Healing the split: An autoethnographic exploration of psychosis following trauma

Abstract

This research project aims to explain how a trauma can lead to a false and distorted understanding of reality and how this can in turn lead to psychosis. Having worked for many years trying to understand her psychosis, the author wanted to research and explain what had happened to her. To fulfil this aim, an auto-ethnographic qualitative method was chosen, whereby the author utilised and analysed her own diary entries over time. This method allowed the researcher to disclose and explore aspects of her life that could have been too intrusive, or even potentially distressing had they been probed as part of a third-person perspective, the researcher becoming a participant in someone else’s project. Psychosis is a condition characterized by subjective difficulties with reality. Winnicott’s explanations of the formation of the false self in psychosis are used to explore how reality’s understanding fails. Special consideration is given to Winnicott’s final paper “Fear of breakdown”, in which he indicated the existence of a “not lived” trauma in psychosis, because of ego immaturity and the subject’s inability to encompass the experience. The trauma needs to be remembered and lived through to resolve the psychosis. Bion’s theory of thought complements Winnicott’s thinking, with its explanation of the difficulties to process and the need to digest trauma. Ferenczi’s work is also utilized to evince how people may be led to behave in uncharacteristic manners, at times even displaying violent behaviour because of trauma. In this respect, the idea of ‘possession’ by another is put forward to interpret psychosis and its resulting behaviour. In addition, Bollas’s understanding of psychotic symptoms is looked at and especially how they can be brought to some form of resolution by helping the individual to integrate what is being externally projected. Owing to the trauma experienced by the researcher, she failed to understand what was happening when the behaviour of her attacker forced her to internalize it with a different meaning of its reality. Her auto-ethnographic case is examined and compared, using the qualitative method of Thematic Analysis, to the published clinical cases and memoirs of Renée (Marguerite Sechehaye) and Marie Cardinal. This comparison shows how different traumas at different ages will have a different impact and different consequences on the individual, insofar as a trauma experienced by an adult will have less impact on cognition or thought forming, for instance, if before the trauma there was a healthy psychological development. However, psychosis following trauma remains a common factor, because the true self is forced into hiding and a false self with a false understanding becomes dominant. It is argued that it may not be due to ego immaturity that the traumatic experience is not integrated within the psyche, but – as in the researcher’s own experience – that it may be the behaviour of the abuser (or similar factors) compelling and imposing the failure to ‘live’ the experience. Finally, the resolution of psychosis is explained by allowing the subjective truth of the victim of trauma to be remembered, processed, understood, and eventually newly integrated as reality. This would allow for the failure in the understanding of reality to be overcome. To look for those areas where reality has not been understood is recommended as the foundation for treatment, while the therapist needs to remain aware of how a dormant psychosis can still be triggered there.