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By Els van Dongen

Worlds of Psychotic humans brings a clean twenty-first century voice to the lives of these with critical mental problems, concentrating on the way during which psychiatric sufferers event their subjective worlds. according to ethnographic study accrued on the psychiatric clinic of Saint Anthony's within the Netherlands over a interval of 5 years, it seeks to explain from the point of view of the psychological sufferer many of the fears and hopes that mark an individual's come upon with the fastened reality-structures of a medical psychological ward.

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Extra resources for Worlds of Psychotic People: Wanderers, Bricoleurs and Strategists (Theory and Practice in Medical Anthropology)

Example text

No psychosis. That would be quite different. The patient speaks of it as a kind of twilight condition: It just has to do with that at night everything is different. It is all quiet and you don’t hear anything…If you cannot sleep you just lie there thinking and then you hear sounds and all that. Three interpretations from three people: such fundamental differences in subjective interpretation can easily exacerbate uncertainty and doubt in patients: H [the girl with the difficult breathing] sometimes asked me: Do you hear that too?

The metaphor of a steam engine, well known in the Netherlands, is frequently used by psychotic patients to express distress (Nichter 1981),2 without connecting it immediately to madness or mental illness. As accumulated stressful situations merge to elevate the distress, the first signs of approaching psychosis are dismissed as ‘blowing off steam’, and ‘reducing the pressure’. This is also an attempt to transform it into a less frightening emotional problem, and my case studies indicated that it led to problems being neglected until a crisis point 30 SHAPING THE CONTEXT OF SPEECH EVENTS was reached.

They had to adjust their behavior to the ward and to the hospital rules. It was also a shock to note that other people were ‘that way’ and that every thought and deed prior to one’s own illness was clearly not as self-evident as hitherto assumed. People did not arrive on just any island; in fact, they found themselves on a therapeutic island (Van Haaster 1991: 18). Among other things it meant that the task and role divisions of patients and staff were quite clear, sometimes stated in a written contract.

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