By Victoria Harris, MD, MPH
My recovery from psychosis was a gradual process. It started when a kindly psychiatric provider in the county jail informed me that I was delusional.
Before that, I had spent almost a year becoming progressively more ill until I could no longer discern where reality started and stopped. I spent months terrified, convinced that I had been harmed and was going to be harmed again. I lost weight because I couldn’t manage organizing my food. I slept at odd hours of the day and was up for most of the night.
I had seen things that would frighten the most seasoned detective and heard things that made my life intolerable. I was having conversations with people on TV and was convinced that I was a central figure in current national politics. I was confused much of the time and couldn’t manage to pay bills or schedule Skype calls with my kids. I was arrested and incarcerated four times.
For a long time, I desperately wanted to know what was wrong so I could get help. However, I couldn’t figure out what I needed to do in order to get more help than the psychotherapist I was seeing and the prescription medications I was taking. So, while I was a tad shocked when the psychiatric provider gently told me I was psychotic — I cried with relief.
To fully move forward, I must pause and reflect on what helped my progress when things were most bleak.
Neuroplasticity, my brain’s potential to adapt to change, proved to be crucial to both surviving incarceration and recovering from psychosis. Much has been written about neuroplasticity and our brain’s ability to lay down new neuronal networks as a result of disease or trauma. While the brain is one of two organs that cannot regenerate (the other being the heart), it can form new pathways and connections and change how parts are wired. I fully embraced this concept as I strove to find ways to manage my newly acquired insight into being psychotic while also being incarcerated.
I was so grateful that a psychiatric provider had named the problem and was actively working with me to make things better. He adjusted my medications, and after several weeks — and some clearing of my mental state — I was able to start moving toward recovery. However, that process was far from linear.
I could see immediately how psychosis influenced my social behavior in the cellblock after I was released from solitary confinement. When I tried to call my kids, using the phone consistently vexed me due to the numerous instructions and buttons to push in a particular sequence. Once I would finally get it working, I couldn’t concentrate on the conversation over the noise of the TV and inmates’ chatter bouncing around inside the cinderblock walls. I was horrified to discover that I couldn’t read and understand even a short story, and it took a great deal of patience to learn a new card game.
I knew that I would never be fully comfortable or indifferent to my surroundings while incarcerated. In light of that realization, I actively sought recovery on both cognitive and interpersonal levels. I used the concept of neuroplasticity — that my brain could change and heal — as my guide.
What was it, exactly, that I was actively doing to promote recovery from psychosis while I was incarcerated?
I accepted any form of help (that did not have an obvious price) that was offered to me: from the psychiatric provider who was making medication adjustments to other women who were patient when they realized what was going on with me to corrections officers who let me go outside in the yard early in the mornings. I knew that the biggest obstacle to accepting help was my pride, so I got into the habit of doing a “pride check” if I was going to turn down a genuine offer of help.
Caring for Myself
In jail, all the usual creature comforts such as pillows, lotion, music, coffee or tea, etc., are either completely unavailable or can only be acquired with commissary money. I had no way to access these luxuries, including warm clothing, until I had been incarcerated for about a month.
Despite this, I made the most of what was available for personal grooming and even managed to come up with my own dental floss. I did my best to honor the parts of my personality and physical body that could find comfort.
I wrote and followed a daily schedule, I was physically active at least five days a week (I used an imaginary treadmill while watching TV in the cellblock), and I allowed myself to come and go from the social environment of jail as needed. Importantly, I allowed myself to be human and to make mistakes, particularly because I had been so ill and the environment was so foreign to me.
Once I was no longer actively psychotic, I resumed my mainstream religious practice as best as I could while incarcerated. I used substitute symbols to represent candles, wine and bread so I could continue to derive a sense of community, solace and strength from ritual. I took advantage of jail visits from people from another religion to make connections. I also practiced compassion and tolerance when some women ridiculed me or tried to destroy my daily spiritual work.
The emotional issues triggered by what had unfolded over the previous 10 months were far too great to examine in depth while I was incarcerated. So I allowed myself to focus instead on cognitive rehabilitation.
I worked slowly and diligently to regain enough focus to first read magazine articles, then make notes on what I was reading, then advance both the length and complexity of the material. I worked to write down long-forgotten songs from my childhood over five decades ago and eventually wrote long letters to family. I reviewed multiplication and division tables until numbers behaved as they had before I became psychotic.
It was very slow going at first — almost as if the psychosis had been a thick glue that slowed my ability to process anything. But by the time I was finally released, my psychosis had cleared. My cognitive rehabilitation was not yet complete, although my ability to focus had vastly improved.
The trials and tribulations of this journey were not over. But I had built the foundations for both surviving and healing — for putting my shattered life back together — using the concept of neuroplasticity as my guiding hope.
Victoria Harris is honored to have worked as both a general physician and a psychiatrist. She is the parent of two young adult children who are courageous, brave and a source of inspiration for many. Victoria now lives in Eastern Washington and can be found enjoying the trails with her Diggity Dog.
Note: This piece was originally published in the Fall 2020 issue of the Advocate.
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