This post was precipitated by the news of the execution just days ago of a man who suffered from severe neuropsychiatric illness (SNI) for most of his life. In fact, the onset of psychotic symptoms for him began perhaps possibly more than a decade before it is typical for most people. The execution of this man set my thoughts upon something I have been thinking of recently…
…That being locked inside of the state of psychosis can be a type of death – of the self.
It can take years to acquire deep insights into SNI even with direct exposure to it. It took several years after I began to call myself an advocate before I began to think that psychosis had to be much more complex that just a some hallmark symptoms (such as delusions and hallucinations). I came to perceive that consciousness itself must be severely altered when someone became detached from reality to the degree that bizarre acts of self-harm or harm to others took place. Who should be held criminally responsible for a symptomatic act of unlawful behavior, or violence when the self is “dead”?
Understanding SNI requires exposure, research, cognitive capacity, and contemplation. Sometimes, when I conceive of a particular idea and I reach the point where I think that my conceptualization is sound, I am able to construct a new string of words for a web search.
Yesterday, a web search hit on this poignant account of what it is like to descend into psychosis. Fortunately, for the woman in this first-person narrative, she experienced enough of a flicker of insight, that she was able to recognize the need to get medical attention. Sadly, for people afflicted with persistent and profound anosognosia, they will never know that they are experiencing a potentially life-threating and dangerous neurological detachment from reality. That said, even though her flash of insight may appear to have been a moment of connection with reality, readers should be circumspect to the fact that anything a person thinks, says, or does while in the neurological state of psychosis can be an element of delusional mentation – which means, that even the thought of calling the doctor could have sprung from a tangled delusion…the act may not reflect “sanity” or insight.
The woman in this story was trapped in the state of psychosis for six months. This altered mental status was not some type of psychological existential experience – this is not what psychosis is, psychosis is a neurological symptom. It can be surmised from elements in the story that “she”, or more accurately, her brain’s severely disordered semblance of mind, was doing all sorts of things that a “crazy” person is not supposed to be able to do – things that require high-level executive functioning. This is why psychosis can be so potentially dangerous. Consider why the human body is engineered to paralyze ambulation and other motor functions while a person is asleep. Given that the state of consciousness is disordered in psychosis, intact executive functioning can be similarly and even more dangerous because of bizarre psychosis mentation.
Everyone’s psychosis is different. Tragically, some people experience neural dysfunctions that directly cause dark and violent ideation and symptomatic violent behaviors, both premeditated and paroxysmal. Not everyone will become violent without pharmaceutical treatment because their brains are not identically afflicted at the neural level. Unfortunately, some will harm themselves or others – that is why SNI in general or psychosis in particular should always be taken very seriously.