The Hidden Trauma Created By The Psychiatry System (It’s Making People Worse)

The Hidden Trauma Created By The Psychiatry System (It’s Making People Worse)

Reclamation Radio Transcript

Kelly

[00:00:00] Isolation room, injections, all that’s super traumatizing for the patients. Oftentimes, people will comply because they don’t wanna get into trouble, and then once in there, you need to adapt to the program, and if you don’t comply, it’s really hard to get out.

Anneke

I don’t think the average person has any concept unless they’ve had a loved one or themselves have been likely involuntarily retained in one of these wards or units.

Kelly

Call somebody crazy is a weapon and a way to silence a person. It is a tool that is being used to hide the, the abuse. It’s a way to not ever being caught. If people start to understand how their nervous system works with reflecting and in relationships, it becomes a much more logical story.

Anneke

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Anneke

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Anneke

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Anneke

Hi, and welcome back to Reclamation Radio. I’m Dr. Kelly Brogan, and today I have a conversation with a registered psychiatric nurse named Anneke Sips, who I met through my community and offerings and who has recently published a book called The Wisdom of Psychosis. We delve into her experience and her audacious reframes of what we are calling psychosis.[00:02:00]

Anneke

We explore how you can listen, truly listen, to somebody who is having an experience of so-called perceptual disturbance and what that actually looks like and what it can yield. We talk together about what actually goes on In a psych ward. Things that you might not otherwise believe. And we talk about how to interact with so-called acute psychotic symptoms in another person.

Anneke

Basically, we unpack this very vague term that is a bucket for all sorts of rejected and unwanted behaviors on the part of another human being, and we begin to plant the seeds that she grows so beautifully in her book of what is the deeper meaning that can grow around this experience [00:03:00] of fractured reality, of so-called delusions, of perceptual disturbances, and the greater social context that can ultimately embrace people who are having this experience, and how we can broaden the definition of so-called psychosis to include natural experiences that humans have every day all the time.

Anneke

I hope that this is helpful for somebody that you know, or for yourself, or to just begin to expand the definition of what is bad and wrong and condemnable in this experience of humanity that we are sharing together. Welcome, Annika, to the show.

Kelly

Thank you so much for the invitation.

Anneke

Oh, it’s such a pleasure, and I was yapping to you before we started recording that I, we have so much to unpack in this potentially controversial, you know I love that, as a provocateur, [00:04:00] uh, discussion The place that I wanna start, however, is in our shared history as conventionally trained clinicians.

Anneke

So I’d love for you to talk a little bit about your, your credentials, your training, and what inspired you to move towards that training because, you know, I’ve shared many times, uh, you know, with regard to my own journey, that it was when I was working a suicide hotline in college at MIT-

Kelly

Mm-hmm …

Anneke

that I was supervised by psychiatrists, and I was given the impression that we have cracked the code of human behavior, we know how to end human suffering, and we just need to get people into the hands of prescribers so that they can take their medication and no longer feel, you know, despair or anguish or ho-hopelessness or whatever it is.

Anneke

And when I dig a little deeper, I can see the signatures of, of my emotional immaturity, and I can see [00:05:00] that I was the one who was really uncomfortable with human suffering, and I needed to resolve that externally, right? Like, I needed to resolve that on behalf of anybody who was standing in front of me and struggling so that I could feel better, so that they could regulate my system.

Anneke

But that’s what landed me in medical school, was specifically to become a psychiatrist, and I know you have your version that overlaps a lot with mine. So I’d love to start there. And then I wanna talk a bit about what it’s actually like on a psych ward, because there are not a lot of people I can talk to, especially not in a public forum like this, to expose really what goes on.

Anneke

Because I often say, like, you, you wouldn’t believe it, right? Like, people think of like, oh, One Flew Over the Cuckoo’s Nest. Like, that’s like a dramatization from decades past. Like, no, you would not believe, you know, the compulsory treatments, the inhumanity, the extraordinary, um, abuses that, that go on at the hands [00:06:00] of people who really mean well.

Anneke

A-and that’s the most confusing and cognitively dissonant part of it. So I, I’d love to just start there before we get into Really, uh, what I believe is such an, an important offering in the form of your, your book, The Wisdom of Psychosis. So, so tell us about your journey into conventional medicine, and let’s start there.

Kelly

Yeah. Well, thank you again for the invitation. And indeed, uh, it’s very nice to speak with another person who knows that world from the inside out because it is something. I started in 1998, so that’s quite some years ago, and I’ve been hanging around in psychiatry for more than 20 years. I’m working for more than 10 years now in my private practice, so there’s a lot of experiences there in psychiatry.

Kelly

I started when I was 18, and also, well, [00:07:00] what I know now as a wounded healer , I think, but, um, started as a wounded girl, young woman with the idea of, of course, helping people. And I was very curious about what happens in somebody’s mind. I wanted to understand the, the human mind and human behavior better, and I thought, in my idea back then, the best idea is to, uh, enter psychiatry.

Kelly

And there you will learn all about that. You will understand everything about the mind. So yeah, I was 18. I went to nursing school, so this is where it started. Nursing school and working after one year already also in psychiatric wards. I must say, the first time I stepped in, I knew immediately this is my place.

Kelly

I felt, yeah, clearly that this is the place where I, uh, should be. Many times I’ve been wondering why, [00:08:00] uh, actually, but sometimes you need to go through experiences to, uh, to see afterwards what was actually, um, going on. So yeah, I started as, um, as a nurse and, um, after my nursing education, nursing school, I worked, uh, first in an, um, place where adolescents were brought in often with the first psychosis, but also any other first, um, psychiatric episode.

Kelly

So young people, adolescents and young adults, observation and diagnosis. So that was the, the place for me where I started to, yeah, to lay my- My foundation. I’ve been working also clinically in, uh, addiction wards, so working with all kinds of addictions and detox, uh, wards. And after, I think, 10 years working in clinical place, I, uh, studied more, became a com- a community psychiatric nurse, and then, uh, [00:09:00] we, um, we worked in outreach teams.

Kelly

So before in the clinics, it was mostly crisis wards and then, um, as a community psychiatric nurse in outreach teams, but also in a crisis team. So crisis has been my thing. So, uh, clinically, uh, of course, um, especially in that time, even a little bit more than now, isolation room, injections, like, yes, all that super traumatizing, uh, for the, what we call the patients.

Kelly

But also realizing now, uh, this was also very traumatizing for the people working there, I believe.

Anneke

Yeah. Yeah. I wanna, I want to linger here for a moment for the reasons that I suggested, which, which include that I don’t think the average person has any concept unless they’ve had a loved one or themselves have been, you know, voluntarily, but more likely involuntarily retained in one of these wards or, or units.

Anneke

In [00:10:00] my experience as, as a physician, m- usually an intern or a resident in my case, although I did spend maybe two years moonlighting in the emergency room as an attending Wow, that was a dissonant time ’cause I had already started to wake up. Anyway, the role of the nurses on staff could be reduced in many ways to medication compliance, right?

Anneke

Because y- you have this, this yearning in your heart you describe to connect to human behavior, the dimensions of the human experience, the psychological, you know, aspects of a person struggling, right? And then you, you get all of this training and, and most of what you do, at least in the inpatient units, is, you know, in, in many ways confirm that patients have complied with their medication, right?

Anneke

So you mentioned injections, but what are some of the ways [00:11:00] that nurses on staff or that you remember experiencing enforced compliance on these units?

Kelly

Well, definitely it starts, uh, before people, um, got into these units with the kind of the threat if you’re not complying with the treatment plan, um, in outpatient care, let’s say, then you need to…

Kelly

well, you end up in a psychiatric hospital. So oftentimes people will comply because, um, they don’t wanna get into trouble, and then once in there, you need to adapt to the program. There’s this, the day, the daily program and medication or the treatment plan, but most, yeah, ninety-nine percent of the time this is medication, and if you don’t comply, then you’ll, you’re not like, uh, working, uh, you know, working with the program, not working with the plan.

Kelly

So it’s really hard to get out. So what people do is they take the medication, and very often [00:12:00] they put it in their, uh… like behind their teeth, in their cheek, and then they s- they, they act as if they swallow, and then they spit it out, of course.

Anneke

And then that’s why there are mouth checks, right? And that’s why, you know, ultimately, and a- and a- and you were practicing in the Netherlands, is that right?

Anneke

Yeah. So I, I don’t even know if, if there’s a direct, uh, translation from what it was like here in the States. I was in the, in New York City during most of my training. But ultimately, if you are non-compliant, disobedient, there’s a kind of court system in the hospital Where you don’t have fair representation, you don’t have a prayer of, of really securing any, uh, liberties or rights as a result of that process.

Anneke

And y- at least in my experience, usually what comes out of the court proceeding is that you can be injected against your will, right? So that you can be [00:13:00] held down four points and injected whether you like it or not, uh, with a medication of the prescriber’s choice. And so I’m guessing you witnessed this kind of a thing too.

Kelly

Of course, and I was really good in injecting, so I did it very often ’cause I was already thinking that kindness and gentleness was a good idea, but it’s really hard in those situations. And well, first there wa- there is this layer of just, uh, being able to hold a person inside and then the, the medication on top, that’s a little bit, uh, in the next procedure, let’s say.

Kelly

So it’s not, in the Netherlands it’s not automatically the s- the same thing. I don’t know how it is in America. So that is, um… But I think already to, uh, to keep you from your freedom is a big thing. And of course, for safety and all these reasons, I understand that, you know, that, that safety is important, but very often, yeah, it hasn’t been very fair in my opinion.

Kelly

And also the medication, there were of course rules [00:14:00] and regulations to offer medication as a treat- in a treatment plan, but very often medication was given, uh, because there was a critical dangerous situation which oftentimes was just not fair in my opinion. For example, yeah, somebody would have been waiting in front of the door while we had a, um, meeting with the staff, and the person was standing there already for an hour or longer, and maybe after we were done, then everybody walked past by this person, and the person was like, “Hello, I am having…

Kelly

I have a question.” And for example, they wanted to smoke. There were maybe certain areas where you could smoke, and the person who smokes, they were just waiting there until somebody could light the cigarettes, and waiting already for an hour, still standing there. Patience, still patience. And, um, well, this is just an example that I, that I remember now, um, on the top of my head.

Kelly

Uh- That the patient is asking again for a, for a fire, and the nurse [00:15:00] thought that the patient came too close and thought it was a dangerous situation. I’m like, “Well, nothing is happening.” So he says, “Get away, you’re too close.” And the patient’s like, “Come on, I’m waiting here already for one and a half hour.”

Kelly

“Wow, you, your voice is up.” Now… And, well, before you know there’s a, there’s this critical situation. An, uh, an alarm is being pushed, six people are there. People are, of course, resisting, and then there is a fight, and there is only one loser.

Anneke

Right. And while there is typically a, a procedure, you know, that, that approximates some sort of legal process that I referenced for ongoing mandatory injections, what we used to call five and two, right?

Anneke

Five of Haldol, two of Ativan is given for situations like this that are subjectively determined to be dangerous all, all the time, all day long. I mean, this was going on. And so the, the violence that you’re suggesting even the staff was witnessing and, and does witness [00:16:00] is a consideration for the quality of life, the psyche, the trauma activation of even the providers.

Anneke

I mean, it’s interesting because as somebody who’s totally apolitical these days, I was a, a libertarian back then, even in my atheistic, you know, pharma-loving days. And so I had a very high threshold for, we called it two PCing for… It takes two attendings to decide that somebody does not get to stay outside of the hospitalization, right?

Anneke

So I had a very high threshold for that just because, I don’t know, it was against my nature for some reason But I still believed that I was a part of something necessary, right? And, and that there certainly wasn’t a viable alternative in these cases for people who were either dangerous to themselves, dangerous to others, had failure of outpatient treatment, right?

Anneke

These very, uh, impressionistic criteria. [00:17:00] So can you– it sounds like you can, connect to the part of you that had a yearning to serve, you know, the human experience in that way, however it looked then. Today, as you’ve really awakened to a broader context, like, do you feel compassion for that version of, of Annika and the, and the people that you, yeah, impacted?

Kelly

Yes. And I feel, uh, I feel compassion for… also for all the, the, the, the colleagues and for myself and for all the people who are impacted because it’s not– I think the individual, uh, people, they don’t have such a, so much choice, I think. There is a whole larger system around it that is, you know, the design of the system is not very healthy, I believe.

Kelly

And so it’s really hard to, to do anything else. So I believe people… Well, everybody who’s working there has a big heart and want to help other people.

Anneke

It’s interesting, [00:18:00] though, that it also can translate into, like, an everyday kind of sadism, you know, that, that even though most of us got into that field from a benevolent impulse, uh, at least I witnessed a good amount of sadism on the part of the staff towards the patients.

Anneke

I mean, even the way a lot of attendings modeled talking about patients, you know, as like help rejecting complainers or frequent flyers or, you know, there was like all sorts of, yeah, different dehumanizing rhetoric. And, and now I see it as a way to wall off, right? Like to close off maybe a sensitive heart to what is very difficult to feel.

Anneke

As I was referencing when I used to work that suicide hotline, it- it’s maybe one of the most exquisite experiences we can have as humans is to, to keep our heart open as somebody else, um, struggles in front of us, right? So I know that you have come to [00:19:00] recontextualize not only human suffering, but a specific flavor of, of human suffering that we call psychosis.

Anneke

And I want to bridge this conversation into a context for this concept of psychosis and at least my perspective that everybody, and particularly women, I would say, holds a deep fear that we will be found crazy, right? And so many of the, the folks that you and I know and have worked with and have had, have walked intimate paths with, have had that experience, right?

Anneke

Where they have been marginalized, labeled, and condemned to an experience of rejection on the most existential level, right? So I sometimes joke that I became a psychiatrist so that I could sit on that side of the crazy desk, right? Like, so that I could make sure nobody ever thought I was crazy, right?

Anneke

[00:20:00] And, and I’ve come to appreciate that, that at least the women that I attract and, and make contact with have this deep fear that they may or may not have a relationship with, that they will be found crazy, right? And, and the trope that, you know, “You’re, you’re just acting fucking crazy,” you know, or, “You’re crazy,” is…

Anneke

It is, um, dismissive of a, a kind of core feminine essence. I don’t know how else to say it. It’s, it’s a very, very powerful condemnation. So because of this fear that we all have, you know, like we don’t know how to be around people who are having perceptual disturbances, who are experiencing reality in an unshared way, uh, let alone whose behavior is erratic or unpredictable, confusing, s- appears to be violent.

Anneke

Although in my experience, the role that medication plays in inducing violence in this population is almost never addressed by, you know, the conventional [00:21:00] system, but that’s another conversation. I’d love to know how you interact with The concept of crazy, you know, the concept of psychotic, and where do you think your fear of that went?

Anneke

You know? Or is it just something that you, you held and you held into the light and it birthed this body of work that you now have to offer, which is to suggest that psychosis is not what we’ve been told it is by the dominant narrative.

Kelly

Well, I think first of all, being called crazy or call somebody crazy is kind of a, a weapon and a way to silence a person.

Kelly

So, uh, definitely working also a lot with the people with association issues, let’s say, or ri- the people who suffers from ritual abuse, it is a tool that is being used to hide the, the abuse. Also to program somebody and to call somebody [00:22:00] crazy, like to… It’s a way to not ever be, um, being caught, let’s say, because that other person is crazy, right?

Kelly

So I think it’s a very ders- dangerous field to be in ’cause I, I wouldn’t mind to, to, to speak a little bit just to open that little window. We don’t have to go deep into that, but ritual abuse, very big one, I think. Very important.

Anneke

Yeah, I thought that when you said that too.

Kelly

Just in, and even if it’s just, like, mentioned, that’s good.

Anneke

Although I’d like to, I wanna get to what you think of as, like, root c- root cause drivers, so that might be a good time, like, next question. So, so yeah, just to backtrack a little bit, I was just asking about, like, basically why you’re not afraid of this concept of crazy, like how it’s been neutralized For you, and, you know, is that because it means something different-

Kelly

Yeah

Anneke

to you?

Kelly

Yeah. So this concept of crazy or psychosis, of course, I’ve been raised by psychiatry because this was my, [00:23:00] my workplace, to think in a certain way until I, um, stopped thinking in that certain way. That way of, um, you know, that how, uh, psychiatry looks at psychosis. And I’ve also been, uh, observing myself what I, what I’ve seen coming in, in the, in the hospitals, but also in my private practice now.

Kelly

And I saw that, uh, it was not really very clear what was actually psychosis. So many things are called psychosis, so I’ve seen people with mystical experiences, I’ve seen people with spiritual awakening experiences, with kundalini experiences, energy rising, near-death experiences, the dark night of the soul.

Kelly

So a lot of crisises that were called psychosis or people with what was called personality disorders or borderline or depression or… Like, what is that concept of psychosis? And I am a [00:24:00] very, a very critical by nature, and I’m very curious, so I’m like, I like to ask the questions. And oftentimes I was thinking, “Well, I see what, uh, what’s happening here and what kind of behavior that we observe,” and honestly, what happens in my mind is not very different or maybe even crazier.

Kelly

And how could it be that they end up here on this side of the line, and how do I end up here as a nurse? And we are, we’re very similar, and also our way of thinking. Because also when I, when I was looking at my own experiences that happened at a young age and the things that were happening in my family, I thought this was a, this was very psychotic maybe by itself, maybe more crazy than what happened, uh, in the hospitals, uh, with, with the clients.

Kelly

So in my, in my experience, and what I see in, uh, in the West is that psychosis is, uh, typically seen as a mental health disorder, a disconnection from [00:25:00] reality. And we see that our, that our altered thoughts or emotions and perceptions, and doctor, uh, that’s… There is a, a, a psychiatrist that I, that I really admire in the Netherlands.

Kelly

His name is Dr. Jim van Os, and he has shown that psychosis are way more common in society and in the normal human experience than what we were thinking. And another thing that I, that I see is that, uh, psychosis is not something that we are, but it’s something that we experience, and that is, I think, a very important element here.

Kelly

It’s an experience, and it is, uh, something sometimes what I, I compare with the flu. Uh, we can catch the flu wi- without becoming the flu. And we can move through a psychosis without being the psychosis itself. And yeah, so psychosis is a state of consciousness, and there is a broad spectrum of these states of consciousness and these altered states.

Kelly

And [00:26:00] besides what we see in the West, a lot of cultures experiencing different s-states of consciousness, and that is not ca- that’s not called a psychosis or crazy, but it’s actually something else. It is be s- it’s seen as something, uh, that is pure enlightenment or it’s actually, uh, very important to, to treasure because important gifts are, uh, or insights come through these experiences.

Kelly

So what we label as, as a disease, I don’t think that is the best way to look at it because then we’re missing out on this broad spectrum, and we miss out an opportunity to actually learn from all these experiences. So, and because I’ve been thinking more deeply in this way, for me, it’s not something that I’m afraid of.

Kelly

It’s also not something I’m afraid of in myself. It’s not something I’m afraid of in other people. So the similar kind of people that I used to [00:27:00] see in a clinical ward that were ca- like, that were labeled very, like, dangerous, I sometimes see now in my private practice. So it’s very interesting to see what kind of behavior people show and for what reasons and under what circumstances.

Kelly

And if I see this more under, in line with trauma and trauma expression, if we look at it through the lens of, uh, of a trauma experience, then, um, yeah, then we, we can also, you know, treat it very differently and use a different approach to what we call crazy or psychotic.

Anneke

Yeah, it’s interesting because I often reflect on how the most powerful tool that a clinician in this arena can bring to bear, whether it’s in the holistic or integrative or conventional space, is a well-regulated nervous system, right?

Anneke

Is your own calm. And I imagine that when you sit with somebody who would otherwise have been [00:28:00] incarcerated on a ward, and you are not afraid of them, that that itself deeply influences and impacts the trajectory of that person’s behavioral experience, right? Because when you’re reactive, when you’re afraid, when you attempt to control their behavior, there are other managers and parts that get, um, turned on.

Anneke

And if, if part of the, the experience of these altered states that is difficult to integrate into mainstream society is that these folks have parts that don’t communicate well, right? So they have a part that believes something and then another part that is just not even aware that the part that believes this thing is pulling the strings, right?

Anneke

The integration becomes possible when you model that all the parts are welcome, and it’s just forestalled if you insist that one of these parts is irrational, doesn’t belong, needs to

Kelly

be

Anneke

subdued, you know. [00:29:00] And I’d love to talk a little bit more about what you see as– Because, right, these– I know you agree with this, that, that these t-terms that we use in the realm of psychiatry and the DSM, these are subjective trash bins for observations and patterns that have not been scientifically validated, doesn’t really mean much, even though there are criteria.

Anneke

Interestingly, I’m sure you’ve noticed this too, some of those criteria for psychosis are now very popular trends in new age society, right? So if you look at magic or referential thinking, which is this notion that you are, are putting meaning into something that doesn’t inherently have meaning, right?

Anneke

That, that if you see, you know, four forty-four on the clock, it means something to you. That’s considered a psychotic behavior. I wonder if that’s changed, but back in the day, [00:30:00] magical thinking was a large umbrella that includes most of the new age approach to reality, right? Where you’re Imbuing with meaning your immediate surroundings.

Anneke

So, you know, with in mind that we don’t even really know what we’re talking about when we say the term psychosis, what do you think of as the role of trauma and some of these c- common paths that people walk into the system where they get labeled and corralled?

Kelly

Well, definitely I think what I’ve heard and I’ve seen, I met in my life hundreds if not thousands people with this label, let’s say.

Kelly

And psychosis and trauma, there’s very often a connection there. Back in the day when I started, there was, uh, it, that wasn’t, that wasn’t, um, that information wasn’t available. I think literally only in 2016 as far as I can remember, [00:31:00] the first, like, scientific papers came out that maybe psychosis and trauma has something to do with each other.

Kelly

But I’ve seen this already, uh, all those years, that there were, like, traumatizing events happening in somebody’s life. And speaking with, uh, with people, they would also, uh, like for example speaking about hearing voices is a very common thing in human beings actually. This, uh, is just common human experience, but oftentimes it’s also, uh, connected to psychosis, of course.

Kelly

And when people go through s- uh, traumatic e- events or experiences or painful experiences, the voices would be, uh, different than when they would not go through painful or traumatic experiences. So these voices, they, they literally have something to do with the experience that is happening. So I think, uh, the reason why there are, let’s say, quote-unquote, “psychotic experiences” [00:32:00] or, uh, altered states of consciousness is because there, there was trauma or painful experiences happening before that.

Kelly

And then, like what we said also earlier, is when you get into a treatment, um, situation, this is also, uh, a high possibility of being extra or re-traumatized. So I think trauma and psychosis are super linked in many different ways.

Anneke

You might have a sense that supporting your energetic and subtle body is important, but how exactly does one do that?

Anneke

Like, short of scheduling regular sessions with an energy healer, how do you do that? Most of the time I find that when we take supplements, it’s from the energy of fixing ourselves, and honestly, it’s really no different than taking a medication at that point. That’s why I love flower remedies, and specifically my girl Katie Hess’s elixirs from Lotus Way.

Anneke

The formulations that she creates are so nuanced that sometimes it feels like I wrote the descriptions [00:33:00] myself The last one I took was designed to dissolve go, go, go mentality as well as fatigue, weakness, apathy, and resistance to self-care. Relatable? Okay. I have a monthly membership called Flower Revolution where I get a new and super powerful on-point remedy sent to me every month, and it blows my mind how resonant each one is with exactly where I am in my process.

Anneke

I think of this as a truly feminine investment that harmonizes my process and allows me to walk, talk, and interact with grace. You can try it for a month or six

Kelly

at the link below, and if you just want to dip a toe in to learn more about how flowers heal you, you can take their quiz.

Anneke

The work of Robert Whitaker, which I know you also know, demonstrates that the long-term treatment outcomes of the untreated, right, in, in, in this category and in pretty much every so-called category of mental [00:34:00] illness are far superior to those who are treated, right?

Anneke

That the antipsychotic medications actually, you know, propagate the problem that they purport to resolve, right? So they, uh, induce recurrent hospitalizations and lower levels of functioning and all these outcroppings of other syndromes and, and symptoms, and that folks are longitudinally better off if they, uh, avoid the system, right?

Anneke

And that’s not an opinion. It’s not a theory. It’s not based on how nice holistic health is. Like, that’s just actually what the data bears out. The very rare non-industry funded long-term data. And I wonder what the role of what you’re suggesting is the trauma of the hospitalization itself, which, you know, you and I can look back and agree is part and parcel of what goes on there and seems unavoidable, seems like a necessary evil, right?

Anneke

Seems just kind of like how it has to work. You know, it’s interesting to consider how much of a part of those bad outcomes, [00:35:00] you know, the actual experience of the meta-trauma of the hospitalization turn is let alone the disempowerment and the reinforced sense of brokenness that comes from You know, complying with appointments and taking a prescription that has your name on it, you know, that you must take with all of these hard side effects because you’re actually crazy.

Anneke

So when I think about the way that you must listen to your patients and offer them a space of acceptance, which has to be exceedingly rare when it comes to this category, right? ‘Cause there are lots of folks who can listen to somebody who’s struggling with anxiety or somebody who’s, you know, struggling with addiction or even depression, maybe even suicidality.

Anneke

But to, to open up your heart to somebody who is in this kind of an altered [00:36:00] state, I think is exceedingly rare in my, in my experience. So I wonder if you can share some of the things that you have learned that have surprised you, that you think might surprise other people to hear, uh, from working with these kinds of…

Anneke

I don’t know if you call them patients or clients, but working with these kinds of folks who would otherwise be managed.

Kelly

Well, I think first of all, there is a great stigma. So people are– that are labeled with, uh, psychosis, other people oftentimes are afraid because of the stigma that, that is there. Um, oftentimes we see in newspapers or somewhere else that, you know, there was a mass shooting and the guy was schizophrenic or, uh, psychotic.

Kelly

So I think that is one thing. There’s a, there’s this fear again. So, um Again, starting to see a person without a label, but l- just like, uh, [00:37:00] yourself, that’s a really good start, I think. Like it’s, uh, everybody could, um, could be in a situation of, of being afraid. And if it’s, if you’re afraid because of a story that for you sounds very, uh, weird or hard to believe, that, that doesn’t matter.

Kelly

So for me, it’s important to, uh, not judge a person on, on the story, but just listening to and try to understand that if that would happen to me, that, for example, if somebody would, would try to poison me through the heating system, I would also be afraid. It would also scare me. So I … Like a lot of people, and especially in the holistic kind of scene, they are all, like, super non-judgmental.

Kelly

Uh, ex- until, uh, people are talking about things that they never experienced themselves or they think is very weird or crazy, so then, uh, all of the sudden it’s, um, it is judged as being crazy or weird [00:38:00] or, or people just simply don’t know how to deal with it or they are afraid, which is something that, uh, that I’ve seen a lot, and not only in people outside of the healthcare community but also within psychiatry and the healthcare community, that if we are not labeling or judging

Kelly

This is very interesting, I think what I say. If you’re not labeling or judging, but, uh, just, uh, see that other person as equal to yourself and a human with fear, then, um, oftentimes we are afraid to make things worse. So we are afraid that … Like, for example, like stay with that example. Person says, “My neighbor tries to poison me through the radiator.”

Kelly

And if I’m not immediately, uh, say, “Well, that’s not possible,” then I, then, uh, we’re afraid to make it worse. But there are many things that we can do, um, different than judging and also different than making it worse. We can simply listen to start with, [00:39:00] and listen very, uh, authentically. So listen with care and if, if a person tells a story, you can ask questions.

Kelly

And this sounds very, like, too simple to, uh, too simple for words, but this is one of my biggest surprise actually that I’ve learned in working with psychosis That we can actually just listen without judgment, without making things worse. We can listen, and we can repeat what the person says. For example, “Ah, I hear that you, um, that, that you…

Kelly

that there is poison in your radiator and that your neighbor tries to poison you at night.” “Yes,” the other person is saying. I’m not giving any suggestion if I think this is right or wrong. Like, who am I? I’m not the, the judge in this situation, but I’m, I’m here to listen. And strange enough, this, this almost never happens [00:40:00] So this is some- something that I’ve been practicing with a lot, work it like where I was still working in the mental health care scene in psychiatry, and I was trained by Xavier Amador.

Kelly

He’s an American man, and he trains a group of psychiatrists and me in this LEAP system because I was, like, a little bit the, the stubborn one who wanted to be trained as well. And they said, “No, but this is, uh, you’re already doing other training.” I was like, “No, I also… I just pay it myself. I really wanna do the training.”

Kelly

And I was very happy that I followed my, uh, my guts here. This was called the LEAP training, L-E-A-P, and it stands for Listen, Empathize, Agree, Partner. And listen, the first L is, like, was surprisingly for me the most difficult part. And this was, the group was filled with psychiatrists, with experienced psychiatrists, but we are doing something else when we are entering a room and we start the conversation.

Kelly

We are [00:41:00] saying, “Ah, I see that you’re afraid of your neighbor. I see that you’re panicking,” or, or, “I see that there’s a da- a dangerous situation here.” And the gu- the, the, the patient or the, the clients may think, “Well, oh, can I just explain what, what I’m experiencing here?” So it’s very hard. I’ve, I’ve been surprised how hard it is to, uh, to simply listen.

Anneke

Without an agenda, right? And not listen in a patronizing way so that you imagine the person will, like, get it out of their system and then see another perspective, AKA your perspective. Because I think even in the, you know, therapy realms, there probably are folks who imagine that they are listening, they’re asking questions, they’re being empathetic, but they come with an agenda that is almost unavoidable, right?

Anneke

And the agenda is, “I’m gonna get you to see that what you’re saying isn’t true.” Right? And people can feel that, right? Their animal body [00:42:00] senses the absence of that P in, in the LEAP acronym, which is the partnering, right? Are you really on their team or not? Do you have your own independent agenda? And I, I think that this, uh, there’s probably no realm where this is more challenging than when there is, you know, a divergence of, of reality, literal, you know, perception of, of reality.

Anneke

So in my experience working with folks who are having these kinds of perceptual disturbances or what we would call delusions, and of course, psychiatry has pattern recognized all these different types of delusions from paranoid to grandiose, et cetera, is very important to have supportive family, loved ones, friends involved.

Anneke

And maybe even that’s the difference between somebody who ends up captured by the system as some sort of surrogate family, malevolent family, family, and somebody who can remain outside and move through an epoch of their [00:43:00] consciousness, you know, in, in the comfort of their own home. Have you observed that?

Anneke

I mean, do the folks who, with whom you have what you would call good outcomes, maybe we should define what that is. Do they typically have support systems in place? Do they have partners and You know, brothers and sisters and parents who show up to their appointments. What does it look like when it goes well?

Anneke

I mean, w- let’s define also what a good outcome looks like for you.

Kelly

Yeah. So the importance of family members and a support system around a person, I think this is very important. Oftentimes it’s also lacking, I see that, because I think there is the, the psychoeducation, the education is not clear enough.

Kelly

People don’t know how, like, uh, if, uh, if the, the, the care community doesn’t really realize, for example, the effect of trauma and also this way not speaking about this with the clients and the [00:44:00] support system, then oftentimes the trauma or the pain or continues or the nervous system is being triggered and/or at least not regulated.

Kelly

There’s often a great amount of sensitivity, and if, uh, nobody keeps this in mind and, you know, and b- people are being pushed and also, of course, people need to function in a society that is oftentimes not really the best fit for these sensitive, uh, human beings. And yeah, if, if nobody is informed about this, then, you know, people are keep trying to push them in a little box that they might not fit.

Kelly

And so I think that psychoeducation is very important. Also in the, the, the regular, like, guidelines, psy- psychoeducation is also on number one, but what is the psychoeducation mean? Does it mean to, uh, to learn about what medication is available, not even, like, what are all the side effects and all the [00:45:00] information about medication, but just, like, this is the kind of medication that we, uh, want to try.

Kelly

Like, this often, uh, is the main, the, the main psychoeducation that is given. Well, I think psychoeducation needs to be about the polyvagal theory and how the nervous system works, and I think it’s important to understand that family members understand how, uh, trauma works, what the internal parts are, what, what is this, this not- notion of a, a core self or your, what is

Kelly

who you are in essence. And I think this is a, a pathway to walk together, the community, the, the, the families, the, and the clients or the, the people who are in alter states and, um, maybe get stuck there or having problems there. So I think there, there’s a lack that is, uh, a problem, and so this is also one of the reasons why I wrote my book, to inform people in a very broad way, inform them not only, um

Kelly

[00:46:00] Well, there’s a little chapter about the, like, the, the Western psychiatry and how, you know, the, the categorization and, uh, explanation of what is psychosis. But that is like 2%, so the, the other 98% is about all the, the broad spectrum of what else, you know, can be, can be taken in account if you, like, investigate, like, who you are, because that’s the core, the essence of, of everything, I think, at the end of the day.

Kelly

Like, the question who am I, and why do I behave in a certain way, and why are maybe voices very loud in my, in my head? And how… What do I need? Like, what is my, my, like, system around me like, and is this supportive or it’s not… is this not supportive? So yeah, very important, uh, to have a support system, but is, but only if the support system is well-informed, I would say.

Kelly

So this is why this book is not… Like, I hope that [00:47:00] it will create a space for a broader view for clients or patients themselves, but also for the family members or everybody in their surroundings, and also the, the care providers who might also benefit from a more broader perspective on things than other, like, other than what they’ve been trained to believe.

Kelly

Like, or that’s also was my personal experience. I, like, what I now know about psychosis is what I’ve learned through, um, my experiences and my own investigation, uh, with, uh, all kinds of people around me. But that is so much more. It’s, like, 100 times more than what I’ve learned in this smaller, uh, perspective of the Western psychiatry.

Kelly

So yeah, I think the surrounding the, the… is very important, not only the, the family surrounding, but also community and society in itself, because I think there’s also, uh, we can all ask [00:48:00] ourselves the question, like, how, uh, tolerant are we, and how easy is it for us to deal with a person with another expression of life, of living, another expression or another opinion?

Kelly

Well, this is a broad topic that is, uh, very alive in these days, I think. Yeah, so what if somebody is expressing a point of view on life and living and meaning of life which is very different? Like, we were talking about the dangerous side of it, but I think also it’s good to realize that this is a very, very small percentage.

Kelly

Even in psychiatry, this is a, a very small percentage of the people is, like, dangerous. And then of that small percentage, I think it’s not even true, but it’s because people are being pushed, and being pushed in a corner, and then they were kind of defending themselves. And then, yeah, psychiatry won. And, uh, and, uh, and so it’s, like, another dangerous person, [00:49:00] but I, I don’t think that is, uh, the, the largest group.

Kelly

So we have– we’re dealing or we’re talking about people who are just thinking maybe in a very unique way and maybe just very different than, uh, how we, uh, you know, how we, how we think. Which maybe it’s also very interesting to listen to other people’s view and, uh, the meaning that people give to life.

Kelly

And this meaning-making, I think it’s, it’s important. It’s sometimes different than what kind of meaning that we make to things. So but it doesn’t mean it’s, it’s, it’s, it’s crazy or, or dangerous or anything like that.

Anneke

Yeah. In a sea of so many inversions, I often consider not only, you know, what I referenced earlier, which is like how now in dominant culture there’s so much evidence of what we would otherwise call psychotic thinking, but that the identified patients, right, like the [00:50:00] folks we think of as psychotics, quote, unquote, schizophrenic or crazy, you know, could it be, you know, that they are expressing it in a way that is a very wise response to their particular circumstances?

Anneke

But then we have all of the so-called normal folks who are from a particular lens, through a particular lens under mass delusion, right? If you look at like trauma-based mind control and the kinds of belief fields that, that you can be captured by, and you look at the, the really crazy shit that people are led to believe, it becomes normative.

Anneke

And you look at the sort of the, the, the socialization of these beliefs, it becomes really hard to understand like what is abnormal, what is normal, what is a wise response, what’s a-an unhealthy response? Like is it a Krishnamurti world where, you know, it’s [00:51:00] no sign of health to be well adapted to this society?

Anneke

And, and I think that’s a lot of what you, you offer in, in this book and your work is the possibility that this is a normal part of the human experience. It’s something we’re all in our own way susceptible to, whether it’s because of our particular traumas, uh, or our responses to them. And until, and if we’re willing to open up to accepting this as a part of the human experience, we’ll, we’ll never really be able to see what it looks like on the other side.

Anneke

So I’d love to talk a little bit about like what the trajectory and arc looks like when you treat folks and work with folks facilitate their, their journeys because, you know, when I was in conventional psychiatry, a lot of what we would say around psychosis is that it’s very egosyntonic is the word we would use, right?

Anneke

So it’s, it’s, it’s not often perceived as a problem by the patient [00:52:00] versus depression, for example, that is egodystonic, right? They, they show up for treatment because they don’t like how they feel. Well, the folks who are in these kinds of altered states are dragged into treatment because they don’t really have a problem typically with how they feel.

Anneke

It’s, it’s you who has a problem, the bystanders and observers. So I wonder if that’s something you deal with. I’m guessing there’s a selection bias because the people who come to you must perceive that there’s something that could be integrated or optimized and, and what… Yeah, like I mentioned earlier, like what does a An outcome look like for you when somebody you’re working with says, “Okay, I don’t need to work with you anymore.”

Anneke

Like, what actually shifts? What happens there?

Kelly

Well, I think, uh, first of all, oftentimes people are actually, like, sent by parents or by family members, something like this. But I think from, in, in, in, uh, the way I do this, in my way of, uh, treatment, let’s say, or, uh, uh, working with people, the first thing that’s very [00:53:00] important is normali- n- normalization.

Kelly

So normalizing anything, and also, uh, see the, uh, common humanity, and then we notice that we’re not so very different, uh, from each other. And this makes it people are, uh, yeah, feeling safe very, uh, easily. This is very important. I think this is the opposite of what I’ve been experiencing in the, uh, clinical mental health, is the safety was, like, very often not there.

Kelly

So I think if you start with safety, normalizing, see the, or find, meet a common humanity, that is a really great start. Then, um, offering a non-judgmental, kind and gentle approach is, uh, you know, a trauma-informed approach is also very important. And a, what I call spiritual aware, because very often spirituality, and who am I question, and the greater [00:54:00] universe, and all kinds of wildness is, is very often a topic of the conversation.

Kelly

And I find this very interesting and very enlightening to listen to. So I’m also showing that I’m very interested to listen to the story and, and I’m curious. And, and then, um, when people start to speak, and maybe, uh, it’s quite wild and, and broad, and the universe and, um- Uh, sometimes people also notice themselves that it’s, it becomes a little tricky at some points to, to stay grounded, or they feel a little bit confused or lost in their story.

Kelly

And there then I can, uh, I can, uh, just maybe offer, like, support in more, like, grounding or, like, not even, like, a full yoga practice or anything, but I am a yoga therapist, so I know all these skills. So well, why not try to, to ground a little bit, uh, here and also explain [00:55:00] how, uh, important it is to ground yourself, to stay connected to the Earth, because then all these fantastic things that are here can become your superpowers.

Kelly

But now you may get lost in, you know, in everything that happens, and nobody understands. And, and, uh, and then also, I would be honest, like I, I’m super interested, but honestly, I don’t understand anymore where we’re going, but I really want to understand, so help me here. Help me out. A few … People feel hear-heard.

Kelly

And, and I think if, yeah, if we’re, if we’re really focusing on, uh, keeping that superpower of being very open and having this skill of seeing things, uh, knowing also that it can mean that if you’re seeing so many things and you’re very sensitive for things, that you might also be that person that puts the finger on the hotspots in society or in other systems, and it might [00:56:00] cause troubles, and not because of you, but because you’re reflecting something or, or maybe issue or a problem in somebody else.

Kelly

So if people start to understand how their nervous system works, how it works with reflecting and not in relationships, and then they, you know, it’s … it becomes a, a very much more logical story, and, uh, it’s not so very crazy.

Anneke

So you unpack many dimensions of support, not only for someone who is or has experienced these so-called altered states, but also for loved ones.

Anneke

And I know that’s, as you mentioned, part of what you’re offering is a, a kind of a toolkit, you know, for people, not only a framework, but then also… Intervention’s probably the wrong word. Supportive techniques. How about that? That, you know, others can bring to bear if somebody that they love might otherwise be captured by the system.

Anneke

So- In, you [00:57:00] know, sort of teaser format as we close, I wonder if you can share what you see as the most important couple of tools, you know, to have in our belt when it comes to encounters with, you know, what you described as the way that energy can move in this like almost potentially dysregulated way or disconnecting way versus when you can harness it, you can stay grounded, and you can almost live in this liminal space for a period of time until there’s a shift, right?

Anneke

And that would look like a very different kind of so-called psychotic episode than what we see in the movies and what you and I have seen, you know, in front of our faces. So What do you think are, are some of the top things to, to consider when it comes to more acute interventions?

Kelly

Well, literally, I’ve seen it or I still see it in front of my eyes.

Kelly

I see the acuteness just drifting, [00:58:00] drifting off quite quickly. Like it’s, it’s, uh, like literally matters matter of minutes. Like, and sometimes … Well, it’s, it’s a little bit hard to give like the … Because it’s, it’s, there’s such a broad, uh, also spectrum of tools, let’s say. And for examp- like, I would not suggest to like to hold people all the time, but for example, it can h- it can be that for some people you feel like this is, the, the

Kelly

It needs some holding because a … Like, I work with internal family systems, IFS, and of, like I said earlier, the, this polyvagal theory is very much interwined in all the work I do. But if you clearly see that there is this baby parts being triggered, then yeah, like, it, it doesn’t make sense to have this cognitive conversation and to try to solve in a way as if, you know, as if you’re speaking to a 40-year-old, uh, man.

Kelly

But if you’re actually offering, and like it’s, it’s oftentimes also intuitive. It’s not al- You know, intu- [00:59:00] intuition is very important, but there are also real, like, skills besides that. But if you also dare to, uh, to step into that and dare to offer, uh, of stepping in that role of being a mother or stepping in that role of being the really great sister or that friend that the person needs, I think that is very beautiful.

Kelly

And that is also something that, that back in the day, my colleagues in psychiatry couldn’t always appreciate. Like, they thought I was, I was not setting boundaries or anything like this. So people oftentimes don’t understand it. And I remember well there was, uh, this man already 15 years ago or something, and he called me his professional friend.

Kelly

And honestly, I was the only one, the only person that, uh, that he saw on a regular base as a nurse who was coming to his house. And I thought this was so sweet. And back then, like 15, 20 years ago, I still, uh, was, uh, like much younger than [01:00:00] I am now and, and less developed in, uh, uh, in, in that way But already I felt this was a compliment, and I thought this was, this was a very beautiful way of approaching.

Kelly

But I s- I hear my colleagues, they thought that was pretty crazy. Like, “He’s not your friend. You’re an expert, and you need to know, and you are, like, above them, and, uh, you need to tell them what to do instead of being equal and a friend.” But I feel that it’s, uh, important if you can play these roles, and this is actually also something that I’ve learned from you, like this…

Kelly

Like, to, to, you know, to sometimes to, to play a role and do this consciously and play the role of being a mother. Why not? And I don’t mean that, that, y- I mean, the, that the person will stay with you, uh, for three weeks, but you can play that role for one minute. Like, what is that kind of feeling that the person need in this moment?

Kelly

So this might be something that is not very common to many people, but yeah, I’m very [01:01:00] happy to, to work in this way and offer what is needed for all the different parts that are being triggered in the moment.

Anneke

Yeah, it’s amazing to consider how your ultimate qualification is not so much your credentials at this point, but really the level of parts integration that you’ve done, right?

Anneke

Because when you’re aware of all of these different dimensions of yourself, then you can empathize on a level that isn’t available when you’re busy projecting your rejected parts onto the so-called patient, which is what most of us who are attracted to the mental health field are so, in my humble opinion.

Anneke

Because we imagine that there is a way to control the experience, right? And, and so of course, by definition, we haven’t done the self-integration work that would allow us to meet our bad, so-called, you know, bad and wrong, rejectable, let alone crazy parts. So I can see that in the moment where you’re [01:02:00] sensing What somebody needs in, in terms of these, uh, rudimentary roles and, and archetypes really, you can sense that because you’ve in your way been there, right?

Anneke

You, you recognize it. And, uh, so the, the humility that you bring to bear is, um, part of the medicine, right? And I know, you know, you, you teach in, in the book a lot of techniques for immediate grounding and, uh, presence and, uh, co-location with somebody in a, in a shared space, right?

Kelly

Yes. And also, um, like there’s, th- there are these techniques that we can all learn very easily.

Kelly

Something with the breath, something that is grounding, you know, to, uh, like embodiment. We didn’t speak about it much, but very important also in psychosis. Nobody talks about it. Like in all these 30 years, I never hear much about embodiment. And there, I, I’ve also did [01:03:00] research on like in PubMed, but there’s not much to find about embodiment in psychosis.

Kelly

Like it’s really crazy. But I’ve been designing interventions in academic hospital actually working with first psychosis, and for years I’ve been offering these interventions and they were researched and studied. These were yoga interventions, so it was all about The, like, you know, the, the embodiment and, and so I’ve seen it in front of my eyes what’s the results and, and sometimes things were triggering.

Kelly

It’s al- also possible, and then we can, we can speak about it. But another thing, I think what is in acute situations very important that people know that I’m available. That’s another thing that I think is a little, uh, different than what my colleagues do. I am, uh, just available. So sometimes people, they text me Saturday night and, you know, uh, I can answer.

Kelly

And so, like, I’m not always answering, and because sometimes I’m doing something else, and then I’m, I’m telling the people or, you know, next day, like, or n- next [01:04:00] time I wasn’t available. But, uh, very often, like, for me, it’s a very small act to, to, yeah, to see that I see them. So I’m not going fully in, and maybe I don’t take, uh, hours in that time, depending on what’s going on.

Kelly

If, like, but mostly there is not so much of a, of a big crisis, but it’s an, uh, an ask for attention. And well, well, it’s also not only in, in psychosis, but, uh, especially also personality disorders or other psychiatric issues, it’s often said, “Well, if people ask attention, well, you’re actually not giving it.”

Kelly

I feel like it works really well to me if I’m just offering that attention because, again, I’m normalizing the situation and people are not asking much attention. If I give the opportunity to call me when they really need it, but I’m also saying, “I’m also human, remember? I also have a life,” so I try not to, to, to use it too often, only if it’s really necessary.

Kelly

People don’t [01:05:00] overuse it. But if they use it, then… And I give maybe just one little sentence, like it takes me three seconds, but it’s such a big thing. And, um, yeah, so these are some a little bit irregular things that I do for- I’m like what?

Anneke

Yeah, for human connection. I mean, it strikes me that you’re just treating these individuals as adults, which is something that we are not -trained to do.

Anneke

Not directly, but indirectly, we are trained to, uh, infantilize, you know, our, our patients. And so these, these radical acts of adult human connection, I can imagine, are, are often all that is needed. Well, I am so grateful that you’re out there doing this work, offering this service. As somebody who doesn’t practice anymore, I’m all the more grateful, you know, that you are available literally and figuratively, and that you’ve also crystallized your perspective [01:06:00] into a text.

Anneke

I, uh, you shared with me an early reading of it. I’m super excited to, to make sure that everybody listening has access to your book and to your services, and I wanna thank you, Anneke. Thank you.

Kelly

Thank you so much again for the invitation. Yeah.