The need for Changes for more Effective and Humane Treatment of Mania/Schizophrenia, Depression, Anxiety, and Psychotic Breakdown

My present psychiatric diagnosis, is schizophrenia (due to hearing voices and so-called social withdrawal) with occasional depression. This diagnosis is somewhat incomplete, as I also sometimes suffer from mania, where I get very elated, have racing thoughts, and occasionally can't sleep for a whole night. Very occasionally, I don't sleep for two whole nights and days, and on these occasions, I get a burn-out effect of severe depression causing anxiety, and where the anxiety and stress again prevents me from sleeping. Then the severe depression and anxiety, co-exist alongside each other, with one exasperating the other, and thus making me more depressed and more manic or anxious.

On these occasions, I am both very mentally alert and anxious, and yet very tired at the same time, as the severe depression and anxiety, overlap at different times, although the mania or anxiety still seems to be the overall overriding factor. As a result of all of this, psychosis can arise, as the mental alertness and anxiety resides in my sleep, and the sleep or dream-state of mind, starts to manifest itself in my waking consciousness. It is on these occasions, that I find it very hard to sleep much at all, and it is then, that I sometimes experience negative and intrusive hearing voices, and some delusions.

On these occasions, when I am very depressed and anxious at the same time, I need to get short durations of rest or sleep during the day, and gradually increase the durations, and then go to sleep fairly early at night, and sleep more or less right the way through until the morning. I need to get an hour to three hours sleep during the day, to make up for some of the lost sleep at night. I have had manic-depressive, schizophrenic, or schizo-affective psychotic breakdowns before, in 1991, and in 2000, when on both occasions I was first admitted, and then went freely into psychiatric hospital, roughly for a few weeks on each occasion. I have also seen another patient, in 2000, in psychiatric hospital, who was going through very similar experiences to me, and who I tried to help.

The second time I had a breakdown and was hospitalised, I was sedated by 10 mg of Olanzapine, and which decreased the mania, anxiety, stress, and negative and intrusive hearing voices, and which also helped me sleep, but the first time I was in psychiatric hospital, I was not sedated, as I was just on a fairly low dose of 8 mg of Stelazine, and which wasn't a very strong sedative. As a result of this, and as a result of being made to stay awake all day, I had to undergo a lot of unnecessary suffering, and which could very easily have been prevented and avoided, if I was treated more effectively, appropriately, and humanely.

Psychiatrists need to realise, that people who are suffering from a manic-depressive, schizophrenic, or schizo-affective psychotic breakdown, are in great pain, distress, anxiety, and stress, and need an anti-psychotic drug which also sedates them, or a sedative along with their anti-psychotic medication. Psychiatrists also need to realise that these patients, very much need short and increased durations, of rest and sleep during the day, in order to reverse the manic-depressive, schizophrenic, or schizo-affective psychosis - to make up for lost sleep - and to ease their way back into a sound and well-balanced sleep pattern. Most psychiatrists and psychiatric nurses, now realise this, when a patient is admitted to psychiatric hospital, for the first few days, but sometimes these patients are prevented from short durations of rest or sleep during the day, and from the moment they arrive, and which slows down the recovery process and good sleep patterning, and which also prolongs the psychosis. .

My present psychiatric medication is 3 mg of Risperdal a day for hearing voices. Risperdal is fine for hearing voices, but in any dosage, it is not an effective sedative for the mania or anxiety I sometimes experience. I was taking Olanzapine before I was changed onto Risperdal, and which did sedate the occasional mania, anxiety, or stress, and help me sleep, as it is a strong sedative, but I had to come off of Olanzapine, because it can cause or increase diabetes and weight gain.

I very much need my psychiatrist, to make a prescription for me, for a sedative, so I can take it when the need arises, and to arrange this with my GP, to be added onto my regular prescription, so I can put a tick next to it, and collect it from the chemist as the need arises. I have requested this twice before, but all that has happened is that my Risperdal dosage was increased, as it was still believed by two separate psychiatrists, that I was experiencing stress and anxiety due to schizophrenia. This also means, that the psychiatrists need to add to my current diagnosis, from schizophrenia with some depression, to schizo-affective, and so I am treated and medicated humanely and properly.

I saw my psychiatrist recently, and gave him a letter explaining the main points of all of this. His first response, was to say that I was not schizo-affective or experiencing mania, and that he had seen no signs of these symptoms in me. I commented that when I am manic, he isn't there with me to see me, and that he would have to live with me, or experience what I do, to see signs or symptoms of mania. He said that I wasn't manic, because mania has three main aspects to it: 1. Motor movement symptoms, 2. Mood symptoms, and 3. Thought symptoms. I explained to him that I did have racing thoughts, elation, and restlessness when I am manic, and when I can't sleep for a whole night or nights, but he said that I don't have manic motor movements, and that the racing thoughts, elation, and restlessness were caused by the Risperdal that I take, and that I still didn't have all three components to mania.

My psychiatrist then said, that I suffer from neither classic manic depression disorder nor classic schizophrenia, because I had a lot of insight into my mental health problems, and that most manic-depressives and schizophrenics have no insight into their own mental health problems. He said that I was suffering from a mental illness because I hear voices, and that I also suffer from stress, and from the side-effects of the Risperdal anti-psychotic medication that I take. In response to my request, he has now prescribed me a sedative (1 mg of Lorazepam), to be added onto my repeat prescription, and to be used as the need arises, and he suggested that he doubled the strength of my sleeping tablets, and which I have agreed to.

So it is the case that me and my psychiatrist, have a fundamental disagreement about my diagnosis. I say I sometimes suffer from mania, and he says that I don't, but that I suffer from a mental illness and stress. One criticism I have of some of what he said, is that he is taking a very textbook, extreme, black and white thinking view, of what is mania and what isn't, because there are various degrees of it, but I think that I do get the occasional manic episodes or cycles. I am prepared to admit that I could be wrong, or that the mania is actually something different, like stress, as he suggests, but he never says that he doesn't know, or that he could be wrong. He is a bit of a know-all, and always thinks that he is right. He can also never seem to agree to differ with me, but instead seems to militate against what I say, if it is different from his own opinions and explanations.

The other main criticism I have, of some of what my psychiatrist said, in our latest session, is that I don't have classic manic-depression or schizophrenia, because I have a lot of insight into my own mental health problems. I agree with him, that I have a lot of insight into my own mental health problems, but it is not just insight about my own mental health problems, but also based upon my observations and interactions with other psychiatric-diagnosed people. I am also able to be receptive, to the mental health problems of others, and internalise their thinking-patterns or similar experiences, so I can learn about this, teach others about it, and understand and help them.

The other point, is that there are reasons why most psychiatric-diagnosed people do not have insight into their own mental health problems, as they are discouraged from doing so by most psychiatry, social work, and the mental health system. The rule of confidentiality, is often misused to prevent people from seeking the causes or influences to their mental health problems, and for finding solutions, and from sharing their experiences, and learning and teaching with others. Most psychiatric-diagnosed people, are encouraged to be very selfish about their mental health problems, and to remain very ignorant and secretive about it, including many of those diagnosed people, who see themselves as outspoken users of services, or psychiatric survivors.

My Most Recent Mystical Experience

For me, a mystical experience does not necessarily mean a religious one, but rather a revelation of a deeper, extended, or more hidden aspect of social reality. There are certain types of music, which induce deep, spiritual, mystical experiences in me. One such CD, is called Milk and Kisses, by The Cocteau Twins. It is not my favourite album by The Cocteau Twins, as Treasure is my favourite album by them, followed by Blue Bell Knoll, but it's the one album which has the most spiritual and profoundest effect upon me. It's also an album which I have to play over and over again, for it to have the full effect.

The last time I listened to Milk and Kisses, I listened to it for about three hours, whilst in a very receptive and meditative state of mind, and I fell into a kind of trance, and into a state of mind inbetween sleeping and waking. With my eyes closed, and being half-asleep, I saw people I knew, in the room, and very briefly conversed with them, even though they weren't really there, and the whole experience was very pleasant and reassuring. One person I saw was an old woman, who I'd not seen before and didn't know, and who said she had been occasionally watching over me.

What occurred to me about all of this, was that it opened my mind up to a reality which exists beneath sleep, and is a set of weavings of our connections with known and unknown others. It is the internalisation of reality, and a basis of another kind of social reality, internalised into our experience and mind.

I used to drink and socialise with an half-Irish friend, and because I was with him in both experience and mind, in the ways I related and connected to him, I was able to absorb and internalise his thoughts, emotions, and experiences, through a kind of transference, and now I know what it was like when he used to talk, shout at, and see people who weren't there. I now have a deeper and wider understanding of this, that there is much more of an aware and active state of mind beneath sleep, but which we only partially become aware of by experiencing dreams whilst we sleep.

Thinking Allowed: Hearing Voices

The Radio 4 programme, Thinking Allowed, linked on the Intervoicewebsite, looked at new sociological research on hearing voices. Theprogramme started off with an extract from Woman's Hour, of a womanwho heard the negative voice of her stepfather, who died when she was three.

Julie Arthur-Kirby was the guest speaker on the ThinkingAllowed programme, and senior lecturer, in the department of socialand psychological science, at Edgehill University, and author of apaper called Natural Body, Social Mind,: An Experience of VoiceHearing. I thought it was an excellent programme, which said many things whichI had discovered from my own experiences, observations, and findings,and had written about in my articles. I agree with the speaker, JulieKirby, that people in supportive social environments, experience supportive voices, whereas people in disruptive or unsupportive environments, experience disruptive and unsupportive voices. I now live in a supportive environment, and I hear positive and supportive female voices (mostly when and where I want to hear them), but if mycircumstances ever changed for the worse, or a bad or negative event triggered me, it could very easily bring the negative and intrusive voices back.

It was also mentioned in the programme, that the negative voices canchange to positive voices, if the person's social circumstances changed, and as they meet new people, and then the voices take upon the characteristic of those new people. This has been very true for me, as I have internalised the positive and supportive voices, of female psychotherapists, I have had therapeutic relationships with in the past, and who were both very good to me.

I'm glad it was mentioned in the programme, that voices can be caused by or due to over-socialisation. This often occurs, when psychiatric-diagnosed people, are forced to socialise against our consent or will, and when our privacy is violated and invaded. Social interaction is very important, but it's also important that it isn't forced upon us, and that our privacy is also safeguarded, respected,and protected.

Speaking in Tongues, Mumbling Out Loud, and Incoherent Speech (Part III)

As a psychiatric-diagnosed person, I realise that all kinds of different people, have all kinds of different responses towards myself and other diagnosed people. There are also some common trends and behaviours amongst non psychiatric-diagnosed people though, especially where mentalism is concerned.

There are some people in society, who will try to provoke mad, irrational, and disruptive responses in psychiatric diagnosed people, by acting provocative and crazy, and because they have issues with their own mental health problems, and which remain unexplored and unresolved. I also find that many people in authority, have communication problems and personality disorders, in that they can't enter into any kind of mutual discussion and debate, are very easily irritated, and lose their concentration very quickly.

Some people will also project their communication problems, onto psychiatric diagnosed people, to say we have a communication problem,and that we can't conform to normal, mutual, or structured conversation, when the communication problems are theirs and not ours. These people usually have problems with their own identity, and with integrating into society in some way.

In my previous two articles on incoherent speech, I looked at the nature of such speech and language in context to the social and interpersonal causes or influences. I feel it's important here, to again mention that incoherent speech is not a disruptive thing, which is trying to fragment, destroy, or divide mutual conversation, although it is usually a response to some conflict and fragmentation by others, in that it seeks a wider or a mutual consensus.

When psychiatric-diagnosed people, make what seem like strange statements, this is to a great extent, because they are imagining a statement, that would be referred back to their thoughts or commentsabout something. They are also imagining a statement, of something referred back to them in agreement or recognition, and which again, is part of a common consensus. The consensus in society, of ordinary everyday speech, then becomes internalised within the person, who then releases this, in order to experience and externalise it.

I was also saying, in my first article on incoherent speech, that psychiatric-diagnosed people often talk seemingly incoherently, as a way of avoiding the rational thought-control of the voices or of other people, because if the psychiatric-diagnosed person speaks in meaningless statements, this can disrupt the voices rational dominance and control, and fragment or distract the voices from the conscious mind.

I realise that for some people reading this, they may think that therefore psychiatric-diagnosed people, are opposed to all rational thought-control, as in the context of normal relating, or transactions, and everyday conversation and speech. This was not what I was saying, because I was referring specifically to hearing negative and/or intrusive voices, and talking about very negative and critical one-sided inquisition.

There may be some psychiatric-diagnosed people, who are indeed opposed to all rational thought-control by other people socially, and that has to be taken into consideration, and realised that there are all kinds of reasons why they are like that, but that in many ways, it is a reasonable stance to take. On the other hand, most diagnosed-people, are not opposed to actual rational free-thinking and communication,and very much value the importance of rational thinking and logic, in context to sound thought and communication, and in context to safe and sound mental health.

This Voice (poem)

Oh, this voice
Would sound like a miraculous mountain
Of truth and wisdom.
Like an evolving sphere of conscious continuum
If only you could hear this voice.
Like a band practise at it best,
And like an unteachable test,
A message of determination and choice,
If only you could hear this voice

A resume of the book "Stigma - Notes on the management of spoiled identity" by Erving Goffman

Erving Goffman defines stigma as something which extensively discredits and disqualifies the individual from social acceptance and limits life-chances. Overall and throughout, he reviews some popular work on stigma, and then at the end of the book clarifies the relation of stigma to the subject matter of deviance.

He begins by explaining that the Greeks originated the term stigma to refer to bodily signs which were cut or burnt into the body, and which were designed to expose something unusual or bad about the person, that a religious term stigma was then used to describe blemishes upon the flesh claimed to be from holy grace, and that then a medical term stigma was used to describe bodily symptoms of physical disorder. Now in the present day, the term stigma is used much in the original sense, but to refer to the stigma itself rather than to bodily signs of it.

He says that there are demands made upon a person by others through ritual interaction, but that these demands become righteously presented demands. He also says that these demands are made in effect, meaning that we don't realise what these demands are until they are looked back upon in retrospect. He therefore makes a distinction between what he calls a virtual identity and an actual social identity, meaning that the virtual is what is imagined or unconsciously anticipated, and that the actual is what is actually revealed and realised about the person. In this way, he describes stigma as a special kind of relationship between attribute and stereotype, and with a discrepancy between a persons virtual and actual identity.

A stigma is something which discredits a person from normal everyday acceptance, and he describes it as something which only looks at a part of a person, rather than looking at the whole person. A stigma regards a person as not quite human by definition, can rationalise an animosity based upon social class, and create a whole range of imperfections based upon the original one. He also says that a stigma can involve double-standards, of an expectation or demand made about another person that does not apply to the person themselves who is making the demand.

He talks about a gestalt of disability, meaning that the stigmatised person who has a failing in one area might be automatically assumed by others that he is disabled in other unrelated areas, and he describes how a split may occur between self and self-demands, with the self turning against itself in not accepting itself as others may not accept it.

He then says that having a stigma can make a person very self-conscious about what others are thinking, by having to calculate the impression he or she is making. He says that minor feats of ability of the stigmatised can be seen as extraordinary things by the non-stigmatised (or normals), and that minor failings can be seen as part of stigmatised differentness. He says that a show of emotion can be held back by ex-psychiatric patients, as the person may be afraid that this may be taken as a sign of his disability, and that he may feel exposed because some people may have a morbid curiosity about his condition.

He also says of the psychiatric patient that whilst hospitalised, and while he is with adult members of his own family, that he is faced with being treated tactfully as if he were sane when there is known to be some doubt, even though he may not have any; or he is treated as insane, when he knows this is not just.

He then talks about the own and the wise. The own means those who have the same stigma, and the wise are those who have become knowledgeable about stigmatisation, and to some extent share the burden of the stigma, and who are friends, relatives, or representatives of the stigmatised; and he talks about group formation of the own and the wise, mentioning that the wise must not only be offered but also accepted by the own. Representative groups may differ or even be at competition with each other on the matter of management by the own or by the wise.

Moral career

is described as when the stigmatised adopts the standpoint of the normal, acquires the identity beliefs of the wider society, and has a general idea of what it would be like to posses a particular stigma. The stigmatised learns that he has a particular stigma, and this time the consequence of possessing it. The timing and interplay of these two initial phases form important patterns, and establish the foundation for later development and distinguishing among the moral careers available.

A turning point of a moral career, or a radical reorganising of ones past, is when the stigmatised accepts his own group of stigmatised people as full-fledged human beings, removes his own prejudices from the past, and questions the prejudices of his pre-stigma acquaintances.

In the chapter on information control and personal identity, he says of social information, that it is about the more or less abiding characteristics of a person, as opposed to the moods, feelings, or intents that he might have a particular moment, that it is conveyed by the very person it is about, and conveyed through bodily expression in the immediate presence of those who receive the expression. Some signs that convey social information may be frequently and steadily available, and routinely sought and received, and these signs he calls symbols.

Prestige symbols can be contrasted to stigma symbols, namely, signs which are especially effective in drawing attention to a debasing identity discrepancy, breaking up what would otherwise be a coherent and overall picture with a consequent reduction in our valuation of the individual. By intention or in effect the ex-mental patient conceals information about his real social identity, receiving and accepting treatment based upon false assumptions concerning himself.

Gffman describes three phases in the learning process of the stigmatised as: 1. Learning the normal point of view and learning that he is disqualified according to it. 2. The next phase consists of his learning to cope with the way others treat the kind of person he can be shown to be. 3. Learning to pass (i.e. hiding or concealing social and personal information about a disability).

He says that what are routine for normals can be difficult situations in managing information to the stigmatised, and that a person with a secret failing must be alive to the social situation as a scanner of possibilities, and is therefore likely to be alienated from the simpler world of which those around him apparently dwell.

Goffman uses a threefold typology of social identity (what can be actually known about the person from their abiding characteristics), personal identity (documentation or group of facts known about the person), and ego identity (that which the individual feels about stigma and its management).

He writes that identity ambivalence (to his own group) might be felt by the stigmatised when he sees his own acting in a stereotypical way, flamboyantly or pitifully acting out, and that he may feel normal in comparison to those more stigmatised than him.

He also says that professionals will help out, sometimes of telling how they handled a difficult situation, and he goes on to describe what he calls professional presentations. He says that a disclosure etiquette develops, meaning that the stigmatised is told to reveal discrediting information about himself in a matter-of-fact way, at an appropriate time, and calmly. (Breaking the ice and humour may also be used by the stigmatised to disclose information about a disability.)

He says that advise about personal conduct sometimes stimulates the individual into becoming a critic of the social scene, an observer of human relations. The stigmatised can become 'situation conscious' while normals present are spontaneously involved within the situation itself constituting for these normals a background of unattended matters.

Professionals in their presentations both encourage the stigmatised person to be a part of his own group and different, whilst also (contradictorily) encouraging him or her to identify with normals and the wider society they constitute. Of these professional presentations are warnings against attempting to pass (hide stigma) completely, and against fully accepting as his own the negative attitudes of others around him. The stigmatised individual is also warned against minstrelisation (foolishly acting out bad qualities imputed to him) and normification (pretending to be very normal).

He says that an 'adjustment model' is presented and that the individual is told he must not be ashamed of his difference and try not to conceal it. And because normals have their troubles too, the stigmatised individual should not feel bitter, resentful, or self-pitying. A cheerful, outgoing manner should be cultivated. Normals really mean no harm; when they do, it is because they don't know any better. Normals should therefore be tactfully helped to act nicely. Snubs, slights, and untactful remarks should not be answered in kind, but the normal must be re-educated, point for point, and with delicacy showing that in spite of appearances the stigmatised individual is a fully human being. The stigmatised are to be gentlemanly and not to push their luck; they should not test the limits of the acceptance shown them, nor make it the basis for still further demands.

The tolerance of normals is advocated as part of a bargain of which is the 'adjustment model', but which is really a one-sided agreement. The nature of a 'good adjustment' requires that the stigmatised individual cheerfully and un-self-cosnciously accept himself as essentially the same as normals. Since the good adjustment line is presented by those who take the standpoint of the wider society, one must ask what the following of it by the stigmatised means to normals. It means that the unfairness and pain of having to carry a stigma will never be presented to them; it means that normals will not have to admit to themselves how limited their tactfulness and tolerance is; and it means that normals can remain relatively uncontaminated by intimate contact with the stigmatised, relatively unthreatened in their identity beliefs.

Of the difference encouraged by professionals, Goffman says that this differentness itself derives from society, and that before a difference can matter much, it must be conceptualised collectively by the society as a whole. Thus, even while the stigmatised individual is told that he is a human being like everyone else, he is being told that it would be unwise to pass or let down his own stigmatised group. In brief, he is told that he is like everyone else and that he isn't. The individual is also asked to regard the acceptance normals have of him as if it is complete acceptance when it isn't. Thus a phantom acceptance is allowed to provide the basis for a phantom normalcy.

On deviation Goffman looks at ordinary deviations, saying that the playing of the stigmatised role and normal are both required to be accepted as part of ones own and the wider society. He then goes on to look at deviations in high and lower society as groups, except for the group-isolate individual who remains isolated. He points out that whilst there are iatrogenic treatments which can cause illnesses, so there are iatrogenic labels which students create in order to study people.

Speaking in Tongues, Mumbling Out Loud, and Incoherent Speech (Part II)

After reading my first article on Speaking in Tongues, Mumbling Out Loud, and Incoherent Speech a few times, I imaginatively empathised with the readers, and thought I should say more on the matter, and on other related issues. Plus, I have had some new experiences of speaking seemingly incoherently, both in terms of the social and interpersonal causes or influences, and in dealing with, and understanding, people's various reactions and responses.

 

I want to say more about so-called talking in tongues, as I didn't mention this much in my first article on the matter. I sometimes talk in tongues, when I am brainstorming for thoughts or ideas, or after a long day or evening of conversation, and which is the residue thoughts, emotions, and conversation from the day or evening, going through my mind, and releasing itself. This has the same or a similar affect to Buddhist, Hindu, or other religious chanting, as a kind of meditating for re-charging or emptying the mind. Talking in tongues, can also be a way of dealing with overwhelming creativity, imagination, or emotional passion.

 

In my first article, on seemingly incoherent speech, I mentioned that this can be similar to the way, that a person takes notes in studying, as thematic reminders, and are therefore condensed elements of details and huge chunks of information. A good example of this, was some years ago when I was in a pub, and I used to sit and drink and write lots of notes in my writing pad, on my forthcoming articles. One of the bar staff, who asked to read my notes (without asking that they were indeed just notes), asked me if I minded her showing them to her colleague, to show her colleague what she described as disorganised, rambling, and crazy nonsense. This is the same with some incoherent speech, that if the other person or people, don't attempt to acknowledge or unravel the symbolic and condensed details, and huge chunks of information behind it, then it will indeed seem incoherent and like crazy nonsense.

 

It's important to look at some other people's defensive, ignorant, and prejudiced reactions, responses, and assumptions, towards seemingly incoherent speech. The other person or people, might think that the psychiatric diagnosed person who is speaking seemingly incoherently, is taking the Mickey out of them, or deliberately trying to confuse or annoy them. Other assumptions, are that the person is either crazy and irrational, or that they are being arrogant to expect others to go through all the effort of decoding, and that the person is also lazy, because they can't be bothered to explain their ideas to others, who have different interests and emphasis, and who might need clarification. This view is intolerant to what seems like crazy nonsense, insisting that there are plenty of other people out there, who will be seen as talking actual mutual meanings, instead of what is seen as cryptic doggerel.

 

There may be some people who for various reasons, can't moderate or translate their seemingly mad language, and so I see my role as defending or speaking out for them, as I also sometimes mumble out loud, speak seemingly incoherently, and speak in tongues, but I have the insight, experience, and observation to understand and explain it, and know how to relate, connect, and respond to it. Also, in my articles I try and move to the level of others, very much share in mutual meanings, and I try to imagine the level of the other people's understanding, and move to a position where I can speak in their terms.

 

One of the reasons psychiatric diagnosed people, speak seemingly incoherently or ramblingly, is because they don't want to be pinned down to restricting specifics, and because they do not agree with the over-riding superstructure, fixed, narrow, or rigid agenda of the conversation. Psychiatric diagnosed people , have much more of a tendency, to talk seemingly incoherently in a group, when there is a lack of democracy, and when there is one or more people dominating or controlling the conversation, and not least because they want to change the subject or shift the agenda.

 

Sometimes a psychiatric diagnosed person will say something, that seems like it is out-of-context, but is actually some line out of a poem, song, or film they have seen, or some other idea which occurs to them, and which takes on a new humorous meaning, when mentioned in context to the conversation, although it's not always mentioned where the term or phrase originates from. This is quite common amongst some people, and not necessarily done by psychiatric diagnosed people.

 

One very strong assumption and myth, about some people who sometimes speak seemingly incoherently, is that they are trying to fragment or disrupt a conversation, and are thinking or operating through a process of disconnected or disorganised thoughts, emotions, and ideas. It is also seen as a very subjective way of thinking and relating to others. Very critical, negative, and judgmental responses and reactions, can cause the psychiatric diagnosed person to retreat from the narrow or usual mutual meanings, speak seeming nonsense, and talk what seems like metaphysical thought and speech. In actual fact, when a psychiatric diagnosed person does this, it can be due to connecting themes or parts, and not disconnecting them, but to change the nature of the conversation from very critical, negative, or judgmental, towards some kind of wider shared meaning and consensus, and in order to avoid conflict. It is a way of the psychiatric diagnosed person, sorting this out in their own mind, and trying to change other people's way of communicating. This puts the subjective themes or ideas of both individuals or groups, into a new meaning and context, and into a more objective point of shared compassion and agreement.