163: The Hidden Trauma Created By The Psychiatry System (It's Making People Worse) | Anneke Sips

Maybe you're doing a lot right. You're working out, you're eating decently, and still your body feels puffy, your hair feels thinner, and your skin feels creepy. You were taught to call that aging, but I am choosing not to. I don't believe that beauty is vanity. I believe it's a hobby. it's a skill it's something that you can practice and learn at any age so i'm hosting a free beauty backroom event for midlife women who are ready to glow up and feel leaner stronger and more radiant than they have perhaps in their entire life i will be sharing exactly what i've done over the past couple of months to do just that so 2026 is your rebrand year come play with me kellybroganmd.com forward slash BB. Isolation room, injections, all that's super traumatizing for the patients. Oftentimes people will comply because they don't want to get into trouble. And then once in there, you need to adapt to the program. And if you don't comply, it's really hard to get out. I don't think the average person has any concept unless they've had a loved one or themselves have been likely involuntarily retained in one of these wards or units. Call somebody crazy is a weapon and a way to silence a person. It is a tool that is being used to hide the abuse. It's a way to not ever be caught. If people start to understand how their nervous system works with reflecting and in relationships, it becomes a much more logical story. Hi, and welcome back to Reclamation Radio. I'm Dr. Kelly Brogan. And today I have a conversation with a registered psychiatric nurse named Annika Sips, who I met through my community and offerings and who has recently published a book called The Wisdom of Psychosis. We delve into her experience and her audacious reframes of what we are calling psychosis. We explore how you can listen, truly listen to somebody who is having an experience of so-called perceptual disturbance and what that actually looks like and what it can yield. We talked together about what actually goes on in a psych ward, things that you might not otherwise believe. And we talk about how to interact with so-called acute psychotic symptoms in another person. Basically, we unpack this very vague term that is a bucket for all sorts of rejected and unwanted behaviors on the part of another human being. And we begin to plant the seeds that she grows so beautifully in her book of what is the deeper meaning that can grow around this experience of fractured reality, of so-called delusions, of perceptual disturbances, and the greater social context that can ultimately embrace people who are having this experience and how we can broaden the definition of so-called psychosis to include natural experiences that humans have every day, all the time. I hope that this is helpful for somebody that you know or for yourself or to just begin to expand the definition of what is bad and wrong and condemnable in this experience of humanity that we are sharing together. Welcome, Annika, to the show. Thank you so much for the invitation. It's such a pleasure. And I was yapping to you before we started recording that we have so much to unpack in this potentially controversial, you know, I love that as a provocateur discussion. The place that I want to start, however, is in our shared history as conventionally trained clinicians. So I'd love for you to talk a little bit about your credentials, your training, and what inspired you to move towards that training because, you know, I've shared many times with regard to my own journey, that it was when I was working a suicide hotline in college at MIT that I was supervised by psychiatrists and I was given the impression that we have cracked the code of human behavior, we know how to end human suffering, and we just need to get people into the hands of prescribers so that they can take their medication and no longer feel despair or anguish or hopelessness or whatever it is. And when I dig a little deeper, I can see the signatures of my emotional immaturity and I can see that I was the one who was really uncomfortable with human suffering and I needed to resolve that externally, right? Like I needed to resolve that on behalf of anybody who was standing in front of me and struggling so that I could feel better, so that they could regulate my system. But that's what landed me in medical school was specifically to become a psychiatrist. And I know you have your version that overlaps a lot with mine. So I'd love to start there. And then I want to talk a bit about what it's actually like on a psych ward, because there are not a lot of people I can talk to, especially not in a public forum like this, to expose really what goes on. Because I often say like, you wouldn't believe it. Right? Like people think of like, oh, one flew over the cuckoo's nest. Like that's like a dramatization from decades past. Like, no, you would not believe, you know, the compulsory treatments, the inhumanity, the extraordinary abuses that go on at the hands of people who really mean well. And that's the most confusing and cognitively dissonant part of it. So I'd love to just start there before we get into really what I believe is such an important offering in the form of your book, The Wisdom of Psychosis. So tell us about your journey into conventional medicine and let's start there. Yeah. Well, thank you again for the invitation. And indeed, it's very nice to speak with another person who knows that world from the inside out, because it is something. I started in 1998. So that's quite some years ago. And I've been hanging around in psychiatry for more than 20 years. I'm working for more than 10 years now in my private practice. So there's a lot of experiences there in psychiatry. I started when I was 18 and also, So, well, what I know now as a wounded healer, I think, but started as a wounded girl, young woman with the idea of, of course, helping people. And I was very curious about what happens in somebody's mind. I wanted to understand the human mind and human behavior better. And I thought in my ID back then, the best idea is to enter psychiatry. And there you will learn all about that. You will understand everything about the mind. So, yeah, I was 18. I went to nursing school. So this is where it started. Nursing school and working after one year already also in psychiatric wards. I must say the first time I stepped in, I knew immediately this is my place. I felt, yeah, clearly that this is the place where I should be. Many times I've been wondering why, actually, but sometimes you need to go through experiences to see afterwards what was actually going on. So yeah, I started as a nurse and after my nursing education, nursing school, I worked first in a place where adolescents were brought in, often with the first psychosis, but also any other first psychiatric episode. So young people, adolescents and young adults, observation and diagnosis. So that was the place for me where I started to lay my foundation. I've been working also clinically in addiction wards. So working with all kinds of addictions and detox wards. And after, I think, 10 years working in clinical place, I studied more, became a community psychiatric nurse. And then we worked in outreach teams. So before in the clinics, it was mostly crisis wards. And then as a community psychiatric nurse in outreach teams, but also in a crisis team. So crisis has been my thing. So clinically, of course, especially in that time, even a little bit more than now, isolation room injections, like, yes, all that's super traumatizing for what we call the patients. But also realizing now this was also very traumatizing for the people working there, I believe. Yeah, yeah. I want to linger here for a moment for the reasons that I suggested, which include that I don't think the average person has any concept unless they've had a loved one or themselves have been voluntarily, but more likely involuntarily retained in one of these wards or units. In my experience as a physician, usually an intern or a resident in my case, although I did spend maybe two years moonlighting in the emergency room as an attending. Well, that was a dissonant time because I had already started to wake up. Anyway, the role of the nurses on staff could be reduced in many ways to medication compliance, right? Because you have this yearning in your heart you described to connect to human behavior, the dimensions of the human experience, the psychological aspects of a person struggling, right? And then you get all of this training and most of what you do, at least in the inpatient units, is, you know, in many ways confirm that patients have complied with their medication, right? So you mentioned injections, but what are some of the ways that nurses on staff or that you remember experiencing enforce compliance on these units? Well, definitely. It starts before people got into these units with the kind of the threat. If you're not complying with the treatment plan in outpatient care, let's say, then you need to end up in a psychiatric hospital. So oftentimes people will comply because they don't want to get into trouble. and then once in there you need to adapt to the program there's this the day the daily program and medication or the treatment plan but most yeah 99 of the time this is medication and if you don't comply then you you are not like working uh you know working with the program not working with a plan so it's really hard to get out so what people do is they take the medication and very often they put it behind their teeth in their cheek, and then they act as if they swallow, and then they spit it out, of course. And that's why there are mouth checks, right? And that's why, you know, ultimately, and you were practicing in the Netherlands, is that right? Yeah. So I don't even know if there's a direct translation from what it was like here in the States. I was in New York City during most of my training. But ultimately, if you are non-compliant, disobedient, there's a kind of court system in the hospital where you don't have fair representation. You don't have a prayer of really securing any liberties or rights as a result of that process. And at least in my experience, usually what comes out of the core proceeding is that you can be injected against your will, right? So that you can be held down four points and injected whether you like it or not with a medication of the prescriber's choice. And so I'm guessing you witnessed this kind of a thing too. Of course. And I was really good in injecting. So I did it very often because I was already thinking that kindness and gentleness was a good idea, but it's really hard in those situations. And well, first there is this layer of just being able to hold a person inside and then the medication on top. That's a little bit in the next procedure, let's say. So it's not in the Netherlands, it's not automatically the same thing. I don't know how it is in America. So that is, but I think already to keep you from your freedom is a big thing. And of course, for safety and all these reasons, I understand that, you know, that safety is important. But very often, yeah, it hasn't been very fair, in my opinion. And also the medication, there were, of course, rules and regulations to offer medication in a treatment plan. But very often medication was given because there was a critical, dangerous situation, which oftentimes was just not fair, in my opinion. For For example, yeah, somebody would have been waiting in front of the door while we had a meeting with the staff and a person was standing there already for an hour or longer. And maybe after we were done, then everybody walked past by this person and the person was like, hello, I have a question. And for example, they wanted to smoke. There were maybe certain areas where you could smoke and the person who smokes, they were just waiting there until somebody could light the cigarettes. and waiting already for an hour, still standing there. Patience, still patience. And, well, this is just an example that I remember now on the top of my head that the patient is asking again for a fire and the nurse thought that the patient came too close and thought it was a dangerous situation. I'm like, well, nothing is happening. So he says, get away, you're too close. And the patient's like, come on, I'm waiting here already for one and a half hour. Wow, your voice is up. Now, before you know, there's this critical situation. An alarm is being pushed. Six people are there. People are, of course, resisting. And then there is a fight and there is only one loser. Right. And while there is typically a procedure that approximates some sort of legal process that I referenced for ongoing mandatory injections, what we used to call five and two, right? by Valdol to Vadavan is given for situations like this that are subjectively determined to be dangerous all the time, all day long. I mean, this was going on. And so the violence that you suggesting even the staff was witnessing and does witness is a consideration for the quality of life the psyche the trauma activation of even the providers I mean, it's interesting because as somebody who's totally apolitical these days, I was a libertarian back then, even in my atheistic, you know, pharma loving days. And so I had a very high threshold for, we called it two-piecing. It takes two attendings to decide that somebody does not get to stay outside of the hospitalization, right? So I had a very high threshold for that just because, I don't know, it was against my nature for some reason. But I still believe that I was a part of something necessary, right? And that there certainly wasn't a viable alternative in these cases for people who were either dangerous to themselves, dangerous to others, had failure of outpatient treatment, right? These very impressionistic criteria. So can you, it sounds like you can connect to the part of you that had a yearning to serve, you know, the human experience in that way, however it looked then. Today, as you've really awakened to a broader context, like, do you feel compassion for that version of Annika and the people that you impacted? Yes. And I feel compassion for also for all the colleagues and for myself and for all the people who are impacted because it's not, I think the individual people, they don't have such a, so much choice. I think there is a whole larger system around it that is, you know, the design of the system is not very healthy, I believe. And so it's really hard to do anything else. So I believe people, well, everybody who's working there has a big heart and want to help other people. It's interesting, though, that it also can translate into like an everyday kind of sadism, you know, that even though most of us got into that field from a benevolent impulse, at least I witnessed a good amount of sadism on the part of the staff towards the patients. patience. I mean, even the way a lot of attendings modeled talking about patience, you know, as like help rejecting complainers or frequent flyers or, you know, there was like all sorts of, yeah, different dehumanizing rhetoric. And now I see it as a way to wall off, right? Like to close off maybe a sensitive heart to what is very difficult to feel. As I was referencing when I used to work that suicide hotline. It's maybe one of the most exquisite experiences we can have as humans is to keep our heart open as somebody else struggles in front of us, right? So I know that you have come to recontextualize not only human suffering, but a specific flavor of human suffering that we call psychosis. And I want to bridge this conversation into a context for this concept of psychosis. And at least my perspective that everybody, and particularly women, I would say, holds a deep fear that we will be found crazy, right? And so many of the the folks that you and I know and have worked with and have had, have walked intimate paths with, have had that experience, right? Where they have been marginalized, labeled, and condemned to an experience of rejection on the most existential level, right? So I sometimes joke that I became a psychiatrist so that I could sit on that side of the crazy desk, right? Like I said, but I could make sure nobody ever thought I was crazy, right? And I've come to appreciate that at least the women that I attract and make contact with have this deep fear that they may or may not have a relationship with that they will be found crazy, right? And the trope that, you know, you're just acting fucking crazy, you know, or you're crazy, is dismissive of a kind of core feminine essence. I don't know how else to say it. It's a very, very powerful condemnation. So because of this fear that we all have, we don't know how to be around people who are having perceptual disturbances, who are experiencing reality in an unshared way, let alone whose behavior is erratic or unpredictable, confusing, appears to be violent. Although in my experience, the role that medication plays in inducing violence in this population is almost never addressed by the conventional system, but that's another conversation. I'd love to know how you interact with the concept of crazy, the concept of psychotic. And where do you think your fear of that went, you know, or is it just something that you held and you held into the light and it birthed this body of work that you now have to offer, which is to suggest that psychosis is not what we've been told. It is by the dominant narrative. Well, I think first of all, being called crazy or call somebody crazy is kind of a weapon and a way to silence a person. So definitely working also a lot with people with dissociation issues, let's say, or people who suffered from ritual abuse. It is a tool that is being used to hide the abuse, also to program somebody and to call somebody crazy. It's a way to not ever be caught, let's say, because that other person is crazy, So I think it's a very dangerous field to be in because I wouldn't mind to speak a little bit just to open that little window. We don't have to go deep into that. But ritual abuse, very big one, I think. Very important. Yeah, I thought that when you said that, too. Just even if it's just like mentioned, that's good. Although I'd like to I want to get to what you think of as like root cause drivers. So that might be a good time. Like next question. So, yeah, just to backtrack a little bit, I was just asking about like basically why you're not afraid of this concept of crazy, like how it's been neutralized for you. And, you know, is that because it means something different to you? Yeah. So this concept of crazy or psychosis, of course, I've been raised by psychiatry because this was my workplace to think in a certain way until I stopped thinking in that certain way. that way of how psychiatry looks at psychosis. And I've also been observing myself, what I've seen coming in in the hospitals, but also in my private practice now. And I saw that it was not really very clear what was actually psychosis. So many things are called psychosis. So I've seen people with mystical experiences. I've seen people with spiritual awakening experiences, with Kundalini experiences, energy rising near dead experiences, the dark night of the soul. So a lot of crises that were called psychosis or people with what was called personality disorders or borderline or depression or like what is that concept of psychosis? And I am a very, are very critical by nature and I'm very curious. So I like to ask the questions. And oftentimes I was thinking, well, I see what's happening here and what kind of behavior that we observe. And honestly, what happens in my mind is not very different or maybe even crazier. And how could it be that they end up here on this side of the line? And how do I end up here as a nurse? And we are, we're very similar and also our way of thinking. Because also when I was looking at my own experiences that happened at a young age and the things that were happening in my family, I thought this was very psychotic maybe by itself, maybe more crazy than what happened in the hospitals with the clients. So in my experience and what I see in the West is that psychosis is typically seen as a mental health disorder, a disconnection from reality. And we see that our altered thoughts or emotions and perceptions and doctor, there's a psychiatrist that I really admire in the Netherlands. His name is Dr. Jim van Oss. And he has shown that psychosis are way more common in society and in the normal human experience than what we were thinking. And another thing that I see is that psychosis is not something that we are, but it's something that we experience. And that is, I think, a very important element here. It's an experience and it is something sometimes what I compare with the flu. We can catch the flu. without becoming the flu. And we can move through a psychosis without being the psychosis itself. And yeah, so psychosis is a state of consciousness. And there is a broad spectrum of these states of consciousness and these altered states. And besides what we see in the West, a lot of cultures experiencing different states of consciousness. And that's not called a psychosis or crazy, but it's actually something else. It's seen as something that is pure enlightenment or it's actually very important to treasure because important gifts or insights come through these experiences. So what we label as a disease, I don't think that is the best way to look at it because then we're missing out on this broad spectrum. and we miss out an opportunity to actually learn from all these experiences. So and because I've been thinking more deeply in this way, for me, it's not something that I'm afraid of. It's also not something I'm afraid of in myself. It's not something I'm afraid of in other people. So the similar kind of people that I used to see in a clinical ward that were called like that were labeled very dangerous, I sometimes see now in my private practice. So it's very interesting to see what kind of behavior people show and for what reasons and under what circumstances. And if I see this more in line with trauma and trauma expression, if we look at it through the lens of a trauma experience, then we can also treat it very differently and use a different approach to what we call crazy or psychotic. Yeah, it's interesting because I often reflect on how the most powerful tool that a clinician in this arena can bring to bear, whether it's in the holistic or integrative or conventional space, is a well-regulated nervous system, right? is your own calm. And I imagine that when you sit with somebody who would otherwise have been incarcerated on a ward and you are not afraid of them, that that itself deeply influences and impacts the trajectory of that person's behavioral experience, right? Because when you're reactive, when you're afraid, when you attempt to control their behavior, there are other managers and parts that get turned on. And if part of the experience of these altered states that is difficult to integrate into mainstream society is that these folks have parts that don't communicate well, right? So they have a part that believes something and then another part that is just not even aware that the part that believes this thing is pulling the strings, right? The integration becomes possible when you model that all the parts are welcome and it's just forestalled. If you insist that one of these parts is irrational, doesn't belong, needs to be subdued. And I'd love to talk a little bit more about what you see as, because I know you agree with this, that these terms that we use in the realm of psychiatry and the DSM, these are subjective trash bins for observations and patterns that have not been scientifically validated. It doesn't really mean much, even though there are criteria. Interestingly, I'm sure you've noticed this too, some of those criteria for psychosis are now very popular trends in New Age society, right? So if you look at referential thinking, which is this notion that you are putting meaning into something that doesn't inherently have meaning, right? That if you see, you know, 444 on the clock, it means something to you. That's considered a psychotic behavior. I wonder if that's changed. But back in the day, magical thinking was a large umbrella that includes most of the new age approach to reality, right? Where you're imbuing with meaning your immediate surroundings. So, you know, with in mind that we don't even really know what we're talking about when we say the term psychosis, what do you think of as the role of trauma and some of these common paths that people walk into the system where they get labeled and corralled? corralled? Well, definitely. I think what I've heard and I've seen, I met in my life hundreds, if not thousands people with this label, let's say, and psychosis and trauma, there's very often a connection there. Back in the day when I started, that information wasn't available. I think literally only in 2016, as far as I can remember, the first scientific papers came out that the maybe psychosis and trauma has something to do with each other. But I've seen this already all those years that there were like traumatizing events happening in somebody's life. And speaking with people, they would also like, for example, speaking about hearing voices is a very common thing in human beings. Actually, this is just common human experience, but oftentimes it's also connected to psychosis, of course. And when people go through traumatic events or experiences or painful experiences, the voices would be different than when they would not go through painful or traumatic experiences. So these voices, they literally have something to do with the experience that is happening. So I think the reason why there are, let's say, quote-unquote psychotic experiences or altered states of consciousness is because there was trauma or painful experiences happening before that. And then, like what we said also earlier, is when you get into a treatment situation, this is also a high possibility of being extra or re So I think trauma and psychosis are super linked in many different ways The work of Robert Whitaker which I know you also know demonstrates that the long treatment outcomes of the untreated right in this category and in pretty much every so-called category of mental illness are far superior to those who are treated, right? That the antipsychotic medications actually, you know, propagate the problem that they purport to resolve, right? So they induce recurrent hospitalizations and lower levels of functioning and all these outcroppings of other syndromes and symptoms, and that folks are longitudinally better off if they avoid the system, right? And that's not an opinion. It's not a theory. It's not based on how nice holistic health is. That's just actually what the data bears out the very rare non-industry funded long-term data. And I wonder what the role of what you're suggesting is the trauma of the hospitalization itself, which you and I can look back and agree is part and parcel of what goes on there and seems unavoidable, seems like a necessary evil, right? Seems just kind of like how it has to work. It's interesting to consider how much of a part of those bad outcomes, the actual experience of the meta trauma of the hospitalization. Churn is let alone the disempowerment and the reinforced sense of brokenness that comes from complying with appointments and taking a prescription that has your name on it that you must take with all of these hard side effects because you're actually crazy. So when I think about the way that you must listen to your patients and offer them a space of acceptance, which has to be exceedingly rare when it comes to this category, because there are lots of folks who can listen to somebody who's struggling with anxiety or somebody who's struggling with addiction or even depression, maybe even suicidality, But to open up your heart to somebody who is in this kind of an altered state, I think is exceedingly rare in my experience. So I wonder if you can share some of the things that you have learned that have surprised you, that you think might surprise other people to hear from working with these kinds of, I don't know if you call them patients or clients, But working with these kinds of folks who would otherwise be managed. Well, I think, first of all, there is a great stigma. So people that are labeled with psychosis, other people oftentimes are afraid because of the stigma that is there. Oftentimes we see in newspapers or somewhere else that, you know, there was a mass shooting and the guy was schizophrenic or psychotic. So I think that is one thing. There's this fear again. So again, starting to see a person without a label, but just like yourself, that's a really good start, I think. Like everybody could be in a situation of being afraid. And if you're afraid because of a story that for you sounds very weird or hard to believe, that doesn't matter. So for me, it's important to not judge a person on the story, but just listening to and try to understand that if that would happen to me, that, for example, if somebody would try to poison me through the heating system, I would also be afraid. It would also scare me. So like a lot of people, especially in the holistic kind of scene, they are all like super non-judgmental until people are talking about things that they never experienced themselves or they think is very weird or crazy. so then all of a sudden it is judged as being crazy or weird or people just simply don't know how to deal with it. They are afraid, which is something that I've seen a lot and not only in people outside of the healthcare community but also within psychiatry and the healthcare community that if we are not labeling or judging, this is very interesting, I think what I say, if you're not labeling or judging but just see that other person as equal to yourself and a human with fear, then oftentimes we are afraid to make things worse. So we are afraid that, like for example, I stay with that example, a person says, my neighbor tries to poison me through the radiator. And if I'm not immediately say, well, that's not possible, then we're afraid to make it worse. But there are many things that we can do different than judging and also different than making it worse. We can simply listen to start with and listen very authentically. So listen with care. And if a person tells a story, you can ask questions. And this sounds very like too simple for words, but this is one of my biggest surprise actually that I've learned in working with psychosis, that we can actually just listen without judgment, without making things worse. We can listen and we can repeat what the person says. For example, ah, I hear that there is poison in your radiator and that your neighbor tries to poison you at night. Yes, the other person is saying. I'm not giving any suggestion if I think this is right or wrong. Like, who am I? I'm not the judge in this situation, but I'm here to listen. And strange enough, this almost never happens. So this is something that I've been practicing with a lot, like where I was still working in the mental health care scene in psychiatry. And I was trained by Xavier Amador. He's an American man. And he trains a group of psychiatrists and me in this LEAP system because I was like a little bit the stubborn one who wanted to be trained as well. And they said, no, but you're already doing other training. I was like, no, I just pay it myself. I really want to do the training. And I was very happy that I followed my guts here. This was called the LEAP training, L-E-A-P. And it stands for Listen, Empathize, Agree, Partner. And listen, the first L, was surprisingly for me the most difficult part. And the group was filled with psychiatrists, with experienced psychiatrists. But we are doing something else when we are entering a room and we start the conversation. We are saying, ah, I see that you're afraid of your neighbor. I see that you're panicking or I see that there's a dangerous situation here. And the patient or the client may think, well, can I just explain what I'm experiencing here? So it's very hard. I've been surprised how hard it is to simply listen. Without an agenda, right? And not listen in a patronizing way so that you imagine the person will get it out of their system and then see another perspective, a.k.a. your perspective. Because I think even in the therapy realms, there probably are folks who imagine that they are listening, they're asking questions, they're being empathetic, but they come with an agenda that is almost unavoidable. unavoidable, right? And the agenda is, I'm going to get you to see that what you're saying isn't true, right? And people can feel that, right? Their animal body senses the absence of that P in the LEAP acronym, which is the partnering, right? Are you really on their team or not? Do you have your own independent agenda? And I think that there's probably no realm where this is more challenging than when there is a divergence of reality, literal perceptions of reality. So in my experience, working with folks who are having these kinds of perceptual disturbances or what we would call delusions, and of course, psychiatry has pattern recognized all these different types of delusions from paranoid to grandiose, et cetera, is very important to have supportive family, loved ones, friends involved. And maybe even that's the difference between somebody who ends up captured by the system as some sort of surrogate family, beloved family, and somebody who can remain outside and move through an epoch of their consciousness in the comfort of their own home. Have you observed that? I mean, do the folks with whom you have what you would call good outcomes. Maybe we should define what that is. Do they typically have support systems in place? Do they have partners and brothers and sisters and parents who show up to their appointments? What does it look like when it goes well? I mean, let's define also what a good outcome looks like for you. Yeah. So the importance of family members and support system around a person. I think this is very important. Oftentimes, it's also lacking. I see that because I think there is the psychoeducation, the education is not clear enough. People don't know how, like if the care community doesn't really realize, for example, the effect of trauma and also this way, not speaking about this with the clients and the support system, then oftentimes the trauma or the pain continues or the nervous system is being triggered or at least not regulated. There's often a great amount of sensitivity. And if nobody keeps this in mind and people are being pushed and also, of course, people need to function in a society that is oftentimes not really the best fit for these sensitive human beings. And yeah, if nobody is informed about this, then, you know, people are keep trying to push them in a little box that they might not fit. And so I think that psychoeducation is very important. Also in the regular guidelines, psychoeducation is also on number one. But what is psychoeducation mean? Does it mean to learn about what medication is available? Not even like what are all the side effects and all the information about medication, but just like this is the kind of medication that we want to try. Like this often is the main psychoeducation that is given. Well, I think psychoeducation needs to be about the polyvagal theory and how the nervous system works. And I think it's important to understand that family members understand how trauma works, what the internal parts are, what is this notion of a core self or who you are in essence. And I think this is a pathway to walk together the community, the families and the clients or the people who are in older states and maybe get stuck there or having problems there. So I think there's a lack that is a problem. And so this is also one of the reasons why I wrote my book to inform people in a very broad way, inform them not only, well, there's a little chapter about the Western psychiatry and how, you know, the categorization and explanation of what is psychosis. but that is like 2% so the other 98% is about all the broad spectrum of what else you know can be can be taken in account if you like investigate like who you are because that's the core the essence of of everything I think at the end of the day like the question who am I and why do I behave in a certain way and why are maybe voices very loud in my in my head and how what do I need Like what is my system around me like? And is this supportive or is this not supportive? So, yeah, very important to have a support system, but only if the support system is well informed, I would say. So this is why this book is not like I hope that it will create a space for a broader view for clients or patients themselves, but also for the family members or everybody in their surroundings. And also the care providers who might also benefit from a more broader perspective on things than other than what they've been trained to believe. That's also my personal experience. What I now know about psychosis is what I've learned through my experiences and my own investigation with all kinds of people around me. But that is so much more is like 100 times more than what I've learned in this smaller perspective of the Western psychiatry. So, yeah, I think the surrounding is very important. Not only the family surrounding, but also community and society in itself, because I think there's also we can all ask ourselves the question, like how tolerant are we? And how easy is it for us to deal with a person with another expression of life, of living, another expression or another opinion? Well, this is a broad topic that is very alive in these days, I think. Yeah. So what if somebody is expressing a point of view on life and living and meaning of life, which is very different? Like we were talking about the dangerous side of it, but I think also it's good to realize that this is a very, very small percentage. Even in psychiatry, this is a very small percentage of the people is like dangerous. And then of that small percentage, I think it's not even true, but it's because people are being pushed and being pushed in a corner. And then they were kind of defending themselves. And then, yeah, psychiatry won. And so it's like another dangerous person, but I don't think that is the largest group. So we're dealing or we're talking about people who are just thinking maybe in a very unique way and maybe just very different than how we think, which maybe it's also very interesting to listen to other people's view. and the meaning that people give to life. And this meaning-making, I think, is important. It's sometimes different than what kind of meaning that we make to things. But it doesn't mean it's crazy or dangerous or anything like that. Yeah, and a sea of so many inversions, I often consider not only what I referenced earlier, which is like how now in dominant culture, there's so much evidence of what we would otherwise call psychotic thinking, but that the identified patients, right? Like the folks we think of as psychotics, quote unquote, schizophrenic or crazy, you know, could it be, you know, that they are expressing in a way that is a very wise response to their particular circumstances But then we have all of the so normal folks who are from a particular lens through a particular lens under mass delusion, right? If you look at trauma-based mind control and the kinds of belief fields that you can be captured by, and you look at the really crazy shit that people are led to believe it becomes normative. And you look at the socialization of these beliefs, it becomes really hard to understand. What is abnormal? What is normal? What is a wise response? What's an unhealthy response? Is it a Krishnamurti world where it's no sign of health to be well adapted to this society. And I think that's a lot of what you offer in this book and your work is the possibility that this is a normal part of the human experience. It's something we're all in our own way susceptible to, whether it's because of our particular traumas or our responses to them. And until and if we're willing to open up to accepting this as a part of the human experience, will never really be able to see what it looks like on the other side. So I'd love to talk a little bit about what the trajectory and arc looks like when you treat folks and work with folks, facilitate their journeys. Because when I was in conventional psychiatry, a lot of what we would say around psychosis is that it's very egocentronic is the word we would use, right? So it's not often perceived as a problem by the patient versus depression, for example, that is ego dystonic, right? They show up for treatment because they don't like how they feel. Well, the folks who are in these kinds of altered states are dragged into treatment because they don't really have a problem typically with how they feel. It's you who has a problem, the bystanders and observers. So I wonder if that's something you deal with. I'm guessing there's a selection bias because the people who come to you must perceive that there's something that could be integrated or optimized. And what, yeah, like I mentioned earlier, like what does an outcome look like for you when somebody you're working with says, okay, I don't need to work with you anymore? Like what actually shifts? What happens there? Well, I think first of all, oftentimes people are actually like sent by parents or by family members, something like this. But I think from in the way I do this, In my way of treatment, let's say, or working with people, the first thing that's very important is normalization. So normalizing anything and also see the common humanity. And then we notice that we're not so very different from each other. And this makes that people are feeling safe very easily. This is very important. I think this is the opposite of what I've been experiencing in the clinical mental health is the safety was like very often not there. So I think if you start with safety, normalizing, see the or find me to come in humanity, that is a really great start. then offering a non-judgmental, kind and gentle approach is, you know, a trauma-informed approach is also very important. And what I call spiritual aware, because very often spirituality and who am I question and the greater universe and all kinds of wildness is very often a topic of the conversation. And I find this very interesting and very enlightening to listen to. So I'm also showing that I'm very interested to listen to the story and I'm curious. And then when people start to speak and maybe it's quite wild and broad and the universe and sometimes people also notice themselves that it becomes a little tricky at some points to stay grounded or they feel a little bit confused or lost in their story. And there then I can just maybe offer like support in more like grounding or like not even like a full yoga practice or anything, but I am a yoga therapist, so I know all these skills. So, well, why not try to ground a little bit here and also explain how important it is to ground yourself, to stay connected to the earth, because then all these fantastic things that are here can become your superpowers. But now you may get lost in everything that happens and nobody understands. And then also, I would be honest, I'm super interested, but honestly, I don't understand anymore where we're going, But I really want to understand. So help me here. Help me out. People feel here. And I think if we're really focusing on keeping that superpower of being very open and having this skill of seeing things, knowing also that it can mean that if you're seeing so many things and you're very sensitive for things, that you might also be that person that's puts the finger on the hotspots in society or in other systems. And it might cause troubles and not because of you, but because you're reflecting something or maybe issue or a problem in somebody else. So if people start to understand how their nervous system works, how it works with reflecting and not in relationships, and then it becomes a much more logical story. And it's not so very crazy. So you unpack many dimensions of support, not only for someone who is or has experienced these so-called altered states, but also for loved ones. And I know that's, as you mentioned, part of what you're offering is a kind of a toolkit for people, not only a framework, but then also interventions is probably the wrong word. supportive techniques that others can bring to bear if somebody that they love might otherwise be captured by the system. So in a sort of teaser format, as we close, I wonder if you can share what you see as the most important couple of tools to have in our belt when it comes to encounters with what you described as the way that energy can move in this like almost potentially dysregulated way or disconnecting way versus when you can harness it, you can stay grounded and you can almost live in this liminal space for a period of time until there's a shift, right? And that would look like a very different kind of so-called psychotic episode than what we see in the movies and what you and I have seen in front of our faces. So what do you think are some of the top things to consider when it comes to more acute interventions? Well, literally, I've seen it or I still see it in front of my eyes. I see the acuteness just drifting off quite quickly. Like it's literally a matter of minutes. like and sometimes well it's a little bit hard to give like the because it's it's there's such a broad uh also spectrum of tools let's say and for example like i would not suggest to like to hold people all the time but for example it can it can be that for some people you feel like this is that it needs some holding because a like i work with internal family systems ifs and like i said earlier, this polyvagal theory is very much intertwined in all the work I do. But if you clearly see that there's this baby parts being triggered, then yeah, it doesn't make sense to have this cognitive conversation and to try to solve in a way as if you're speaking to a 40-year-old man. But if you're actually offering, and it's oftentimes also intuitive. It's not all. You know, intuition is very important, but there are also real skills besides that. But if you also dare to step into that and dare to offer stepping in that role of being a mother or stepping in that role of being the really great sister or that friend that a person needs. I think that is very beautiful. And that is also something that back in the day, my colleagues in psychiatry couldn't always appreciate. Like they thought I was not setting boundaries or anything like this. So people oftentimes don't understand it. And I remember, well, there was this man already 15 years ago or something, and he called me his professional friend. And honestly, I was the only one, the only person that he saw on a regular base as a nurse who was coming to his house. And I thought this was so sweet. And back then, like 15, 20 years ago, I still was like much younger than I am now and less developed in that way. But already I felt this was a compliment and I thought this was a very beautiful way of approaching. But I heard my colleagues, they thought that was pretty crazy. Like he's not your friend, you're an expert and you need to know and you are like above them and you need to tell them what to do instead of being equal and a friend. But I feel that it's important if you can play these roles. And this is actually also something that I've learned from you, like this, like to, you know, to sometimes to play a role and do this consciously and play the role of being a mother. Why not? And I don't mean that, I mean, that the person will stay with you for three weeks, but you can play that role for one minute. Like, what is that kind of feeling that the person needs in this moment? So this might be something that is not very common to many people. But yeah, I'm very happy to work in this way and offer what is needed for all the different parts that are being triggered in the moment. Yeah, it's amazing to consider how your ultimate qualification is not so much your credentials at this point, but really the level of parts integration that you've done. Because when you're aware of all of these different dimensions of yourself, then you can empathize on a level that isn't available when you're busy projecting your rejected parts onto the so-called patient, which is what most of us who are attracted to the mental health field are so, in my humble opinion, because we imagine that there is a way to control the experience. And so, of course, by definition, we haven't done the self-integration work that would allow us to meet our bad, so-called bad and wrong, rejectable, let alone crazy parts. So I can see that in the moment where you're sensing what somebody needs in terms of these rudimentary roles and archetypes, really, you can sense that because you've been your way, been there, right? You recognize it. And so the humility that you bring to bear is part of the medicine, right? And I know, you know, you teach in the book a lot of techniques for immediate grounding and presence and co-location with somebody in a shared space, right? Yes. And also, like, there are these techniques that we can all learn very easily. Something with the breath, something that is grounding, you know, to, like, embodiment. We didn't speak about it much, but very important also in psychosis. Nobody talks about it. Like in all these 30 years, I never hear much about embodiment. And I've also did research like in PubMed, but there's not much to find about embodiment and psychosis. Like it's really crazy. But I've been designing interventions in an academic hospital, actually working with first psychosis. And for years, I've been offering these interventions and they were researched and studied. These were yoga interventions. So it was all about the embodiment. And so I've seen it in front of my eyes, what's the result. And sometimes things were triggering. It's also possible. And then we can speak about it. But another thing I think what is in acute situations, very important that people know that I'm available. That's another thing that I think is a little different than what my colleagues do. I am just available. So sometimes people, they text me Saturday night and, you know, I can answer. And so like, I'm not always answering and because sometimes I'm doing something else and then I'm telling the people or, you know, next day, like our next time I wasn't available. But very often, like for me, it's a very small act to, yeah, to see that I see them. So I'm not going fully in and maybe I don't take hours in that time, depending on what's going on. But mostly there is not so much of a big crisis, but it's an ask for attention. And well, it's also not only in psychosis, but especially also personality disorders or other psychiatric issues. It's often said, well, if people ask attention, well, you're actually not giving it. I feel like it works really well to me if I'm just offering that attention because, again, I'm normalizing the situation and people are not asking much attention. If I give the opportunity to call me when they really need it, but I'm also saying I'm also human. Remember, I also have a life. So I try not to use it too often, not only if it's really necessary. People don't overuse it. But if they use it, then and I give maybe just one little sentence, like it takes me three seconds, but it's such a big thing. And yeah, so these are some a little bit irregular things that I do for my clients. Yeah, for human connection, I mean, it strikes me that you're just treating these individuals as adults, which is something that we are not trained to do. Not directly, but indirectly, we are trained to infantilize our patients. And so these radical acts of adult-human connection, I can imagine, are often all that is needed. Well, I am so grateful that you're out there doing this work, offering this service as somebody who doesn't practice anymore. I'm all the more grateful that you are available, literally and figuratively, and that you've also crystallized your perspective into a text. I, you shared with me an early reading of it. I'm super excited to, to make sure that everybody listening has access to your book and to your services. And I want to thank you, Annika. Thank you. Thank you so much again for the invitation. Yeah. I love you.