosis, asking myself “What can I do with this/How can I work around it?” is literally impossible. I am too busy running down the street secretly taking pictures of people who I think are agents from some unknown organization.

So there is a limit to this therapy.

[Xmd5a]

Makes me think of the 'gang stalking' phenomenon.

There are people online claiming to be harassed by groups of people hired by governments or shadow organizations. This ranges from being followed in the street or having people looking at you menacingly at the supermarket, to being subject to psychic warfare using electromagnetic weapons.

I have yet to find a case that convinces me it's not pathological paranoia.

But where it gets interesting is that these people also claim the "harassment" happens on the very forums where they discuss this topic: some posters allegedly make subtle references to info they shouldn't know about, especially because on these imageboards anonymity happens at the thread level.

After having spent enough time on these platforms, this happened to me on a few occasions: posters alluding to my geographical location, or making mentions of things I wrote in other threads with high emotional involvement. I can't tell whether I'm over-interpreting, but one thing that is certain is that these posters were LLMs. I came to that conclusion using various tricks: context-length exhaustion, talking about topics that go beyond their reasoning ability (such as anagrams), and I noticed they fail to properly understand concepts from pictures or to read text behind a link.

Conclusion: the idea of gang-stalking is not an assessment of the situation, it's the tip of a spear meant to induce pathological paranoia.

[suzzer99]

A very good friend of mine is in some kind of severe psychosis right now. She's cut off all her friends and family. While she was still talking to us, she was still so paranoid she refused to even consider seeing a doctor, even though she knew she was on some kind of "never-ending acid trip" as she called it.

But she's still taking care of herself and not a danger to herself or others, so there's nothing we can right now. My big hope is that someday she'll get perspective on this like you have now.

[space_oddity]

What works during recovery or in milder phases of psychosis might not work in its more extreme manifestations. Recognizing and respecting those limits doesn’t diminish the value of this therapy

[tomcam]

So eloquently written. Thank you.

Can I draw from this that when the psychosis gets deep enough you can sort of recognize that you’re in the state (since you’re telling people sorry) but simply cannot control it?

Is it controlled by medication? Does the medication ever fail you and return you to the state of psychosis?

[phkahler]

What happens when it passes? I've never had that kind of thing, but I did find "internal family systems" therapy useful and have wondered if those extreme conditions might be extreme manifestations of the same concepts. If so, there may be a way to tame that stuff.

[tananan]

Sometimes you just have to weather the storm. I don’t think it makes sense to speak of therapies in such times.

[yowayb]

Years ago after some terrible things happened to a friend, she was "diagnosed" by a social worker in Los Angeles as schizophrenic and prescribed (I think it was abilifi). I called bullshit, so she skipped the drugs and has never had another "episode" (because that terrible thing that happened didnt happen again!)

[robocat]

A friend's son was about to be diagnosed Schizophrenic after more than a few nights broken sleep due to night-horrors. Fortunately his Mum could recognise schizophrenia and she managed to get sleeping pills prescribed (with much difficulty) instead of antipsychotics and he got back to normal over a few days with a few nights good sleep.

[hindsightbias]

I don't think a doctor would work off of a social workers diagnosis, but I don't know LA. I have personally talked with the Attending Dr. at two of SF's psychiatric wards and they were emphatically opposed to making any kind of schizophrenic or even bipolar diagnosis for a patient without a significant history of psychotic episodes.

[throw18376]

i think if the main thing is “hearing voices” this kind of thing is probably a good strategy, but there are lots of other probably worse symptoms of psychosis.

[hinkley]

Like thinking you’re the sane one and everyone else is insane.

[ImaCake]

It's helpful thinking for bipolar or depression. When I learnt I had ADHD I realised my "acute depression" was just extreme exhaustion and that there was no need to be sad - that is just my System 1 trying to explain why I can't do anything.

Basically there are a lot of useful heuristics you can get from the concept that your thoughts are only partially under your control.

[nimih]

A close family member of mine is schizophrenic, and, as I understand it, they've always (or, at least, for the past 5-8 years) relied on a combination of drugs and these sorts of therapies to manage their symptoms. That is to say, the drugs are helpful for helping to keep their thinking organized and reducing the frequency and severity of hallucinations/delusions, but those issues never really go away completely, and sometimes a given drug regime stops being effective for whatever reason, so it's very important to have (and to practice!) strategies for identifying when your thoughts are "right" vs "wrong," and being able to deal with the problem effectively when it's the latter.

[sandspar]

1/3rd of schizophrenics are fully symptom free once on the correct medication.

[space_oddity]

Everyone has intrusive thoughts or experiences moments of mental noise