Psychological Nudity in Schizophrenia

Most people experience their minds as private, subjective environments that are sanctuaries from others. The mental world is usually considered to be safe, and we protect its privacy by disguising our behavior so that others cannot gain any insight into our internal mental processes. What what do you do if there are other “entities” prying into your mind?

Psychotic individuals have in their minds the appearance of other entities, symbols or archetypes. These are understood to be illusions — auditory hallucinations — but they have the capacity to make psychotic individuals feel psychologically violated, as it seems to them that there are “others” existing in their minds.

There is a broken sense of intimacy that follows from the auditory perception of other entities occupying the personal arena of the psychotic mind. It is the delusional belief in the actual existence of entities in the mind from which this subjective experience of harm proceeds. Essentially, psychotic individuals perceive themselves to be psychologically “naked” in their own mental realms. This “psychological nudity” is painful, because he or she understands or believes these mental “entities” to be actively observing or perceiving his or her thoughts.

Why is this damaging? Everyone has secrets regarding their past thoughts and behavior to a greater or lesser extent. Psychotic individuals may have tendencies to project onto the “entities” within their minds an awareness of their personal inadequacy. Anything they have done “wrong” in the past seems to be “public knowledge”. There may be tendencies in psychotic individuals to then deviate from normal thought into obsessive ruminations, attuned to conscious awareness of personal inadequacy and failings, instead of engaging in normal mental processes.

The restoration of unselfconscious mental processes is essential in recovery from psychosis. While getting rid of auditory hallucinations would be ideal, it is not necessary; they simply need to be ignored. This may be virtually impossible due to the fact that asking a schizophrenic to try to ignore his hallucinations is like asking him to look at a spot on a wall beside a painting and to try not look at the painting.

Nevertheless, it may be possible for him to deliberately distract himself. Watching TV and listening to the radio are possible options, although these types of entertainment may allow for cultivation of psychotic ideation based upon delusions of reference. This means that the schizophrenic might derive “messages” about himself or his situation based upon attention to these activities that, even while distracting him from internal dialogue with hallucinations, may further psychotic ideation.

Ultimately, the schizophrenic might need to use trial and error in his effort to find appropriate distraction from his hallucinations. Engagement the material world is important, which may be accomplished by spending time in the company of others. However, stigma regarding mental illness and the mentally ill may hinder him in this regard.

An example of involvement in the material world that might be effective might be found in psychotherapy: Addressing the psychotic individual’s subjective experience of psychological nudity may allow that individual to admit his own failings to a psychotherapist. This potentially would negate the self-destructive experience of psychological nakedness. Acceptance and positive regard directed toward the individual by the psychotherapist may help mitigate the punishing experience of psychosis. It would essentially allow for affirmation as a response to psychological nudity.

As discussed, we all have had thoughts or experiences that we wish to hide from others, and we tend to give credence to these, while they may represent isolated incidents. Too much attention to these thoughts and experiences may result in overvalued ideas, and the schizophrenic feels the devastation of these ideas more poignantly than others, due to the fact that entities, which may seem to comment on his thoughts, constitute part of his mental experience.

Negative experience is much more tolerable when it originates from chance events, and it is much more punitive when it is perceived as originating from the deliberate actions of others. Whether the schizophrenic views his psychotic experience as caused by others who are aliens, spirits or other people, it is much more functional to believe it to culminate from what are understood to be hallucinations.

While hallucinations are punitive, acceptance of having a mental illness as a chronic condition may be one of the most positive steps in dealing with it. In a similar sense, revealing these aspects of psychological nakedness that plague the schizophrenic individual to a psychotherapist may alleviate some of the damage to one’s psychological self.

Image via Sharpshutter / Shutterstock.

Ann Reitan, PsyD

Ann Reitan, PsyD, is a clinical psychologist and well published essayist of fiction and creative nonfiction. She holds a Bachelor of Arts in Psychology from University of Washington, Master of Arts in Psychology from Pepperdine University, and Doctorate of Clinical Psychology from Alliant International University. Her post-doctoral research at Washington University in St. Louis, MO, involved personality theory, idiodynamics and creativity in literature. She recently published Illuminating Schizophrenia: Insights into the Uncommon Mind.
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