“Among the serious mental illnesses, psychosis is perhaps one of the most severe forms of psychological suffering,” writes psychoanalytic psychotherapist Giota Efstathiou for this column today, ahead of World Mental Health Day, which falls tomorrow, 10 October.
“The person,” she goes on, “cannot shield themselves from an inner reality that becomes unbearable. They live with an intense fear of the self disintegrating or shattering into pieces, as if carrying the very ‘end of the world’ inside them. Delusion, or even destructiveness, can also be seen as ways of defending against a psychic reality that has become intolerable.”
I should stress here that Efstathiou is the founder and former director of ‘Ariadne’, a Nicosia hostel for the rehabilitation of people with mental health difficulties who come from Athalassa psychiatric hospital. In her note for the column she adds:
“Eighteen years of my working life were bound up with creating and running the ‘Ariadne’ hostel. When I set it up in 2001, my vision was a space halfway between the psychiatric hospital and the community, protected and stable, that could contain these people’s fears, anxiety and psychic disorganisation without cutting them off from life. The experience of those years taught me how healing a stable framework can be. Containment, stability and continuity can gradually act as an auxiliary ‘ego’, until the person is able to restore some of their ties with themselves and with others. That is why I always thought it important for ‘Ariadne’ to be within the city.
“People with psychosis need to walk the same streets as we do, to shop, to work when they can, to connect, to belong. Social reintegration cannot simply mean leaving the hospital.
I still remember a torn canvas from an exhibition of the residents’ art therapy work. To me it symbolised exactly this: a psyche may have suffered deep fractures, and yet the capacity for relationships, creativity and life can still be there.
The state has a duty to create specialised community facilities, intermediate spaces, supported living and real opportunities for rehabilitation. Otherwise, deinstitutionalisation will simply shift exclusion from the psychiatric hospital to the fringes of society.
A person with psychosis is not their diagnosis. How a society manages to hold them within the community ultimately shows how far it can bear the different, the fragile and the unfamiliar without casting it out.”
