Episode 32, available on Spotify, Apple Podcasts, and YouTube
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“What I have striven to do and I'm keen to do is to acknowledge that when you're talking to somebody who's separate from reality, (who) has a psychosis, (that's)... incomprehensible - that it's not some profound failing on their part where they just simply don't have the right moral outlook on the world. They're just fractured into all these silly ideas. I think there's often something really comprehensible at the centre of it, that we should be striving to get at. And if all that does is just make them feel a little less... bewildered, and a little less... on their own in it, I think that's still a valuable thing to aspire to.”
Today’s episode of Keep Talking features Dr. Paul Fletcher, the Bernard Wolff Professor of Health Neuroscience at Cambridge University. Paul talks about psychosis and the brain, the strangeness of psychotic episodes, why the human mind produces delusions and hallucinations, some triggers and causes of transitory psychosis, how we might more ethically treat homeless people in a psychotic state, and how we have improved in our treatment of psychotic people.
Dan shares his own experience with the terror and confusion of marijuana-induced psychosis to help others facing a similar destabilizing and debilitating human experience to feel less alone and stigmatized.
About Paul Fletcher:
"Paul Fletcher is a doctor, researcher and the Bernard Wolff Professor of Health neuroscience at Cambridge University. "
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Time Stamps:
(00:00) Intro
(00:51) Get to know Paul Fletcher
(01:48) Paul Fletcher’s background and how he developed an interest in psychosis
(04:38) Understanding Jerome Lawrence’s quote on psychosis
(11:53) The difference between hallucinations and normal human experiences
(23:49) Dan's marijuana-induced psychosis
(37:45) What one can do to avoid transitory psychosis
(41:39) The prevalence of transient psychotic breaks
(45:46) Regaining normalcy after a psychotic break
(49:15) Decreasing ignorance about psychosis and reducing its stigma
(57:16) The video game "Hellblade," which highlights psychosis
(01:05:02) The need to empathize with those experiencing psychosis
(01:11:03) Alan Graham’s Community First! Village in Austin, TX
(01:18:02) Psychedelics’ effect on the human brain
(01:21:36) Potential ways to treat mental illness in the future
Quotes:
“The difference between neuroticism and psychosis is that the person with a neurosis... recognize(s) it as part of themselves... It's what psychiatrists used to refer to as "ego syntonic"… it's part of them. In psychosis, the critical thing is that the person actually can very much externalize it and blame it on some other person, some other persecutor. It's their reality that has changed their beliefs about the world and the people around them. So it's what that used to be called "ego dystonic" – it's not me, it's something out there.”
“Hallucination is a perception when there really isn't something out there. A delusion is the other sort of limb of psychosis, and that refers not so much to perceptions as beliefs. It's a belief that seems to be held without good evidence, or evidence that other people around you don't experience. And it's held, often very tenaciously, so even if people really do everything they can to talk you out of it, the belief doesn't weaken, the belief remains fixed.”
“I think it's important to acknowledge that, having said that transient mental illness (is) rather like other forms of illness, (it) will be to some extent mitigated if you do look after yourself, if you avoid too much alcohol or drugs.”
“I think if we take something like a delirious state as... the most transient and yet also (among) the most vivid and profound psychotic states... (S)omebody may be (experiencing psychosis) postoperatively, or in the midst of a fever... seeing and hearing things... believing that the nurses are trying to kill them, or kidnap them, or… (are) really absolutely convinced (they are) inhabiting a completely different world; that can pass within 24 hours. There's nothing inherent in the experience that tells you it has to last, or that... some untold psychic damage has been done.”
“What I have striven to do and I'm keen to do is to acknowledge that when you're talking to somebody who's separate from reality, (who) has a psychosis, (that's)... incomprehensible - that it's not some profound failing on their part where they just simply don't have the right moral outlook on the world. They're just fractured into all these silly ideas. I think there's often something really comprehensible at the centre of it, that we should be striving to get at. And if all that does is just make them feel a little less... bewildered, and a little less... on their own in it, I think that's still a valuable thing to aspire to.”
Resources Mentioned:
People Mentioned (Quotes from mlf.org and Wikipedia)
- Alan Graham – “Alan is the founder and CEO of Mobile Loaves & Fishes (MLF), a social outreach ministry that provides food and clothing, cultivates community and promotes dignity to homeless men and women in need. Previously a real estate investor and developer, Alan founded Trilogy Development and the Lynxs Group, which developed Austin’s airport cargo facility and similar facilities at airports around the country.”
- Jerome Lawrence – “Jerome Lawrence was an American playwright and author. After graduating from Ohio State University in 1937 and the University of California, Los Angeles in 1939, Lawrence partnered with Robert Edwin Lee to help create Armed Forces Radio. The two built a partnership over their lifetimes, and continued to collaborate on screenplays and musicals until Lee's death in 1994.”
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