Impact News

Responding to Violence, Suicide, Psychosis and Trauma

Skills in Managing Dangerous Psychotic Behaviour – Part Two

The second part to my YouTube discussion of Psychosis Containment Skills is now available at

Enjoy!

Iain

Filed under: Other Mental Health, psychosis, Violence, , , , , , , , , , , , , , , ,

Managing Dangerous Psychotic Behaviour – On YouTube

Iain Bourne discusses the principles underpinning Psychosis Containment Skills – or the interactive, face-face professional skills used in responding to immediately dangerous  psychotic behaviour. Features include the relationship between psychosis and violence; dysphoric vs reactive drivers; how to spot whether the psychosis is driving the behaviour; the differential role of hallucinations, delusions and paranoia; the involvement of persecutory and command auditory hallucinations; the psychotic vs non-psychotic world; changes in the sensory filtering system; personal space and catastrophic reactions.

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Hearing Healthy Voices

At a time when DSM-V would have us classify just about anything vaguely different as a disorder it is good to be reminded that auditory hallucinations can be healthy. The study below offers further confirmation of Romme’s assertion that health/ill health lies not in the hallucinations themselves, but our relationship with them:

J Psychiatr Ment Health Nurs. 2012 Oct 15;
Auditory hallucinations as a personal experience: analysis of non-psychiatric voice hearers’ narrations.
Faccio E, Romaioli D, Dagani J, Cipolletta S
ACCESSIBLE SUMMARY: Auditory hallucinations are voices heard speaking with the hearer or discussing his or her thoughts or behaviours. They are common also among non-psychiatric population and may be a positive experience. These hallucinations cannot be considered merely as symptoms because they may have an adaptive function. We should avoid trying to helping voice hearers to eliminate or deny voices, and rather we should help them to feel allowed to preserve their voices. ABSTRACT: This exploratory research investigates the phenomenon of non-psychiatric auditory hallucinations from the perspective of the voice hearer, evaluating the possibility that this experience can contribute the maintenance and adaptation of the hearer’s personal identity system. A semi-structured interview was administered to 10 Italian voice hearers, six men and four women, aged 18-65 years, who had never been in contact with any mental health services because of the voices, even though some of them had been hearing voices for decades. Participants were not distressed or worried about the voices; on the contrary they developed their own understanding, personal coping resources and beliefs in relation to the positive functions of the voices. These results indicate that voices cannot be considered merely as symptoms, but may be seen also as adaptation systems. Consequently, we should avoid trying to helping voice hearers to eliminate or deny voices, and rather we should help them to feel allowed to preserve them.
© 2012 Blackwell Publishing.
Affiliation: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padova, Italy.

Filed under: Impact Training, Other Mental Health, psychosis, , , , ,

Different Worlds; working with hallucinations, delusions and paranoia

This dramatic course delivered by Dr Iain Bourne is being made available by Sitra

24th October 2012 in Southampton

Filed under: Impact Training, Other Mental Health, psychosis, , , , , ,

Open Courses “Different Worlds: working with hallucinations and delusions”

SITRA are now offering individual places on the “Different Worlds” course focussing on working with people who experience hallucinations and delusions:

SITRA – Different Worlds

Different worlds: Hallucinations and delusions

23 May 2012, London

25 May 2012, Southampton

24 October 2012, Southampton

This course is ideal for anyone who is working with service users with severe mental health issues. By the end of the course, participants will:

Have a better understanding of different types of hallucinations and their origins.
Have learned about a range of strategies to help service users cope with auditory hallucinations.
Know how to respond to services users in a psychotic crisis.
Have a greater awareness of different types of delusions and paranoid states.
Have a greater awareness of different approaches to the treatment of hallucinations, delusions and paranoia.
Price: Members £89/Non-members £129

Trainer: Dr Ian Bourne

Book now

Filed under: Impact Training, psychosis, , , , , ,

Mentally Disordered More Likely To Become Victims Of Violence When Showing Increased Symptoms

Article Date: 16 Apr 2009 – 0:00 PDT

Contrary to common stereotypes, individuals with major mental disorders are more likely to become victims of violent crimes when they are experiencing an increase in symptoms than they are to commit crime, according to a new study by Brent Teasdale, an assistant professor of criminal justice at Georgia State University.

Teasdale found that patients experiencing delusions, hallucinations and worsening symptoms generally are most likely to become victims of violence. In addition, individuals with mental disorders are particularly vulnerable for victimization during times of homelessness and when suffering from alcohol abuse.

“They actually have higher rates of victimization than they have of violence commission, which I think is counter to the stereotype that highly symptomatic, obviously delusional, visibly mentally disordered people are dangerous, unpredictable and violent,” Teasdale said. “There’s no one size fits all approach to these delusions, but the odds of victimization are multiplied almost by a factor of two when a person experiences these delusions.”

Teasdale analyzed data from the MacArthur Violence Risk Assessment Study, a longitudinal study of psychiatric patients released from three psychiatric hospitals in Pittsburgh, Pa., Kansas City, Mo., and Worchester, Mass. During the MacArthur study, participants were interviewed every 10 weeks for one year about violence committed against them, stress, symptoms and social relationships.

When individuals with mental disorders experience increases in delusions, symptom severity and alcohol problems they may be more focused on their internal states and have fewer cognitive resources available to devote to interactions with other people, Teasdale said. Other research suggests that victimization happens because caretakers may be driven away, leaving the disordered unprotected.

“If the stigma is that those are people we need to protect ourselves from, one of the ways in which we might do that is self defensive violence. We might strike first and that would lead to the victimization of these folks,” Teasdale said. “If there’s a person that could intercede before that happens, that may be one strategy for reducing victimization risk.”

The findings of the study are important for clinicians who must pay attention to warning signs of worsening disorders as potential risk markers for violent behavior committed by their client, Teasdale said. They could also aid in the creation of assessment tools that focus on victimization risk and classes that better educate families about caring for the mentally ill.

Clinicians also could provide clients suggestions for reducing victimization risk when they notice patients exhibiting greater than usual symptoms, Teasdale said. For instance, during these times clinicians may recommend spending less time in public spaces, increases in guardianship or mandated community treatment programs.

“Most of us know people who have mental disorders. These are our family members and our friends and so we should care about their victimization experience,” Teasdale said. “The stereotypes persist because people are unaware of the victimization risk to people with mental illness. If they learned that victimization risk were higher than the violence commission rates, I think that would help alleviate some of that stigma and help people think about people with mental disorders in a different way.”

Notes:

The study, “Mental Disorder and Violent Victimization,” was published in the 2009 edition of Criminal Justice and Behavior.

Source:
Leah Seupersad
Georgia State University

Filed under: Other Mental Health, Violence, , , , , ,

I talk back to the voices in my head

* Dean Smith * The Guardian, Saturday 4 April 2009

Dean Smith Dean Smith of Stockport who has suffered from schizophrenia.

I was working as a holiday rep in Brittany 15 years ago when I started hearing voices. I was in my mid-20s and thought it was my mates mucking about. I looked inside and outside the flat to see where they were. It felt really scary, because the voices were saying stuff like, “Right, you’re having it” and, “We’ll get you in the end.” Over the next four days, the voices taunted me more and more, and I became depressed and paranoid. I had a strong desire to be with my family – I had no money, but I got back to my mum and dad’s house in Stockport by hitchhiking and dodging fares. The train journey was particularly harrowing: the voices convinced me everyone was talking about me. My family were brilliant. My mum used to care for my auntie, who had mental health issues, so she had some insight, and my dad was very patient with me. My visits to the GP were less successful – I was put on antidepressants and, when they didn’t work, antipsychotics. They didn’t work either, and by now I was regularly hearing three, one laughing in a wicked kind of way, the other two using abusive and threatening language. The voices got me down so much that I started self-harming. I wound up getting sectioned several times. I was put on heavy medication and encouraged to spend my days playing games with the other patients – anything to distract the voices. Each time, I’d come out being a fantastic Scrabble or blackjack player, but none the wiser about the voices. Ten years ago, at 29, I was told I had paranoid schizophrenia. Friends – well, people I thought were friends – immediately associated the diagnosis with knife-wielding murderers. A lot of them stopped having anything to do with me. I realised I’d been given a label that comes with a huge stigma and a prescription of potent, but in my case useless, medication. I remained keen to find out about innovative treatments, and finally, at a mental health seminar, I heard a speaker talk about an approach advocated by growing numbers of mental health professionals that involves people engaging with the voices inside their head. He was from the Hearing Voices Network and I agreed to visit him. He said I should be frank and uncompromising with the voices. If they told me to self-harm, I should just say no. “If anyone else told you to put your finger in the fire, you wouldn’t, so why act on what they say?” he said. He added that if I wanted to know why they were there, I should ask them, and if I wanted them to go away, I should tell them. It was so simple, but it made so much sense. I took his advice, questioning them, challenging them and even cutting them off if I didn’t have time to talk to them. I’d say things like, “I’m watching TV now, I’ll talk to you later” or “Why exactly do you think I deserve it when bad things happen to me? You can’t answer that, can you?” Sometimes I’d do it in my head; other times out loud. I began to recognise the voices as representing the negative feelings I had about myself, and that alone helped me feel less frightened of them. It’s not that they aren’t real, but they ceased to have the power over me they did. I began to realise they couldn’t carry out their threats. Now they bother me a lot less and, when they do, I’m in control of the conversations. I’ll still talk out loud to them if I feel like it, even if I’m on the bus or in the street. I get some funny looks, but I don’t mind. Recently another voice appeared, but this one is positive and happy, sounding like me as a young teenager. He’s mischievous, but funny, and I quite enjoy chatting with him. I’m off medication now and have been discharged from mental health services. I’ve got my own place and have a girlfriend, and I train nurses and mental health staff in helping others to engage with their voices. The fact that I can speak with genuine understanding means I usually have a captive audience. I also work with people who hear voices, getting them to understand the benefits of talking back. I’ve learned that my voices themselves are not a problem. It’s my relationship with them that’s important. Facing them and working with them has changed my life and made me feel optimistic about it instead of scared. • Do you have an experience to share? Email experience@guardian.co.uk

Filed under: Other Mental Health, psychosis, , , ,