Psychosis is a broad term that refers to the symptoms of a range of mental illnesses and is generally characterised by delusions, hallucinations, an inability to evaluate objectively and serious defects in judgement and other cognitive processes, examples of such illnesses might be Schizophrenia or bipolar disorder.
The encyclopaedia Britannica defines psychosis as ‘A severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration of normal social functioning’
A large variety of mental and physical symptoms such as bodily tics, compulsions, phobias and anxiety would be described as neuroses. They are all characterised by having no clear organic or neurological cause and differ from psychosis in that they are all non-specific mental illnesses that can trigger feelings or of distress but do not prevent rational thought, they may impair but not prevent normal social functioning.
Scottish doctor, William Cullen, first coined the term neurosis in the 1700’s, he used it to refer to ‘disorders of sense and motion’ that were caused by ‘a general affection of the nervous system’, he used the term to refer to a range of disorders that could not be explained physiologically. Freud later described mental illnesses with defining features of distress or extreme anxiety as anxiety neurosis.
Psychotherapy and hypnotherapy are the primary type of treatment for neurosis as medication is seldom appropriate or useful. Areas such as stress management, controls of phobias, compulsions and habits have all been shown to respond very well to this type of treatment.
Brief Reactive Psychosis is characterised by the same symptoms as psychosis, such as delusions, hallucinations, disorganised speech and catatonic behaviour. To be termed brief reactive psychosis the symptoms must be present for more than a day but less than a month and for the person to then return to previous normal functioning.
Stressful or traumatic events such as bereavement are thought to be one reason brief reactive psychosis can be triggered but it can often occur quite suddenly without obvious cause. It is not proven that there is a hereditary link to the condition but this has often been suggested. However, by definition, if the symptoms are triggered by alcohol or drug use then they are not brief reactive psychosis.
Often when people display psychotic symptoms, a preliminary diagnosis of brief reactive psychosis is made only for it to be later revised to another psychotic illness, such as schizophrenia, if the symptoms continue to occur for more than a month. The condition is most likely to be seen in adults in their 20’s, 30’s and 40’s and is only half as common in men as in women.
The prognosis for the condition is good as, by definition, the symptoms go away within one month. However, due to the nature of psychotic behaviour, it can often lead to violence, self-harm or sometimes suicide. Clearly, if any of these are a risk then a person may need to be admitted to hospital.
Anti-psychotic medication can be used to control the symptoms and people experiencing the condition can have recurrent episodes in response to further stress.
Psychotherapy is known to be an effective treatment in dealing with the emotional stress that triggered the episode, and in helping the person establish coping strategies to minimise the effects of future stressful situations to prevent recurrence.
Psychotherapy is increasingly being looked on as an important alternative to drug therapy alone. One fifth of all patients with long term psychotic illnesses do not respond solely to medication and so using psychotherapy as part of an integrated approach can be very effective. It is important to remember that hypnotherapy is not suitable for use with patients experiencing any form of psychosis.