6 MIN READ | Mental Health

Maxwell Guttman, LCSW

Re-Positioning Terms Used Commonly with Psychosis

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Maxwell Guttman, LCSW, (2022, May 15). Re-Positioning Terms Used Commonly with Psychosis. Psychreg on Mental Health. https://www.psychreg.org/terms-commonly-psychosis/
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There is no universal way to signify or capture the experience of psychosis. This article is a critical linguistic praxis-based discussion of psychosis. The aim is to make open dialogue’s linguistic and interpretive underpinnings visible.

In doing so, I use Semiotics to mobilise and highlight why critical reflection is vital to understanding, demystifying psychosis, and recasting belief in recovery.

The concept of ‘signs’ has been around for a long time–classic philosophers such as Plato and Aristotle studied these terms. However, the terms are now associated with semiotics. Derived from the Greek root seme, as in semiotics (an interpreter of signs), Saussure and American philosophers used the term through history, rhetoric, and communication.  

Saussure created the terms signifier and signified to break down what a sign is, literally and metaphysically. The takeaway from Saussure’s scholarship was on the level of language, ‘signs’ and the ‘signified’ make up people’s understanding and interpretation of the world. My theory about the connection between semiotics and psychosis hinges on three sets of assumptions:

The accumulation of psychotic symptoms and the worsening of psychosis symptoms are rooted in what linguists call the ‘changing of signs.’ The change or shift then informs how people interpret their world. The difference in understanding occurs on an interpretive spectrum or plane I term the ‘system of signification.’

Identifying psychosis symptoms doesn’t mark or capture a single ‘signified or sign’; relatively, the worsening of corresponding, primary, residual or inactive symptoms. The fundamental restructuring of a person’s interpretation of their system of signs in language, oral expression, and all brain functions interact with the world through use and passage through the mind’s interpretive eye.

Connection to the world

I believe we spend so much conjecturing, arguing, and surmising what psychosis is, not ignoring wholesale commonalities between people’s extreme states. 

Shift the focus: effective treatment, either psychotherapy or some modality, based on the threefold set of assumptions I dispensed earlier.

What are the implications for clinical treatment and people?

The term universal, by definition, means ‘common effect’ (noun) or ‘applicable to all cases’ (adjective). Suppose we analyse both sentencing structures in a linguistic breakdown universal of meaning and usage. In that case, any trained linguist will see what I am tracing through a study of language and altered or extreme states/psychosis

As familiar signifier(s) increase in a  system of signification, the odds of a common effect experienced by people in crisis also increase. Given the projection of worsening psychosis symptoms and the uniqueness of each experience, the chances of any person seeing, hearing, feeling, or smelling something the same way as another person is implausible. And, the commonality–the diversity of the sign–is ever-present.

The impact of psychosis on the human body

Coping with a loss is taxing and stressful. When superabundant, this stress impacts people’s relationships with their worlds. Psychosis symptoms can be a healthy bodily response to radical and unsettling life adjustments. In doing so, the mind is coping with whatever is happening.

The body compensates and handles the change in brain function is, in essence, a method of coping and adapting to something altogether wrong for the body. The response can be healthy, creating a reality by changing or challenging a person’s interpretation.

But, sometimes, the mind must deal with the dysfunction of its regulation by systematically changing its signs.

During initial psychotic symptoms, I fully believe the early moments of a person’s ‘break’ is more systematic, organic, and healthy than the toxic things people say about psychosis. The composition or nature of the break isn’t ‘disorder’ but rather the changing of signs. 

Before psychosis symptoms worsen, I suggest that they shift from more systematic sign changes to more disruptive, arbitrary, and altogether difficult-to-follow changes within a person’s system of signification and interpretation of the world. 

As brain tissue becomes more damaged, neurons and their pathways become more misaligned, and signals become more chaotic and dysfunctional to and from the brain. Therapists can measure the rate of change before things get out of hand and introduce measures to worsening psychosis symptoms by charting and mapping the rate of change within the person’s signification system.

Clinical significance

The clinical significance of these claims has potential. If we assume my claims regarding the experience of psychosis can be measured, mapped out, and analysed for degradation between signifiers’ linkages, this scheme’s usefulness becomes apparent. Further analysis will have to research the correlation between sign association and the experience of the individual who has psychosis.

Given all signs of change, the active disease process moves toward a higher degree of chaos and instability. Measuring distress tolerance to such changes will also be necessary for the research to add new meaning to understanding how everyone’s unique experience shares commonalities. 

Psychosis carries with them a constellation of related and altogether unique symptoms differently. At different times, psychosis symptoms exist in a dark harmony along a spectrum, sometimes feeding off one another and working in complete isolation.

The scope intensifies in many cases over time upon initial activation. The range of psychosis symptoms delineates the impact of the sign on a person. Triggers, age, and developmental circumstances around the symptoms activation and life circumstances matter, but on a case-by-case basis. 

The intensity of the related symptoms, their subsequent manifestation into behaviour, and their possible impact on a person’s mood are all individual. Almost every aspect of someone experiencing psychosis is individual to the person experiencing the disturbance. Therefore, the current provision of clinical treatment is far too broad for the disorder’s individualistic impact. 

The otherworldly nature of psychosis can be settling. When first activating, there is a certain mystique to psychosis. Indeed, psychosis does distort how we perceive reality and plays around with our level of attachment to the world. People in extreme situations, unusual situations, experiencing a new or recurrent crisis, and bizarre situations complicate our existence. We know I and introduce new angles or worldviews to cope. 

These angles can sometimes be fascinating and are seemingly needed to pull ourselves out of a holding pattern. The symptom’s impact on the individual may seem welcome, timely, and needed to experience a necessary change.

In my own experience, my psychosis symptoms activated when I needed to experience a change and adjustment in my life, how I interacted with the world, and how I understood it. The person’s need to adjust or make a life change ‘course correction’ increases the potential for psychosis symptoms. 

I suspect these ‘symptoms’ are maladaptive bodily coping mechanisms. They paint the world in more palatable colours. Psychosis serves to shift human perception enough to identify alternate or new solutions; psychosis can offer an answer to life’s problems by stepping outside your perspective. Job loss or unemployment, relationship changes, and significant life circumstance adjustments are complicated to tolerate. 

Periods of adjustment can sometimes be the pathway to more significant, complex issues if we let our problems go unresolved for long periods. As a result, the brain activates psychosis symptoms so the body can more easily tolerate the change without feeling or thinking about the situation as intensely and painlessly as possible.

There is a reason there are so many homeless people who experience psychosis. Most become psychotic after losing their homes. Their need to adjust to life on the streets is a major, overwhelmingly stressful event. 

Risks and hazards

Psychosis and how individuals are impacted by additional stressors, the symptoms worsen and become unmanageable. So, the gradual and welcome shift in perception will seem and feel welcome for a while, but if the same stressors continue to aggravate, agitate, worsen or persist, expect the detachment to increase and a sharp departure from reality your cards in the near-distant future. 

For the person adjusting to life on the streets or going through a tremendous loss, anything a person needs to do to cope with their reality will accommodate our minds during a crisis to make the change work. The mind doesn’t work the way it should. In the case of psychosis activating, it may seem to work for some time.

People often find solace and comfort in the initial stages of psychosis because their shift in perception is minor and more tolerable. This reality shift can be more comforting than distressing in cases like this.

However, when psychosis becomes out of control, it can be overwhelming, like any other symptom. Life becomes too distant and unrecognisable to live without incident. I suggest that initially, some variance in our reality may seem appealing.

Still, as the symptoms worsen and become more extreme, the interplay between our already stressed situations and our body’s response to the stress is overwhelming, disturbing, and can be very scary to experience. 

No question exists that people prone to psychosis becoming active or reactive is linked to changes, or spikes, with stress and a person’s ability to cope. The mystique associated with the mind and bodily experience during a psychotic episode might have a deeper meaning to be forged from and not something to be discarded or forgotten because it’s too traumatic. 


Maxwell Guttman, LCSW, teaches social work at Fordham University. He is also a mental health correspondent for Psychreg.

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