Schizophrenia, the Pink Elephant and Imagination

If someone says to you “don’t think about a pink elephant”, it’s naturally difficult not to have an image of one spring into your head (unless, of course, you've never seen an elephant).

The same idea applies certainly when it comes to my experience of what some may term 'hearing voices' and maybe to the experience of others too.

However, in place of someone telling me not to think of a pink elephant (in order to conjure up the image of one), you’ll find worry there.

The worry can be about many things, but they all gravitate about the same point, which is that I am really a bad person who wants to do horrible things.

Where it gets tricky is that this worry isn’t voiced internally – so, for example, I’m not consciously going around with the thought in my head: “I don’t want to hurt him (or her)!”

The unfortunate effect of this lack of internally voiced worry is that it is me who seems to be directly generating the 'voices'. 

It seems as though my mind jumps straight in with, for example, the thought of “punch him/her!” (or the equivalent visualisation of such) in response to a situation. It does this with no apparent stimulation other than what one would naturally assume (and I have done) must be the desire to punch random men and women.

When it came along, the idea of hearing voices really appealed to me simply because it instantly absolved me of all the guilt that I had charged myself with over the years. 

I welcomed it with open arms because the content of the 'voices' didn't sit at all well with my character. By defining them as voices meant that I could separate these bad, foreign feeling thoughts from my own good thoughts.

Interestingly, although for a long time I felt as though I had no imagination, now I see that my imagination was always there, I just didn’t recognise it as what it actually was, which, as it turns out is these voices in my head.

It’s only since happening upon the idea of the pink elephant, that I have been able to reach this conclusion. The pink elephant - or rather, the general worry - stimulates my imagination into thinking of horrible things; just like how it’s difficult to stop yourself thinking of a pink elephant when you are told not to think of one.

Unfortunately the horrible things are easily misconstrued as negative due to their content - whereas in reality this is not the case at all.

I now no longer berate myself for hearing these voices. Instead I give myself a big pat on the back when they spring into my mind because they show that I am a very caring person (after all the sole reason for their existence is my desire not to think them). 

I then give myself a second pat on the back in congratulations for having an imagination which can come up with such a creative - albeit terrible - idea; and also picture it so vividly that, at one point, it proved so paralysing to my existence.

I now no longer think of myself a ‘voice hearer’ but instead I think that perhaps the description: 'voice imaginer' is more apt.

Because I had suppressed it out of fear for so many years, I am still in the process of re-engaging with my imagination. I have found that mindfulness meditation has helped, and continue to help me enormously along this path (I often take time to sit back and mindfully listen to and watch my imagination).

Since seeing the voices this way I have noticed a huge difference. It's as though, now that I have owned them using the idea of the pink elephant, they have literally given up their bombardment of my mind.

All schizophrenics go to hell

For as long as I can remember I’ve always been very creative; but also sensitive to the world around me (as many others are I'd imagine). This was okay when I was young because I was a child then and it’s a fact that children are nuts.

However at some point I found the world around me was too much to cope with and as a result I imagined and created a reality for myself where I was in a kind of coma and the world and everybody in it was a figment of my imagination.

At the time this helped a lot, although I was only living a half-life I suppose.

This coping mechanism probably had something to do with my imaginative capabilities, but unfortunately I got so messed up in trying to marry up my nature with a world that is fundamentally unnatural, that in the end I literally shut down everything, leaving just a shell with nothing inside.

Eventually I was diagnosed as a paranoid schizophrenic.

Recently, though, I was introduced to the idea of auditory hallucinations, and because the things in my head do feel external to what I would consider ‘my’ thinking, it seemed to fit that this was what I was experiencing.

There was now a line between the true me and the evil 'voices'.

Of late, I’m starting to wonder if these voices are nothing more sinister than my own imagination. Have I been making a distinction with them simply because they can be pretty nasty and distressing and go against what I would consider to be my personal values?

I’ve also been noting with interest that, often, when I am thinking of something to write, I will just sit back and wait for a voice to pipe up with an idea - of course I don’t always jump on the first thing to be thrown up, since all manner of things appear before me.

The interesting thing is that these ideas feel as though they are coming from the same place as do the voices which plague me especially at darker times.

That’s why I’ve started to wonder if the so called hallucinations aren’t a symptom of a problem with me, but are in fact the imagination which I never learned to cope with and so shut away and abandoned along with everything else.

I suppose it now follows that my new challenge is to re-engage with my imagination.

I can see that the thoughts which - thanks to my religious upbringing (also known as child abuse) - I would have perceived as sins and so tried to suppress, are not evil and do not make me hell worthy.

I am now atheist, as it happens, and so free of the fear of this kind of thought transgression anyway. Unfortunately I am the person I am today because of my experiences, so it is going to be difficult to change – not impossible, but definitely difficult.

At least now I am not afraid to be around people whilst hearing voices and seeing images telling me that I want to rape/punch/kiss/kick/etc them. It is still difficult to be around people because I’m not always on the ball like I am now and tiredness (among other things) plays a major factor in hampering my ability to cope.

The content of the ideas may be troubling but I believe it stems from the fact that my brain is not only a primeval one and not suited to the modern world, but also an extra sensitive and creative one too.

Anxiety that you can't 'push through'

I used to experience a lot of anxiety and panic attacks not long ago. I believe they stemmed from the delusions that people could see inside my head– and the paranoia that accompanied this belief.

The delusions and paranoia developed because I experienced horrible auditory and visual hallucinations and was so fearful that people might be able to get inside my head and see them that I started to believe that they were able to doing so.

I was taught in therapy sessions that all I needed to do was push through the anxiety or panic and once I’d reached the other side I would see that there was nothing to fear to begin with.

The only problem with this reasoning was that the situation itself didn’t bother me – it was the belief that people could see my thoughts that was the problem; and that’s not something that you can disprove.

Vulnerable members of society & housing

The council found us a place to live due to my vulnerability as a sufferer of mental illness when we were facing homelessness nearly a year ago. The flat looked good when we first moved in but it’s now clear that all the problems were literally painted over.

It wasn’t long before mould started re-growing so we alerted the landlord and he told us to open the windows in order to get air circulating. This was fair enough in the spring and summer but now that we’re in autumn it isn’t so simple.

As it turns out our building has no damp course and instead of putting one in the landlord has opted to attach six inch fake walls to the existing mouldy walls in what seems like a quick fix.

Unfortunately there is now mould in every room so the house reeks of it; plus to compound the issue both my wife and I have asthma which is especially affected by mould.

The bit that gets me though is that we have informed the council of the mould situation and yet they still want to house people here when we move out, which I think that is deplorable.

It's a struggle for a young, vulnerable couple to deal with a landlord who behaves like this. It causes a lot of stress, which has gone on to exacerbate my condition and prevent me from proceeding any further with my recovery. 

What do you do? - Schizophrenia - Claiming benefits

I am in still recovery after being diagnosed with paranoid schizophrenia nearly a decade ago. As of yet I have been unable to hold down a job – though not through lack of trying. I hate having to rely on benefits but I have no choice except to do so at the moment.

I don’t deal very well with stress because, as a mechanism for coping, I have shut myself out of my head so that I can only process things by talking to others or sitting down and writing them out. Couple this with the emotional and thought numbing effect of the anti-psychotic medication and you can see my problem.

At the moment stress comes in many forms but the funny thing is that it affects me without it consciously playing on my mind. By this I mean I find myself getting so worn out that it feels as though I’ve crashed into a brick wall but I have no idea why.

When I get into this state I have no energy left to deal with the barrage of intrusive images and thoughts that accost me, telling me (amongst other things) to harm or even kill myself.

Having to be extra cautious not to get into such a state means I am severely limiting what I do day to day. I want to be capable of doing a job now but the reality is my recovery is what’s most important at the moment. 

The human mould

Has it ever been so difficult being inside your own head that you spend every second trying to get out of it?

I latched on to learning Japanese as an outward focus and it enabled me to avoid thinking and in doing so get out of my own head.

As I recovered following the psychotic episode I began to find my way back inside and those fifteen or so years of development I had missed out on suddenly happened in a flash.

Recently I noticed that the things that at one point were fresh and exciting had now been filed away to the back of my mind and I was beginning to lose touch with that way of looking at our world.

Fitting into the human mould is what happens to everyone. You lose sight of what is important because you are so focused on getting on with the world that your brain can cope with that the eyes you used as a child growing into an adult get shorter and shorter sighted until you can no longer see beyond the end of your own nose.

Dark Days - complete flip of personality

I'd been going out with this lady and it was all going well until one day I just flipped and lost all feeling for her. I didn't question why the sudden change had occurred - after all it was how I felt so why would I?

She came over and we broke up, but only a couple of hours later I suddenly flipped back and all of a sudden loved her once again. Deeply regretting my mistake I immediately called her and three years later we are married and living together.

Every so often this same flipping of feeling towards her will occur; we call them 'dark days'. I know that they'll pass so now I just ride them out, but they're still deeply unpleasant and distressing.

Whether it's another part of the schizophrenia I don't know. There haven't been many dark days recently which is of course really nice for both of us but then there hasn't been as much stress in my life - due to taking special care not to overdo it or push myself too far.

Irony

Being unable to work I have a lot of free time. However I’m not the kind of person who will sit down playing Xbox all day - although when it comes to a tossup between reading a book and going for a run I choose the book every time!

It feels like a waste of time if I am not putting my mind to something useful in the effort to recover from my mental troubles. But the ironic thing is that getting regular exercise can actually aid this process.

So in order to improve your mind you need to focus on your body, which is something I initially thought of as being quite narcissistic, and still do when people seem only to care about their physical appearance; but what if it is in our nature to do so? 

I found mine!

There can be times where you have so many things going on that you are unable to hold onto them all at once. It’s at times like these that I wish I could just ‘switch off’.

The funny thing is it is surprisingly easy to do so.

I’ve been practicing Mindfulness meditation for two years now and use when the above kind of scenario arises.

I sit in a chair and take time to just stand back, allowing myself to become transparent and to observe all of these thoughts, stresses and worries as they flow through me.

Welfare

When I was first diagnosed with clinical psychosis my dad was keen to impress on me the importance of not giving in. He was concerned that the mental health professionals were going to wrap me up in cotton wool and be over cautious to the point that I was hardly moving forward at all. His advice remained with me in a way whilst I fought to get better - even if only in a subconscious form.

It’s strange being mentally ill because it’s very easy to forget that you are unwell. Or rather you don’t like to admit it to be true and so every time you have a panic attack or a dark day where the voices overwhelm you, you are quite taken aback. So, as you can imagine, when it comes to benefits it is very easy to feel like a thief or a cheat.

At times I believed I’d get better and be able to have a full time job with all the trimmings (I guess my dad’s words were still resounding in the back of my mind somewhere), but recently I stopped thinking about working. There are a lot of big changes happening in my life at the moment and the stress is proving to be very disrupting.

(I wouldn’t call it admitting defeat because it is definitely not that; I just had my sights set unrealistically high this time and actually it is an achievement to be able to come to terms with my own limits).

Now I rely on the welfare state because I am ill – or it could be that our world is ill, either way I am struggling to live day to day so something must be up! Everyday things seem to take more of a toll on me when compared with most of the other people in my life. I become worn out very quickly – although it’s rarely easy to pinpoint why this is.

Naturally I guess I’d have flown the nest by now; but unfortunately our world is far from natural. Maybe it is me who is ill; I may have a malformed brain – but what caused it to be so? It seems to me that the unnaturalness of our world may have had a part to play. If so then the natural process of child rearing simply goes out the window; which means that another system of support must take its place. Enter welfare.

But am I giving in too easily? I will keep on pushing of course but for the minute I must be sensible and embrace my limits and play the hand that I have been dealt. I guess that it’s disheartening but luckily I have the state to support me whilst I figure out a different route through this life.

Medication

I like to say that Japanese saved me. I stumble upon it during my second attempt at University when I noticed it was offered as a complimentary study course and thought it might be cool. After my psychotic episode (that put an end to my studies at degree level) I continued to study Japanese independently at home.

The prospect of a day studying Japanese almost organically became my reason for getting out of bed in the morning and staying away from my bedroom for the rest of the day. Anyone who has been prescribed major tranquilisers will empathise that this is no mean feat!

My studies gave me direction but there was something about learning Japanese that enabled me to remove myself from the difficult mental processes I was experiencing. I could almost tangibly feel my mind whirring around outside of my body. I guess I had essentially managed to put my fingers into my ears and sing “lalalalalalala” at the top of my voice.

The interesting thing was that through this technique I was gradually able to explore my boundaries more and more. It was as though the Japanese study was some kind of temporary scaffold that enabled the reconstruction - by which I mean the rehabilitation – of me on a personal level.

Now the Japanese has largely fallen by the wayside and my passion for thinking has been re-realised which feels great. I know that there is still a long way to go of course, but the progress is promising.

As time passed I began to wonder if my experience with the Japanese study could be compared to my experience with antipsychotic medication. Does the medication provide a supporting scaffold that serves the rebuilding effort?

Anxiety

“I don’t know how”

“Anxiety never killed anybody” my doctor told me; “you’ve just got to push through it and when you come out the other end you’ll see that it isn’t so bad”. I am not a generally anxious person; my anxiety only arises in certain situations. I have recently gained a grasp on where my anxiety stems from which I’d like to share.

It all dates back to when I was younger; I’d struggle to leave the house to go to school but couldn’t for the life of me figure out why. I ended up making all kinds of excuses so that I could stay at home. I found it very confusing: “How come everyone else deals with this problem (I assumed they all did) so easily?” In the end I logically concluded that I was just weaker than them.

It wasn’t until six years later that I was diagnosed with clinical psychosis, so for that period my family and I were almost completely in the dark. Now, six years after my diagnosis I have a new handle on the anxiety.

It all has to do with ‘shutting down’. When put into a situation that I find overwhelming, I can almost hear my mind saying, “screw this I’m out of here!” as it packs up, leaving only the surface thinking – I literally become an empty shell; unable to look inside.

For ages I found this experience to be very disturbing; I’d find myself out in public but I wouldn’t know how to be there, which made me feel very exposed and as a consequence the anxiety inevitability prevailed.

It was only in understanding what was happening when I shut down that I became able to develop a comfort with it. It no longer distresses me because I can say to myself that it’s ok, this is just how your body deals with an overwhelming situation.

I learned to shut down on a subconscious level in order to shut out the paranoid ideas and intrusive thinking that was so distressing to me. I have become so good at suppressing them that I no longer honestly know whether those thoughts are still waiting in the wings, trying constantly to break through.

For now, I must continue to push my boundaries and learn how to be again.

At the moment I still find my inability to do certain things (because I have shut down) to be very frustrating. I scare myself on these occasions because of the violence – which is directed entirely towards myself – that wells up inside me. 

What Came Over Me?

 Today I decided to go to my first Hearing Voices Network meeting, but surprise surprise it was by no means straight forward. I managed to go into the Salvation Army church (where it is held on alternate Tuesdays) after first taking some time to compose myself. I ordered a coffee and sat in the nearly empty café while I drank. I had the urge to write something down which led me to describe how I was feeling.

I didn’t feel myself and at first I grappled with trying to describe what had come over me. I felt like I was being held back as though chains were restricting my body. But then I realised that I wasn’t being confined by some external force at all; I had just shut down. Shutting down is a well-practiced technique that I learned a long time ago in order to block out the noise in my head.

I remember when I was younger I was able to discern the voices as they were fewer in number. But over time they amassed until no single words were perceivable above the overwhelming din. And so I quickly learnt to shut down - or perhaps I didn’t learn and it was purely instinctive. Unfortunately in order to target the voices specifically I had to shut down everything else as well.

It wasn’t too long ago that any meetings with councillors or social workers or psychologists consisted mostly of dead silence whilst I scraped together some semblance of a response to the questions they had posed. The weird thing was that I felt removed as though the lake had frozen over and I wasn’t able to break through the surface. I tried as much as I could but it was just too beyond my power.

Nowadays I find I have very little problem blabbing away to the professionals. Have I acclimatised to that particular kind of situation? Or is that a sign or how far along I am in my recovery? I do an awful lot of writing. I like to think that it is the only way I can process things - well, if not the only way it is definitely the most effective. But now I come to think of it, who says you should be able to process things naturally anyway?

I am rarely bothered by the noise these days; it only seems to be when I am tired that it manages to break through my barriers. On those occasions the noise is unbearable; like a thousand nails scraping down a thousand black boards. It is at these times that words and sentences force their way through; they usually try and convince me to kill myself so that I am no longer a burden on the lives of my loved ones.

At times like this I’ve found that all I can do is ride it out; maybe do some mindfulness meditation if it isn’t too bad that I can imagine my way to that option. I know that it is very difficult for the people I love to see me in such a state so I find it is best to prepare for it by telling them that although I may not seem it I am ok; I just need a big hug when the time comes.

Lowering My Antipsychotic Dose

When I was transferred to a different Community Mental Health Team a couple of years ago, the first thing my new Psychiatrist decided to do was lower my dose of Olanzapine. Unfortunately I had an immediate adverse reaction and my original dose was quickly reinstated.

I wonder now if that kind of reaction didn’t have something to do with my mind set at that particular time in my recovery. Did I see myself as heavily reliant on the medication? Was I scared that I would go back to the person I was without it? Or did I believe it validated my condition?

Two years later I decided voluntarily that I wanted to lower my dose. I told myself that I was in a much better place than before and I was ready to do without that crutch in my life.

At the time I had been studying Japanese for about five years. This was largely to enable me to focus day to day on something that was external to the confused mess of my mind. As I improved I became less reliant on the Japanese and came to see the medication in the same light; it acted as scaffolding, and I wanted to see if I could stay standing were it to be gradually taken away.

When I was first prescribed the antipsychotic medication I didn’t want to take it because I was worried about how it might change who I was. In the end what made me decide to start taking it was seeing how much pain I was bringing to the lives of the people I love. Basically, I was willing to try anything that’d put a stop to that.

I was also paranoid that what I was taking might be a placebo and that everyone – my doctor, the pharmacist, and even my parents were conspiring to trick me; so that if I got better just by taking sugar pills they’d know that there was really nothing wrong with me. I wished there wasn’t something wrong but at the same time I found solace in the knowledge that I was ill and I wasn’t just weak.

As the medication began working the paranoia subsided and those worries quickly evaporated leaving increased appetite and drowsiness in their wake. When I was first prescribed the Olanzapine I was put on the highest safe dose (20mg). It felt as though the Psychiatrist was eager to throw everything she could at me because the more I disclosed to her about my thoughts the higher she ranked up the level of medication.

I found the Olanzapine to be the most appropriate choice of medication and have been on it for about four years now. There were several reasons why I chose to lower my dosage. Firstly, I had done some research and didn’t like the sound of the long term side effects such as Tardive Dyskinesia and high cholesterol; so I was eager to avoid them if possible.

Secondly, I wanted to see what kind of person I was with the medication as low as possible. I was repeatedly told that my illness was no different from a broken leg; it was just not visible to the naked eye. I accepted this but I now doubt its validity. While reading up on my particular medication I came across the analogy of a car engine. Say a car needs its engine oil topping up; taking antipsychotic medication is basically the same as pouring oil over the entire engine so that some of it gets into the right place.

As I understand it antipsychotic medications work but it is not fully understood how they do so.

My psychiatrist told me at one of our meetings that I will be on these medications for the rest of my life. Maybe he is right; there is only one way to find out. I have been on a lower dose for over two months now and it has been an interesting and at times a terrible experience.

The first thing I noticed on the lower dose was the heightened emotional range I was capable of experiencing. Both the positive and negative emotions became more intense. You’d think it would be great to experience more intense positive emotions but at times I was so overwhelmed with excitement that I had to stop doing the things I enjoy.

The next change I noticed was the reduction of the anxiety that had been plaguing me for so long. That was a pleasant and unexpected bonus. Of course I found myself to be less drowsy and consequently less reliant on coffee to fuel my day. However over the past weeks I have been experiencing some negative symptoms.

I’ve been having feelings of distress. I’ve been feeling out of control. The noise in my head is sometimes unbearable. Seemingly insignificant things such as accidentally breaking a cup can throw me completely. I have been told that my body just needs to get used to it, which I sincerely hope is true.

For a long time I had been going along under the assumption that my brain is broken and that something isn’t right up there. But is this the case? Of course it could be but I’d rather believe that I am not damaged and that instead maybe it’s my environment that is.

That could just be wishful thinking on my part. I have now come to see that I live in an imperfect civilisation and that my brain hasn’t evolved to deal with the modern world so it’s not surprising that it struggles.

I recognise the intrusive images and words that I experience (as though they are injected into me) as part of my makeup. They can be distressing and at times I wonder if they really are my thoughts, feelings and desires. Over time I have come to realise that they are all mine – although that doesn’t mean for one second that I have to agree with them (that’s not as easy as it sounds).

I have been told not to look too far ahead; just to concentrate on the next few footsteps. I am still unable to work (even voluntarily for two hours a week) – especially now that I am dealing with my lower dose, which, as you can imagine is very frustrating. I see the people around me progressing whilst I stagnate. I have to remind myself that I am also progressing and that I shouldn’t measure myself by the rule of others.

I have been on a very long and difficult journey and it is important to keep telling myself that I have done well to get this far. I don’t know where my path will lead from now but I am hoping that the lower dose works out.

As for who I am that remains to be seen.­­­