A mirror of the mind
When we think of psychosis, we often picture the most striking phenomena (‘symptoms‘): unusual perceptions (‘hallucinations‘) and unusual thoughts (‘delusions‘). These experiences, although often incomprehensible to the outside world, have a deep and personal meaning for the person who lives them.
Nothing in our mind is random
Psychosis can be seen as a mirror that reflects what lies deep within a person’s psyche. The themes of delusions and the nature of hallucinations can often be traced back to important life events, or for example to unresolved conflicts and deep-rooted fears or desires.
For example:
- An unusual conviction of being persecuted can stem from real experiences of neglect or abuse, in which the person felt constantly threatened.
- Positive hallucinations can stem from a deep longing for connection and support in times of loneliness and isolation.
- The idea that newspapers, radio and television are talking about you can stem from uncertainty about your place in the world.
The importance of context
To unravel the true meaning behind a psychosis, it is essential to pay attention to the context of someone’s life. This means a thorough understanding of their life history, including attachment problems (problems in how you learn about closeness, trust and relationships with important others in your childhood) and traumas (going through overwhelming things in childhood).
The way someone became attached to others in early life, and the traumas they went through, play a crucial part in how their psychosis shows itself. Recognising and understanding these connections can help not only in treatment, but also in fostering empathy and connection between care professionals and those who experience psychosis.
Listening to the stories
Understanding the content of a psychosis requires a listening ear and an open heart. It is important that care professionals do not focus only on reducing symptoms, but also take the time to listen to the stories and the meaning their clients give to their experiences, or help them with this when there is still a lot of confusion. By working together to unravel the symbolism and the underlying themes, people can gain insights that help them recover and grow.
Anyone who listens closely to psychosis discovers that it is about metaphors for ordinary human worries and fears, such as: who am I? How do I relate to other people? What do other people think of me? Can I trust them? What is my place in the world? Do I have something to contribute? Can I trust my body? What are my emotions telling me? What are my possibilities and talents? Do I dare to stand up for myself and be present?
Towards a healing path
Recognising the meaning behind psychosis is an important step towards recovery. It can help people understand and accept their own story. It can guide them towards a path of integration that is aimed not only at reducing symptoms, but also at addressing the underlying causes and fostering personal growth and development.
In our approach to psychosis we should not forget that behind every unusual perception and every unusual thought there is a human story waiting to be heard. By paying attention to these stories, we can clear the way for a more understanding, empathic and effective approach to mental health care.
Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare.
Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’. In 2026 he published 'Wat psychisch lijden is'.
Want to read more?
Blogs by Jim van Os can be read here
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