Women and Psychosis: When the Voices Come

Women and Psychosis: When the Voices ComeDahlia’s teeth were perfectly aligned and so white they were nearly blue, not because she still had dental insurance for bleaching procedures—she’d lost her job in investment banking four years ago—but because she was clever at finding ways to secure lovers who’d be more than happy to help her keep her lifestyle. It wasn’t hard; Dahlia was smart, very smart, and beautiful. She had been extremely successful over a short time and yet she knew how to keep the focus on a man whenever he was the kind of man who needed to feel important, dominant. She’d converted her savvy with high powered clients to an acumen and shrewdness in how to convince a potential suitor to buy—no, invest—in exactly what she was selling.Dahlia walked expertly on nude Louboutins, carried a black Birkin bag, and wore a nose ever so slightly touched by the practiced hands of a surgeon. She was blond the way women who sit in a hydraulic chair with thin strips of foil covering their crowns no less than once per month are blond, which is to say, perfectly. But Dahlia had a secret, one that was growing larger by the moment, threatening to unravel even the fine silk fibers of her Hermès scarves.

This year, Dahlia’s beau was a shipping magnate from London. Luckily for her, she only had to see him twice per month—luckily, because she felt mired in quicksand. Any movement she made sent her sinking faster.

It was a Sunday in January, still early morning, and she had retreated to the rooftop terrace of her Manhattan apartment building. She needed the wind and air to unclog her mind; Dahlia was hearing voices again.

You’re hideous.

Everyone knows you’re a fraud.

Nobody loves you. You cannot possibly be loved! Look at you!

You should die. Kill yourself! Do it! Do it, Dahlia! Join your mother.

Dahlia had lost time. She had no sense of where she was. She only knew she was wearing a wretched shift dress in a fabric that never should have been invented. A too brightly colored afghan was wrapped around her shoulders. She was terribly confused. Then a woman with short cropped hair and a kind face she recognized stepped forward—the nun. Dahlia had been taken to the church again by her building’s landscape gardener. She collapsed into the woman’s arms.

Hearing Voices

Whenever we hear the term “psychotic,” an image comes to mind, one launched inadvertently from the collective cultural archives. We see, perhaps, the rough outlines of a bum standing on a street corner. He’s disheveled. He’s perhaps wearing every item of clothing in his possession and hasn’t bathed in maybe months. He’s shouting at the air. Or we think of the classic psych ward image that is inescapable if we’ve ever watched television or seen the movies—people shuffling numbly about in hospital gowns, catatonic with blankly staring eyes. But what most of us don’t see is our sister or mother or, say, a high powered executive. Psychosis can, and does, happen to anyone.

Joan of Arc, Teresa of Avila, John of the Cross, Socrates, Sigmund Freud, Anthony Hopkins—all reported to have heard voices, and yet, each of them a master of his or her own particular talent, purpose, or craft. Of course, on the other extreme are people like Michael McDermott, who in 2000 used an AK-47 assault rifle to gun down seven people at a Wakefield, Mass., technology firm. McDermott was a diagnosed schizophrenic who claimed he had committed the act on the orders of the Archangel Saint Michael. It’s important to point out that such an instance of extreme violence committed by a person who is experiencing a psychotic break is vanishingly rare.

Instead, between these two extremes, exist the lives of millions of people who live outwardly “normal” lives while they suffer, often direly, with internal anguish over a phenomenon they do not understand, and which, too often, becomes so unsettling that it ultimately overwhelms their ability to live functionally. Current research indicates that 1 percent to 3 percent of people will experience psychosis in their lifetime.

Psychosis occurs across cultures and is entirely indifferent to the socially constructed ladder of socio-economic class. No one is impervious. Gail Hornstein, personality/social psychologist, author, and quiet expert on mental illness, explained in an interview with The Sun Magazine:

Many people who hear voices never attract the attention of the psychiatric system. Estimates are that 4 percent of the UK population hears voices — approximately the same percent that has asthma. In Western society we most often associate hearing voices with illness. If we lived in a part of the world that was given to greater religiosity, unusual psychological experiences might be labeled as divine gifts. All the major religions of the world include figures who heard voices or had other anomalous psychological experiences. If the pastor in an Evangelical Christian church tells the congregation, “God spoke to me last night,” no one in that church thinks he has lost his mind.

Whether the phenomenon is considered an aberration, she goes on to say, depends largely on the extent of a person’s suffering. In the instance of Dahlia or anyone else whose previously well-ordered life begins to crumble due to the experience of what we see through the lens of Western medicine as mental illness, steps must be taken to treat the psychosis so that the person can regain or achieve wellness and functionality.

Dahlia was lucky. Due to the compassionate outreach of a stranger, she eventually found herself in much needed therapy to contend with both recent and buried stresses. She began making regular visits to a psychiatrist and taking medications that began, finally, to assist in quieting the voices she found so disquieting. Although she faced many changes, not the least of them work and lifestyle, she began to face herself more directly, with open eyes. And she found she could, for the first time, embrace the woman she saw in the mirror. Eventually, the only voice she heard when alone was her own.

Posted on December 7th, 2013

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