Doubt is to certainty as neurosis is to psychosis. The neurotic is in doubt and has fears about persons and things; the psychotic has convictions and makes claims about them. In short, the neurotic has problems, the psychotic has solutions.
(Thomas Szasz)
Now I am not a fan of Thomas Szasz and his views on mental illness, however this quote stuck out to me upon reading his works.
As a borderline (someone who suffers from borderline personality disorder) I am well aware of to which borderline the illness refers to. That of the borderline between neurosis and psychosis, neurosis being:
A relatively mild mental illness that is not caused by organic disease, involving symptoms of stress (depression, anxiety, obsessive behaviour, hypochondria) but not a radical loss of touch with reality. (Oxford Dictionary)
AND psychosis being:
A severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality. (Oxford Dictionary)
This tightrope borderline between two mind sets is exactly why the quote at the beginning of this writing is of interest to me. The struggle between two personalities within. Coercing one another into problematic scenarios and continuously trying to solve the unsolvable with behaviours deemed damaging and irrational. Like conjoined twins, with one whispering in the others ear, telling the other there are risks, dangers ahead or that people will hurt or leave them, the other hears this and with a maniacal smile plans on how to survive the monsters it sees and hears around them.
Having suffered psychotic episodes throughout my life due to my BPD, PTSD and psychotic depression, my view on this disordered thought process is that of a person outside of themselves. Being unable to look at it from an internal perspective but more of an outside reflection on behaviours and memories.
When I was experiencing my worst I was delusional and had hallucinations of dark figured angels who towered over me, gesturing at me to follow them and leave the place I was in. As well as seeing fairy like creatures who would whisper to me that this life was not the end, that I could follow them and be safe in a world of magic and beauty. When an episode of this would end I would feel drained and confused, often not knowing where I had been, who I had spoken to or what may have happened to me whilst hallucinating. I would lose time and sometimes days to this.
The cause for this is said to be due to my extreme trauma and my existing mental illnesses. At this point I had not taken psychotropic drugs or any recreational hallucinogenic drug, so it was purely my mind fracturing due to the trauma of sexual abuse and violence.
Now my psychosis presents itself most when I am outside and makes me see every man’s face as the faces of the males who assaulted me. Sometimes watching me and appearing to slowly walk towards me. On occasion I am trapped in what appears to be my British childhood home where these separate incidences took place, I walk through my actual home, but all I can see is my old house. I have laid in my bed and been scared to leave my room as I know when I walk out my bedroom, it will all be unreal.
Certain psychotic episodes I had during the aftermath of my rape when I was 15 are not accessible to me, I know I had them as others witnessed them, but I have no recollection. Unfortunately I have scared people and this is not something I wish to inflict on anyone.
The mental health system we have in the UK is not the worst but it is not adequate. If I were to mention certain things in an assessment I would be hospitalised again, this means I do not share certain information with NHS professionals but I would with a private psychiatrist or mental health practitioners. So like most mentally ill people I am not able to be open myself up and receive FREE treatment for what I need, without being given heavy sedatives like anti-psychotics (which I was on for over 10 years) or being admitted to a psychiatric ward, which from my own experience would not be the best solution for me at all.
The treatment of these illnesses is not good enough, there needs to be a completely new perspective and a new way to administer treatment with the patients needs being assessed on an individual basis, not simply a criteria and box ticking exercise.
Knowing the treatment I need but it not be available to me due to the NHS either not providing it or being too short term, means if you are of a low income (which more people are than not) you have to pay for your treatment, which if you have no spare money after the basics of survival are met, you are not able to afford the treatment and must go without.
Luckily for me I am fortunate enough to have a wonderful husband who supports me and my ongoing recovery. Together we work hard at the long game, we train and educate ourselves to be able to earn more money, so that someday in the near future we can afford my treatment.
Going back to the original point and quote on the feelings and behaviours that come from my borderline between neurosis and psychosis, the need for more understanding is crucial within these disorders. Many who are borderline do not even know what and why this is happening to them, they do not know what the words mean or what borderline it is they are on.
For me knowledge is power! Knowing about my illnesses and having a diagnosis is just the starting point and is valuable to most. Physicians have long argued on the benefits of diagnosis and information for those of us suffering from mental illness. I say this is not their argument to have. These ideas come from an archaic time period within psychiatry which in turn has contributed to the stigma mental illness has today. It is then turned on its head to suggest “we” the mentally ill will be worse off with a label or knowing what our own minds are reacting to or conceiving of. Which then leads to a broader ignorance within society on how mental health is viewed, treated or exists within an individual.
Being on this borderline is a continuous battle within the internal conflicts my mind has rewired itself to do and think. With a thought and an idea to save me and protect me from the evils in the world my neurotic brain lends itself and then a damaging or “mad” way for me to confront or avoid them is offered by my psychotic self. Somewhere in between is me gasping for air…
These struggles need to be understood better by everyone and the stigma associated needs to be challenged at every level.
For more information and help please visit these sites:
The Mental Health Foundation – Getting Help
Mind – The Mental Health Charity
The Movement for Global Mental Health
“The true definition of mental illness is when the majority of your time is spent in the past or future, but rarely living in the realism of NOW.”
(Shannon L. Alder)
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