This essay is part of Antioch Voices, a forum for Antiochians to speak out about issues important to them. Opinions expressed here belong to the author alone and do not necessarily reflect the official position of Antioch University. If you’d like to share your own voice, the first step is to send a short description of what you are planning to write about to [email protected].
Psychotic. Sit with that word for a moment. Notice what rises. If you feel automatic discomfort or fear, your reaction is not uncommon. In the United States, psychotic disorders are often seen as terrifying and dangerous conditions that strip individuals of their humanity. While completing my Bachelor of Science in Counseling degree, I was encouraged to explore the populations with which I would like to work. I contemplated many, but had never considered concentrating on those with psychotic disorders. That is, until I applied for my first job in the field, in an “FEP” program. I did not know that this acronym meant First Episode Psychosis, and only found out during the interview. I was asked how I felt about working with psychosis, and in the true spirit of being twenty-two years old, I took a deep breath and responded, “Uhh, good? Break the stigma?” From there, I was offered the job that changed my understanding of mental health, my passions, and my worldview as a whole. In my work with people experiencing psychosis, and through my studies as an Antioch University Clinical Mental Health Counseling graduate student, I’ve come to know one overarching experiential truth: psychosis is not what stigma stipulates. My clients live through harrowing distortions of reality, and yet despite their fear and confusion, they remain brilliant artists, comedians, deep feelers, and survivors. Every day, they teach me what extraordinary resilience, depth, and grace truly look like.
The time I have spent with my incredible team, mentors, and clients in the FEP program has taught me an indescribable amount. One hard yet hopeful lesson I have learned is that we, in the mental health field, can always do better for people experiencing psychosis. The societal myth persists that the condition is simply a broken mind, disconnected from reality, and remains beyond comprehension. A closer examination reveals a far more complex and deeply human occurrence. Many clients with psychosis carry histories of trauma, shaped by both internal and external experiences. In Western societies, the content of delusions and hallucinations is often seen revolving around themes of death, violence, or violation; the very same criteria the DSM-5 uses to define trauma. These internal experiences trigger real fear, activating the body’s stress response just as intensely as external trauma. To contextualize and partially understand symptom content, I turn to the “aberrant salience hypothesis,” the idea that the excess neurochemical production seen during an episode causes the brain to project meaning where there is none. In doing so, it draws on prominent past experiences, often painful or traumatic ones. Psychosis, in turn, is not simply meaningless neurological chaos. It speaks the language of survival and lived experience, calling for a nuanced approach to care that is often overlooked by dominant, primarily pharmacological, and regularly pathologized treatment approaches.
The ability to endure an acute episode of psychosis is a quiet kind of bravery that rarely receives the respect it deserves. The disruption of one’s sense of reality, bodily autonomy, and social connectedness, compounded with adversity and stigma, demands great resilience. Too often, this courage is met with coercive medicalization rather than person-centered care, making traditional models of treatment that emphasize control and pathology not only ineffective at times, but potentially retraumatizing. To truly rehumanize the treatment of psychosis, we must explore how trauma-informed and socially just practices can be further integrated into our current models of care. While medication can be essential for regulating neurological activity, it cannot alone address the underlying experiences and frameworks that shape the content of hallucinations and delusions. Integrating trauma-informed techniques rooted in creativity, somatic awareness, and relational safety offers a comprehensive approach to support healing the mind, body, and aberrant salience.
We are long overdue for a collective shift in how we see, speak about, and support people living with psychosis. To meet them with compassion instead of control, curiosity instead of judgment, and care instead of coercion is not radical. It is ethical. As clinicians, educators, policy makers, and community members, we must do more. We must reimagine systems that honor complexity, affirm personhood, and hold space for healing in all its forms. The time to notice and unpack what the thought of psychosis evokes in us is now.
Camryn Bryan
Camryn is a dedicated mental health professional working in a First Episode Psychosis program where she provides specialized support to individuals navigating psychotic symptoms. In addition to her direct care work, she leads community outreach and education initiatives aimed at increasing awareness and reducing stigma surrounding psychosis. Camryn is currently pursuing a graduate degree in Clinical Mental Health Counseling at Antioch University, where she continues to deepen her commitment to ethical, compassionate, and community-centered care.
