Experiences labelled as 'psychotic' are often purported to be the result of faulty brain mechanisms or genetic abnormalities. Conversely, these same experiences when understood within the context of childhood adversity are considered 'psychotic-like' and often get labelled as 'dissociative', despite there being no qualitative differences between these phenomena. This impacts treatment profoundly. Dissociative and trauma researchers have developed several recommendations and interventions for working with individuals who hear voices, have extreme fears, have difficulty with deciphering the past from present, and experience extreme depersonalization and derealization. Yet, most clinicians tend to view individuals who have these experiences and are labelled with a dissociative disorder as 'attention-seeking', 'manipulative' and/or suffering the effects of over-zealous practitioners. Psychosis researchers in the mainstream, on the other hand, view these same experiences as hallucinatory, paranoid, delusional, and stemming from cognitive impairments, resulting in biologically intrusive interventions that may or may not be helpful. Relying on experts-by-experience is one way that clinicians can better understand the helpful and harmful aspects of their interventions and to learn new ways of relating to that which might be difficult to understand. The narrative that resulted from these first-person perspectives suggests that differences between those labelled 'psychotic' versus 'dissociative' lie more in gender, class, and race biases. Further, participants recommend that treatment should be guided through an attuned, collaborative, individualized, egalitarian, trauma-informed, relational approach regardless of the framework surrounding their psychic experiences. Diagnoses, medicalized formulations of emotional and spiritual experiences, denial, the use of multiple psychiatric drugs, and professional politics are all considered ineffective, at best, and re-traumatizing, at worst.
Individual psychodynamic therapies , Influencing professions , Experts by experience
