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The Four Elements of Psychotic Symptoms


Symptoms of Stress

DID YOU KNOW that nearly any mental condition can produce “psychotic features” (temporary psychotic symptoms not usually the hallmark of a specific illness) when stress (which produces anxiety) rises to a high enough level? Many are surprised by the fact that, for example, severe depression or anxiety can result in temporary symptoms that meet criteria for psychosis.

ALL PSYCHOLOGICAL SYMPTOMS may be understood as attempts  to defend against unbearable anxiety. That is, as a means to find an explanation for sources of anxiety that will provide comfort. When psychotic symptoms are present, anxiety may be quite unbearable, calling for much stronger defenses.

PSYCHOLOGICAL SYMPTOMS – EVEN PSYCHOTIC ONES – are nearly always “normal” behavior, writ large. You doubt it? Who among us has not at one time or another thought we heard a noise when we later determined we had not.  Ever glimpsed something out of the corner of your eye when nothing was there? Ever had the thought that people laughing at the other side of a room might be laughing at you

FOUR ELEMENTS MUST BE CONSIDERED in the understanding and management of psychotic symptoms. The four elements inform and direct symptomatic behaviors. Considering them helps put behaviors into better perspective. Not everything about a symptom is an expression of illness, and remembering that can make it easier to empathize and connect with the one who is struggling.

HERE ARE THE FOUR ELEMENTS, along with some examples of how to begin thinking about them:

1. The Human Condition

Is it part of the overall human condition to become confused when we are anxious? If bad things have happened in our past, do we not become predisposed to expect bad things to happen in the future? If we have a sensory experience, do we look for ways to explain the experience to ourselves?

2. The Personality

Are not some of us more excitable than others? Are not differing levels of optimism and pessimism present in personality? Do some people become troubled in the presence of others’ anger? In other words, does anxiety cause different people, with different personalities, to react in different ways?

3. Individual History & Environment

Everyone, to some greater or lesser extent, is a product of cultural, family and social histories and environments. Responses and behaviors are shaped by experience.

4. Illness

So what causes a behavior to be considered as beyond the prior three elements: to rise to the level of being a symptom?  Intensity. A thoughtful examination of behaviors in the presence of psychotic symptoms can make it clear that with much less intensity, there would not be the need for such heightened concern.

THE POINT HERE?  We can choose to approach people living with psychotic symptoms differently when we realize that only one in four of the elements of their behavior is entirely about “illness.”

MIGHT THIS MAKE A DIFFERENCE  in how you respond to symptoms and behaviors?

Just askin’ … good question, isn’t it?




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Posted in All Articles, For Family, Friends & Others, Psychoeducation.

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5 Responses

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Continuing the Discussion

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