Recovery and Wellbeing
By Elina Baker & Melanie Attwater
Key Themes: Mental Health, Psychosis, Recovery
In this book, We use the word ‘’psychosis’’ to describe experiences
outside of shared reality, such as voices, visions and an awareness of other
unusual occurrences, which someone may find distressing. Based on our work running groups to support people who have these kinds of
experiences, this book brings together psychological ideas about and
personal experience of recovery in relation to psychosis. Each chapter also contains a ‘section for reflection’, to give you the opportunity to think about how to use these ideas and experiences in your own recovery.
We hope that this book will enable other people struggling with
psychosis, either personally or as a relative, friend or worker, to find ways
of understanding and managing these experiences successfully. We also want to give a message of hope, to let people know that they are not alone and that recovery is possible.
About the Author
I am a clinical psychologist and I have worked with people with psychosis for fifteen years. During this time I have learnt about organisations like the Hearing Voices network and how people with psychosis can help each other move forward from that experience. I have also seen how mental health services can sometimes make things worse for people, through giving them medication with debilitating side effects or making them feel that they have no control over their lives. As a result, I decided to set up groups where people could learn about other ways of coping with their experiences and hear about recovery from people who knew what it was like, because they’d been through it themselves. I was delighted to have the opportunity to work with Melanie, who could bring both her personal perspective and a lot of valuable knowledge from her work as an occupational therapist.
We’ve seen people learn and grow through coming to the Life with Psychosis group, and then getting involved in running it, sharing the benefit of their experience with people at an earlier stage on the recovery journey. I know that groups can be difficult, especially for people with psychosis, who can feel very wary of other people and get easily overwhelmed. So, I hope that this book will give more people the chance to learn about ways of coping with and understanding their experience of psychosis. It is meant to be a work book that someone can go through on their own, or with the support of a mental health worker. Obviously we can’t put in all the information that someone will need so there are lots of suggestions of other places to find out more about the topics we discuss. The book is written in the order we discuss topics in the group, as our group members have found it helpful to develop coping strategies before tackling the challenging questions about how to make sense of their experiences. However, you can look at the different sections in whatever order works for you.
I wanted to help write this book to give hope and motivation to people who have psychosis.
When I had my first psychotic episode twenty years ago all I wanted was for someone to tell me that something good could come out of the situation I found myself in. Since then I have discovered that psychosis could actually be a blessing. Psychosis has given my life a purpose, a sense of focus and direction and changed me as a person. My subsequent career in mental health has given me fulfilment, rewards, and a productive role full of personal meaning.
My recovery started by learning everything I could about mental health. I found it to be a fascinating subject. I learnt how to make sense of my own experiences and look for the kernel of truth in all my memories, fears and preoccupations. I needed to know why I had become unwell and more importantly how I could get better and have a good life.
An Occupational Therapist helped me and she seemed a real and reachable person. Also I was envious of her job: it seemed varied and creative. After my Occupational Therapy training I have been working in mental health ever since, now as a Senior Mental Health Practitioner in the Psychosis and Recovery Team.
I now see the same doctors and nurses at my work that have treated me in the past, as I work in the same NHS Trust. I feel no embarrassment. Instead I feel in quite a powerful position to have a patient’s view of the people who are also my colleagues. I hope I can remind them that recovery is real and possible and right beside them.
I feel I can help the people with mental health problems that come to me. I treat them in the way I wish I had always been treated, and I share my knowledge of recovery with them to try and give them hope and motivation to find a recovery path for themselves. I try to help them find a positive perspective of their experiences.
I have been co facilitating the Life With Psychosis Group since it began in 2011. In the group I have met many inspiring, intelligent and kind people with psychosis. They are all people who are looking for ways to explore their experiences, to find understanding and holistic wellbeing for themselves and for each other. I hope to share some of the positivity we experience as a group to inspire others that psychosis can be a positive experience and a path to living a full, meaningful and satisfying life.
Discovering that voices can’t carry out their threats could help you to feel more confident about standing up to them. When responding to voices, its helpful to try and be assertive. This means expressing your opinions and saying what you want while also showing respect for the other person’s opinions and taking into account what they want. Becoming angry and being aggressive, by shouting and swearing is likely to just make the voices feel threatened and retaliate. Remember that voices may be treating you badly because they are frightened and hurt themselves, so it is important to try and be kind to them. Try saying things which acknowledge the voice’s opinion as well as expressing your own feelings and opinions. For example:
“Thank you for your opinion but I disagree”.
“I know you don’t like it but I don’t think there’s anything wrong with what I’m doing”
“I can tell that you are angry but it hurts my feelings when you say that, so I want you to stop”.
“I can see that you don't like that, but I do”
It can also be helpful to set boundaries, for example by setting a time during the day when it is convenient for the voices to talk to you. This can let the voices know that respect them wanting to talk to you but they need to respect when you want to listen. You may be able to agree other compromises between what the voices want and what you want to.
Listening to voices
Although we cannot be sure where voices come from, they do seem to pick up on and express people’s feelings, particularly if they are not expressing these feelings themselves. So, it can be helpful to try and listen to the voices and see what messages they might have for you, For example, if a voice is angry, it may be reflecting something that you are angry about. If a voice is frightening or wants you to hurt yourself, this may reflect that you are feeling frightened or hurt. It can be helpful to try finding ways to express feelings safely, perhaps by writing them down or talking to someone you trust about them. You can also try and reassure and comfort voices, so that they no longer feel the need to make you aware of fear and pain.
I began to hear a male voice about a year after my first psychotic episode.
It started by giving me instructions over and over again, it seemed to be outside of my head but it was always shouting. The experience was strange and it made me feel very odd and different to begin with.
At first the voice was quite benign, saying things like ‘leave England’, and I thought that it was helping me.
The voice later became nasty and repeated words like ‘kill yourself’.
I became distressed and eventually I started to talk about it and this helped me to give the voice that I heard a face and a name that I could relate to. I thought of the voice as one of my relatives who had behaved in threatening and aggressive ways towards me when I was chaotic with psychosis.
I tried to fight the voice and to overpower it but this did not help. Then a few years ago when I had the opportunity I found a brave and effective way to shift the balance of power in my favour. I told my relative that I heard his voice in my head and it was very annoying. I finally felt like I had taken control of the situation. For me it was a turning point. I asserted my opinion and spoke out about how he was making me feel.
As time went by I noticed a new brief moment of consciousness, a small moment of opportunity when I actually listened for the voice before I heard it; instead of just hearing it out of the blue. That split second was enough, I realised I could dictate what the voice would say. In the briefest moment I could change my thoughts and change the content of the voice to make it say things that were more positive. The voice seems to echo my thoughts so I deliberately changed my thoughts. This was a revelation to me. I could actually make the voice say anything I wanted to hear, so I made it say kinder things.
I could make the voice say ‘love yourself’, instead of ‘kill yourself’, and so on. I was no longer afraid of it. I have learnt how to be stand up and be respected by the voice in my head and also how to put it to one side. I have learnt that I am in control and not the other way around, and now I ‘listen’ to than just ‘hear’ it. Choosing to listen gives me choice and control back.
The voice can seem like company to me. It has been part of my life for twenty years. It is compelling in one way, a companion and someone who always knows what is going on in my head at any moment. It can stop me feeling small as the voice shouts high in the air and makes itself heard. It has become more of a friend to me now, and I think I would miss it, if it I could no longer hear it.
Generally I distract myself by focussing on other more tangible things in my life. I see this process as creating new neural pathways in my mind, new networks that stop me going over the same voice hearing path time and time again. As life is busy and full of other things to focus on the voice is less frequent now, sometimes days or even weeks will pass when I do not hear the voice at all, and I am too busy getting on with my life to even notice.
This product was added to our catalog on Thursday 22 October, 2015.