psychosis an experiential resolution & understanding of first episode psychosis.pdf

8/9/2019 Psychosis An experiential resolution & understanding of first episode psychosis.pdf

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Psychosis: An experiential resolution & understanding of first episode psychosis

ABSTRACT: With 34 years of lived experience I present an experiential understanding of

psychosis, as an adaptive psychosomatic process. Enabled by developing a sensate !evine,

"#$#% a&areness of hidden regulatory processes. 'chore, "##3% 'pecifically, the role of

visceral state and visceral afferent feedbac( on the global functioning of the brain, )orges,

"#$$% during episodes of affective psychosis. *c+orry et al, "#$"% Enabling a psycho

physiological understanding of the bidirectional influences bet&een peripheral physiological

state and the brain circuits related to affective processes, )orges, "#$$% during my first

episode psychosis.

Keywords: psychosis, first episode, phylogenetic perspective, assessment, diagnosis

In "##-, after t&enty seven years of medicating my bipolar type $ disorder mood s&ings,

doing my best to avoid the delusional highs of mania, the despairing desolation of clinical

depression, and the po&erful escape impulse of suicidal ideation. I found myself confronting

the depth of my o&n selfignorance about my internal structure and function, in a need to

improve my capacity for selfregulation. fter almost three decades of experiencing affective

psychoses, &hether on or off antipsychotic medications, I have not used any form of

medication since late "##-, after stumbling on llan / 'chore0s boo(1 ffect 2ysregulation

2isorders of the 'elf, and noticing the constant references to the autonomic nervous system

and its role in psychiatric disorders. 'chore0s boo( triggered a seven year experiential research

effort &hich has been conducted in the spirit of everyone is right in some &ay, it is merely a

matter of (no&ing ho&. 5eich, $6-3% With a particular focus on ho& my birth trauma

experience and my phylogenetic predisposition to intense arousal dysregulation, 'chore,

"##3% combining a stress7vulnerability model, highlighting the interaction bet&een biological

predisposition and environmental influences, *c+orry, et al, "#$"% &ith phylogenetic model

of threat vulnerability. model of nervous disease ac(no&ledging a biomedical model of brain

disease, &hich postulates ho& neural mechanisms are accepted as underlying mental

disorder. *c+orry et al, "#$"% While this polyvagal perspective )orges, "##8% on nervoussystem dysregulation and three neural circuits that regulate reactivity, )orges, "##4%

suggests a natural nervous disease of nonpathologic causation. With my education into

nervous system structure and function enabling me to gain a physiological a&areness of

primary process emotional7affective states, )an(sepp, "##4% and a psychological

understanding1 that physiological states support different classes of behavior. )orges, "##8%

With this phylogenetic perspective bringing an internal sense of ho&, everyone is right in

some &ay, it is merely a matter of (no&ing ho&. 5eich, $6-3% 9ence, through the

development of an increasing capacity for introception, 'chore, "##3% I gained a psycho

physiological a&areness of ho& my social engagement system )orges, "#$$% is vulnerable

to threat and affect dysregulation, 'chore, "##3% after being primed by early life traumatic


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experience. With my improved selfregulation resulting from an experiential integration of this

phylogenetic model of organism function, enabling me to understand ho& the misattuning

social environment that triggers an intense arousal dysregulation, 'chore, "##3% does so

through a nervous system neuroception, )orges, "##4% of both my internal environment and

the external environment1

:he model emphasi;es phylogeny as an organi;ing principle and includes the follo&ing

points1 $% there are &ell defined neural circuits to support social engagement behaviors

and the defensive strategies of fight, flight, and free;e, "% these neural circuits form a

phylogenetically organi;ed hierarchy, 3% &ithout being dependent on conscious

a&areness the nervous system evaluates ris( in the environment i.e., neuroception%

and regulates visceral state to support the expression of adaptive behavior to match a

neuroception of safety, danger, or life threat. )orges, "##4%

:hus, after almost three decades of chronic treatment resistance to presumptions of disease,

(no&ledge about the internal structure and function of my nervous system, has enabled a

resolution of a profound nervous disease. With an experience dependent integration of the

polyvagal theory )orges, "#$$% resolving the habituated muscular7vascular tension and

pressure of a trauma entrained, internali;ed sense of life threat. With my experiential

integration of relevant (no&ledge and progressive resolution, rearroll, "##$% selfdefensive orientation &hich prior to my first episode ofpsychosis, &as habituated to the point of being unnoticed. With a nonconscious split bet&een

feeling and cognition becoming understood as the loss of my1 Infants 'ixth 'ense1 &areness

and 5egulation of @odily )rocesses, )orges, "#$$% or introception. 'chore, "##3% With this

trauma induced loss of a subconscious capacity for selfregulation 'chore, "#$"% resolved

by developing an embodied a&areness of ho&1 *uscle tension creates a buffer, &hich reduces

anxiety but at a cost A a loss of contact &ith oneself and others. It can be a negative loop that

leads to loss of selfregulation. >arrol, "##$% n embodied a&areness &hich explained the

profound split in my capacity for high cognitive function &ith a simultaneous problem of ffect

5egulation the ?rigins of the 'elf, 'chore, $664% because I &as un(no&ingly lost to myself,

through a psychophysiological )orges, "#$$% split in my selfa&areness.


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My irst !pisode Psychosis & "er#ous Syste$ %ysregulation

:he long Bourney to&ards this articulation of my livedexperience, has culminated in a

hierarchical, thermodynamic, dysregulation model of psychosis. model &hich brings a

phylogenetic context to a :raumagenic /eurodevelopmental *odel, 5ead et al, "##$% of

psychosis, and the &idely held vie& of underlying neural mechanisms involved in psychotic

experience. phylogenetic perspective &hich also brings a sense of ho& everyone is right in

some &ay, it is merely a matter of (no&ing ho&, 5eich, $6-3% in my opinion. While the

sudden shift in physiological state &hich precipitated my first episode psychosis, involved three

neural circuits that regulate reactivity consistent &ith the Cac(sonian principle of dissolution.

)orges, $66=% dissolution7dysregulation perspective of ho&, in Debruary $6# a sudden

attachment loss triggered my first episode of mania and set me off on a three decade long

struggle to understand the hidden nature of my affective states of consciousness. lthough at

that time, li(e normal people every&here, I had no (no&ledge or a&areness of my internal

structure and function, to understand and accept my immediate experience. /o (no&ledge of

nervous system function to understand ho& that spontaneous shift in physiological state, &as

an innate resolution of my trauma entrained, avoidance orientation to environmental

challenge. :he sudden dissolution of three principal defense strategiesFfight, flight, and

free;e, )orges, "##4%and the muscular, vascular constriction of an internali;ed life threat,

precipitated by attachment loss and the need to face the challenge of existential isolation.

nervous system reaction to an existential crisis, that may be considered natures &ay of

setting things right. )erry, $66% lthough it &ould be decades before a determined self

education drive, &ould bring me (no&ledge of the phylogenetic nature of my autonomic

nervous system, and the Cac(sonian principle of dissolution1

Cac(son proposed that in the brain, higher ie, phylogenetically ne&er% neural circuits

inhibit lo&er ie, phylogenetically older% neural circuits and GG&hen the higher are

suddenly rendered functionless, the lo&er rise in activity.00 lthough Cac(son proposed

dissolution to explain changes in brain function due to damage and illness, the polyvagaltheory proposes a similar phylogenetically ordered hierarchical model to describe the

se


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elo


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Bust sho& me the &ay, give me a sign, help me pleaseL /othing happened for &hat felt

li(e minutes as I sat there in hopeful expectation &hile loo(ing at my o&n reflection,

loo(ing into my face. :hen it began, a ne& sensation, a feeling at the top of my head

&hich flo&ed do&n slo&ly, do&n through my face, into my shoulders and do&n through

my chest, do&n into my pelvic area. I sat &ith a sense of &hat is it &onder, although

more felt than in any thin(ing sense. sense of &onder that &as similar to the out of

body experience &hen I &as fourteen, except this slo&ly descending calm &as the polar

opposite of the sudden sharp elevation, &hen IKd seemly left my body. It felt li(e IKd

been sitting in a bath of &ater that &as over my head and someone had pulled the plug.

I sat there as calm descended slo&ly from head to toe, as if a mind numbing tension

&ere being drained out of me, li(e &aste &ater flo&ing do&n and out through my toes.

/ext came a mindful realisation of the experience in a pleasant and very &elcomed

surprise. I felt unburdened someho&, refreshed and excited, happy and ne&. @ates,

"#$"%

9ence, the hierarchical s&itch in neural circuits that regulate the autonomic reactivity of my

internal environment, &as mediated by a nonconscious neurorception of safety, as I sat

loo(ing into a mirror at my o&n face, &hile simultaneously a&are of a more complete image

of the external environment. With the spontaneous dissolution7dysregulation action of the

three principal defense strategiesFfight, flight, and free;e, )orges, "##4%suddenly

dissolving the muscular7vascular constriction of an internali;ed life threat, through a

spontaneous rise in the activity of my integrated social engagement system. )orges "##$%

@ringing a middle path psychophysiological perspective to ho&1 heightened vulnerability to

stress is not, as often &rongly assumed, necessarily genetically inherited, but can be ac


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modifies the organs, muscles, blood vessels etc. :he pioneering neurologist ntonio

2amasio has emphasised that the brain is dependent on the body for self(no&ledge.

5ather than language being the necessary feature of self(no&ledge, it is the critical

multiple feedbac( loops &hich inform the brain about activity in the body, &hich

constitutes the basis of all self(no&ledge. 9e argues that the emergent properties of

complex activity in the body are emotional states. Deeling feelings allo&s us to ma(e

sense of our environment and act appropriately. /ote1 self(no&ledge is distinct from

selfconsciousness Mthe capacity to reflect on oneselfN. 'elf(no&ledge supports

appropriate actions in a survival context, and provides the basis for more sophisticated

reflective activity.%

)utting together some of the implications from 'chore0s and 2amasio0s &or(, I &ould

say that &hen the containing function of relationship fails, there is a correlative

brea(do&n of the sensorymotor loop. :he sensory component including sensation and

feeling% is split from the motor function &hich is necessary for acting. @oth feeling and

doing are lifesaving functions A &or(ing together they constitute experience.

Interestingly, @ion defines Gthin(ing0 in terms of the capacity to experience, to ma(e

lin(s, and he attributes this to being able to integrate and assimilate sensory images

the alpha function%. Intense feelings al&ays have a correlative motor Ai.e. muscular A

impulse &hich includes all the primitive urges A to suc(, to hit, to reach, to cry, to tear,

to cling. @ion argues that restraint upon motor discharge is provided by means of the

process of thin(ing. I &ould


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ma(ing language the expositor of nature,

instead of ma(ing nature the expositor of language. lexander @ Cohnson

%iscussion: *y first person account hopes to stimulate a discussion about our common mind

body split and the psychophysiological nature of human experience. With, in my opinion, a

gro&ing need for an integration of :he )olyvagal :heory into clinical diagnostic observations,

and the hidden nature of our selfprotective perceptions, based on a common neuroception

)orges, "#$$% of safety. )articularly &ithin the universal existential context of ho&1 :he

attempt to regulate affect to minimi;e unpleasant feelings and to maximi;e pleasant ones is

the driving force in human motivation. 'chore, "##3%

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psychosis an experiential resolution & understanding of first episode psychosis.pdf

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