The support services that Flourish Australia offers are generally non-medical, which means that we don’t offer things like medication or psychiatric therapy. This presents us with a bit of a challenge whenever we deal with the “Psychotic Symptoms” theme in ACTION, as this is a medical term and, thus, outside our scope. However, Senior Mental Health Worker (Business Services) Kara Lyons and her staff support our Business Services Employees in many different ways, and this includes having CANSAS conversations with them…and yes, this includes the Psychotic Symptoms theme. Panorama asked them how they approach this issue.
People don’t see their own thoughts as “psychotic”
Kara agreed that many of the people who access our services may not see their experiences as being defined as “psychotic symptoms,” and this can make it hard to identify exactly where these experiences fall within the CANSAS conversation. Peer Worker Matthew Roberts has found that a good way to get around this issue is by asking people if they have any “mental health issues,” and whether they are seeing a professional to help them with what they are experiencing. If somebody raises that they want to talk about a specific “psychotic symptom,” then Matthew will discuss whether they should talk about it there and then or leave it until the end of the CANSAS conversation. Matthew says that waiting for the CANSAS as a whole to finish takes pressure off the issue.
Hearing voices and bird noises
Kara told us: “I think the most common ‘psychotic symptom’ that the staff are likely to come across when conducting their CANSAS conversation is hearing voices. Staff have often asked how we can support people with this experience. We will often take coping strategies that have worked for other people in the past, and use these as suggestions. This may include things such as reality checking, paying attention to all five of their senses, or visualising certain images. They could also use distraction techniques such as listening to music, or use various relaxation techniques such as controlled breathing, massage, and so on. There are also some good ‘hearing voices’ workshops out there, and I will often encourage the vocational staff to gather the latest information for referrals.”
Peer Worker Jeanette Rodriguez said that a lot of people have told her about the ways they deal with psychotic symptoms. For instance, people have told her that listening to music can help them when they are hearing voices. This can be quite effective when the voices are whispering, but if the voices are shouting then they can be extremely hard to control. Other people have told her that actively listening and relaxing to the sound of birds can be helpful in dealing with voices.
Look up! Look down!
The “look-ups” is a common experience that people diagnosed with a psychotic illness will have at one time or another. It generally involves involuntary eye movements, such as having your eyes roll back and get stuck. We should note that look-ups isn’t a symptom of psychosis: it’s actually a side-effect caused by many types of antipsychotic medication (the kind used to control voices and other symptoms), and it can be very annoying. However, if a certain medication is helping us function in other ways, or if we are legally obligated to take it, then it may be necessary to simply learn to live with the look-ups every now and again, or to get on some sort of side-effect medication to manage it. Just be sure to keep your doctor in the loop. Also, you could always get a second opinion from another doctor.
Panorama once spoke with a former in-patient who was required to take a new medication. They experienced the look-ups, but to make matters far worse they had absolutely no idea what was going on. Their psychiatrist and the other hospital staff hadn’t bothered to explain the possibility of side effects with the person, which is a pretty big oversight. You can imagine how scary that must have been! So, the lesson of the story is that we should always ask our doctors if there are any side effects when they give us a new medication…just in case they forget to tell you!
Another story is how one of our peer workers was walking along with an employee when the employee suddenly developed the look ups. The employee was understandably alarmed by this. The peer worker sat down with her for a while and made a phone call to a colleague who had some experience on the subject. The employee began to feel better after a while, and they agreed that it would be a good idea to discuss this side-effect with their doctor. The peer worker walked with the employee for a while until the employee expressed confidence in being able to manage by themselves.