Finding Hope in the Lived Experience of Psychosis: Reflections on Trauma, Use of Power and Re-visioning Psychiatry

 

Book Description

 

This book offers first-person accounts of the experience of psychosis from the inside and the outside, through the eyes of two doctors, one of whom has experienced psychosis and both of whom have worked for decades in the field of psychiatry.

Underpinned by rigorous academic analysis using an evocative duo-ethnographic approach, the book explores the cultural and subcultural influences from childhood onwards - both traumatic and resilience-building - that have shaped their lives. Both authors reflect on strategies they learned early in life for dealing with challenges, each managing to function at a high level while avoiding awareness of their vulnerability. They reflect on the potential dangers of using their expertise and position of power in psychiatry simply to diagnose mental illness and prescribe medication. The differences and similarities in the authors’ stories provide a productive tension highlighting the complexities of this paradigm shift that is happening in psychiatry.

Written in the form of two interacting memoirs, this book is of great interest to researchers, clinicians, and practicing psychologists, as well as a general audience with interest in psychosis.

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Table of Contents

Part 1 Becoming Ourselves: Patte’s Story (1951-1980, birth to 29); 1: Trust and Betrayal: The Divided Self; 2: Medical School - Skeletons, Cadavers, Gray’s Anatomy and Desensitisation; 3: An Extreme State and a Sense of Pathway; 4: Research and Metaphor: Medical Nemesis; 5: Completing Medical School - Examining Reflexes; Josephine’s Story (1954 - 1983, birth to 29); 6: Autonomy, Invulnerability, and a Commitment to Service; 7: Losing Sight of Science and Walking Away From Love; 8: Completing Medical School. Training to be Superhuman and Joining the Medical Club;

Part 2 Becoming Doctors and Choosing Psychiatry: Patte’s Story 1980-1995 (ages 29-44); 9: The Pleasant Smell of Aftershave and the Imagined Relief of Not Existing; 10: Worse than a Nuclear Winter; 11: Trust Betrayed: Confronting the Devil; 12: Evolving from Atheism - A Spiritual Emergency; 13: Defining the Essence of Psychiatry; Josephine’s Story 1985-1995 (ages 31 to 41); 14: After Africa - Rekindling Passion for Medicine and Love; 15: Feeling Lost in Psychiatry and Found in Mothering; 16: Beginning to Find my Place in Psychiatry; 17: Jumping Through Hoops and Becoming a Patient;

Part 3 Learning from Experience: Patte’s Story 1996 to 2020 (ages 45-69); 18: A Herculean Task - ‘Hope and a Future’; 19: Something Wrong on the Inside - The Paradox; 20: Finding my Voice … And Losing It Again; 21: Side Effects, Spirituality, and Finding My Niche; 22: Disruption in Meaning-Making: The Last Extreme State; 23: Lighting a Candle for Justice; 24: Ways of Making Sense; 25: The Re-covery Model; 26: Living the Experience of Now - My Life Beyond Psychiatry; Josephine’s Story 1998 to present day (ages 44-65); 27: Becoming a Psychiatrist - A Pathway of Impossible Jobs; 28: My Alternative Training - Pathway to Becoming the Psychiatrist I want to be; 29: Against All Odds: Maintaining My Personal and Professional Identity; Patte’s Story; 30: Creative Energy and ‘The Gift Box’; Epilogue: It’s About Time.

Authors

Patte Randal, LRPC, MRCS, DPhil, has personal experience of recovery from psychosis. Her published research includes evaluation of a therapeutic intervention she developed for people with treatment refractory psychosis, and qualitative exploration of doctors’ experience of mental health care. Retired from 30 years of clinical practice, she now promotes the implementation of ‘The Gift Box’, a collaborative resilience-building tool based on her ‘Re-covery’ model.

Josephine Stanton, MA, MBChB, FRANZCP, is a psychiatrist working with adolescents, children, mothers and babies and their families. Her research has included qualitative studies of mothers who have killed their children, experiences of doctors who have become patients of psychiatrists, and referrers and young people’s experience of engaging with an acute inpatient unit.

Endorsements

A big takeaway from this book is the inequitable clash of world views when a person with lived experience of mental distress enters the sanctum of mainstream psychiatry. As a psychiatric registrar Patte Randal used her lived experience to foster connection, meaning and hope while many of her colleagues were steeped in psychiatric pessimism, biological reductionism, risk management and the use of force. Patte paid a heavy price but persisted for decades and triumphed with recovery affirming approaches that, unlike much of mainstream psychiatry, honour the etymology of her profession as ‘healers of the soul’.
Mary O’Hagan: Former Mental Health Commissioner; Author of ‘Madness Made Me'.’

This book is remarkable for its scope, its honesty and directness. Dr Randal’s life covers so many different perspectives on psychosis and extreme experiences. She has built on Laing’s recognition of finding meaning and the value of human contact for people with psychosis. Through her personal adventures and academic research she has inspired others, including her co-author and interviewer Dr Stanton, and also built a teaching resource in this complex field. Dr Stanton describes her own journey and helps link us to other positive developments in psychiatric therapy. If life is a "gigantic cosmic jig-saw puzzle" then this inspiring book may help you find solutions.
Nick Argyle (MRCPsych; FRANZCP) Psychiatrist in Australasia working with refugees: Formerly Clinical Director Auckland District Health Board.

"This book contains the stories of two remarkable women doctors. Their courage and commitment to all they serve, and themselves, shines out of every page. I have been privileged to work alongside them both over many years and I have witnessed their dedication to challenging the traditional practice of psychiatry to be more humanistic and healing. I have learnt more from Patte than from any professional development I have ever attended.　 They have both walked the walk and have been punished for not submitting to the dominant discourse. Nevertheless, they have persisted and this book is a tribute to their determination and perseverance; as is 'The Gift Box', which I believe is a valuable resource for any service that is genuinely interested in promoting growth and self-development."
Debbie Antcliff (FRANZCP) Retired Psychiatrist: Formerly Clinical Director Buchanan Rehabilitation Centre; Director of Area Mental Health Services Auckland District Health Board.

"Finding Hope in the Lived Experience of Psychosis" provides readers with a unique perspective on paths to recovery. The authors bring out the knowledge and insight that come both from personal experience with psychosis and from professional careers as doctors working in psychiatry. Their exploration of psychosis and extreme states makes for an evocative read."
Robert Whitaker author of 'Anatomy of an Epidemic'.

'The beautiful story-telling stands out in this honest, rich and moving dual account of psychosis viewed from the inside and the outside. Written by two women doctors, trained in psychiatry, this unique evocative book provides a window into a deeply personal experience, and enriches the literature in this complex field.
Patrick McGorry Executive Director Orygen Youth Health Research Centre and Professor of Youth Mental Health at University of Melbourne.

In this lucidly written dual autobiography, two women, each of gifts and understanding, explore their personal experience of the conceptual fault line that runs through the theory and practice of psychiatry - the fault line dividing lived experience and objective clinical science, mind and soma, faith　and scepticism, the numinous and the mundane, compassion and dispassion. They trace their stumbles along this line, their agonies, their triumphant successes and attendant dangers. I played a minor part in the saga of Patte - evidently not on the side of the angels - and recall the hard problems posed for her　senior colleagues in doing her justice. I recommend this book to trainees and teachers in psychiatry. Let them read, and consider how they straddle the fault line.
JJ Wright. Honorary Professor, Department of Psychological Medicine, University of Auckland School of Medicine.

This moving and thought-provoking book is built around the autobiographical accounts of two women doctors who trained as psychiatrists - Patte Randal and Josephine Stanton - and describes their journeys through the profession and as human beings navigating the vicissitudes, challenges, and traumas of life. Crucially, one of the women, Patte, has experienced psychosis herself and through that experience has come to see it as a spiritual emergency, a view that contrasts starkly with the medical reductionist approach of many of her colleagues in mainstream psychiatry. This perspective has enabled her to develop a more human and holistic way of approaching people who are experiencing a psychotic crisis. Readers will appreciate this book’s openness and honesty. It testifies to the importance of being with and learning from people who have lived experience of mental illness and offers an uplifting, positive vision of the way that psychiatry can be practiced in the future.’
Richard P Bentall, Professor of Psychology; Author of ‘Madness Explained: Psychosis and Human Nature‘ and ‘Doctoring the Mind: Why Psychiatric Treatments Fail'.

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Patte Randal: A doctor's story of recovery from Psychosis. Feature from the Canvas supplement of the 22 April 2023 issue of the New Zealand Herald. Click here to read and download.

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Below are the pictures mentioned on pages 96- 97 of the book and the illustrations from Patte’s notebook mentioned on pages 99-100. To view this video, enter the password: Patte