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Week 1 Class notes 4.3C Severe Mental Illness In Urban Context
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Week 1 notes for Pre-recorded lecture and Interactive Lecture
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SarahinRotterdam
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Interview with expert-by-expert experience on psychosis, trauma and recoveryExpert-by-experience: Jeroen Zwaal
Has experienced several psychoses.
Psychosis, recovery, mental healthcare, and the arts.
Theme 1: First experience with psychosis
6 years old. There was a moment during the night, he heard something in the bathroom. His brother and
mother were in the bathroom. His brother was shaking, sitting on the toilet. They did not know he was
there, so no one told him what happened there afterwards.
Started to analyze patterns in his family from when he was 6 years old.
The youngest of four children.
Brother had psychoses. Family gave a lot of attention and energy to the brother. He became the black
sheep of the family: a negative label. The cause of the family problems. -- the brother also started
mental health support.
15th birthday, his mother dies. Afterwards, his life was broken into two: with mother, without mother.
Life with his father and brothers… father worked a lot, grieved… had burnout. Worries for father. Had a
lot of arguments with his father, tensions.
His mother and him was really close. A survival mechanism, can go back to times with her and feel safe,
good. She was struggling with cancer, and did not get the social support she needed from the family.
Narcissism, manipulation of father…
When he was 18 years old, in high school. Studied a lot, mourning of mother, worrying for father.
Suddenly could not sleep. Could not sleep for 2 weeks. This was too big for him to understand, so his
mind was spinning.
Images were helping him, rather than linear words.
Images came in, gave him some space. He could walk in, look from different labels and see what was
happening.
Gave his high school teacher this image. He was asking for help, but his teacher could not understand
the psychosis imagery/symbolism.
Developed a kind of language for himself through metaphors, through which he could describe and
understand himself and the world better than with words.
Got out of connection…
His father was shutting out everyone. So he needed help, but his father wasn't allowing this.
, He had to go to the army. He was very confused. Everyone felt that someone was wrong with him, but
no one did anything. They put a label, as a 'lunatic', and he was free of going to the army.
However, no one explained this to him. He had the delusion that he was given a new mission…he had to
change the world in a good way.
• So, he took the rejection of the army as a sign that there was something bigger for him, a bigger
task. Became part of the delusion.
Could not behave in appropriate social behaviors.
Then, became worse. He opened the car door of a business man. Got in, said take me home.
The police was called.
A police on a horse. Was very big, high. Picked him up by his clothes. The horse stood on his feet. The
horse forced him into reality… he suddenly came to himself. Went to the train station, went home.
Problem with authority…
Father sitting in the living room with his oldest brother. He was so angry, father did not even care. Did
not know what he did that day. This was a trigger, a lot of tension. So he burst without any social
inhibition.
His father called the doctor.
And before, he had said that he should not continue like this, or else he would turn out like his older
brother -- the worst nightmare for him.
His father was not the comfort or safety place for him. Instead, he compared him with his worst
nightmare. He made it worse.
• So, psychosis started at a time when he was trying to discover who he is, his identity. Coming of
age.
• Also, losing him mom made him very vulnerable.
• Tension with father -- not safe at home. Also, with his brother over the years. Father also had
psychosis later on (proof of genetic)
• No social support for his trauma, grief…
Mental healthcare was weak. Did not do anything.
He saw his mother dying.
• 4 months in a psychiatric hospital for his psychosis. The diagnosis was bipolar disorder.
• Was given lithium, and therapy every few weeks, for 20 years.
The start of the episode: sleep deprivation. The trigger which brought him into the delusions.
Also experienced energy- male energy.
In some way, he chose to have a psychosis. He was aware that things were going wrong, but intuitively
he chose to conduct breathing sessions with himself, and collected energy. He disconnected from the
energy, the family system, the trauma he was in.
He was out of his body -- dissociation. A eureka moment, but lost connection to the ground.
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