Psychosis means abnormal condition of the mind, and is a psychiatric term for a mental state often described as involving a "loss of contact with reality". There are a number of theories of the cause of psychosis including stress and brain chemistry inbalances. These theories can be found out on sites such as wikipedia, and are compared to this theory in the relevant subsections in the drop down menu.
To date no one has come up with a theory that explains all types of psychosis, and this theory is no exception. This theory refers to the type of psychosis involving plotting usually by friends and family, and inappropriate beliefs about his/her identity. It concerns itself with brief psychotic episodes in which the individual recovers.
This theory hypothesises that there is a core identity group, which people revert to when no other group is salient. This core identity concept explains why people have social motivation whether they are or are not in an obvious group. It is suggested that the core identity group can influence the process of friendship formation and self esteem, although there are a lot of other factors that contribute to friendship formation and self esteem.
The theory is influenced by Erikson's development stage of core identity, which he said was developed in the teenage years (Psychosis is not usually found in young children), and by Tajfel and Turners's social identity theory in which they suggest that people are motivated to perform in the group that is salient at the time (e.g. a sports team or business they work for). However, they said that when a person was not in a group his personality became prevalent, rather than there being a core identity group. The author believes that the individual is always in a group, and is still motivated to improve their perceived standing in whichever group they are in and the performance of a group as a whole, it is just that the individual might not be consciously aware of what group they are in. This is the same social drive as that talked about by Tajfel and Turner (rather than having two different social drive mechanisms for when in a group and out). After all just because they are not salient in an obvious identity group people do not generally lose social drive/ motivation.
It is suggested that the core identity group is usually a group of people that the individual most identifies with and cares most about what other members think of the individual. It can be absolutely any group of people including for example; family, businessman, working class, neighbours, etc... It is difficult to change the core identity, but anecdotal evidence suggests that for most people it is not impossible. For instance, people can notoriously 'change' as they become rich and famous.
Having a certain core identity does not preclude belonging to other groups. For example, a person with a core identity as a businessman can still be a member of a family and have a role as a father. People are usually motivated to do their best in whichever group is salient at the time, both in terms of their perceived standing within the group and the overall performance of the group. The core identity group usually includes friends and/or family, and it is suggested that it is the group people revert to when no other group is salient. When making personal lifestyle decisions, it is suggested that the person decides what is best for them in the context of their core identity group.
The core identity group is a new concept and is not well supported by studies. It is different in essence to Erikson's core identity, which describes a multifaceted core identity. Some studies have been done that indicate people care more about assessments from friends and family than from other people. Studies also suggest that members of a group are subconsciously motivated to improve their standing in the group, and this should also apply to the core identity group.
This theory also hypothesises that psychosis can occur when a susceptible person subconsciously tries to change their core identity. It is suggested that this can occur in an attempt to improve the calculation of self worth, or an attempt to reduce stress in the person's life, or from a result of a change to the core identity group. This hypothesis also allows for a possible explanation of the mechanics of an episode.
Possible explanation of the mechanism for an episode of psychosis
A possible explanation for what is happening during an episode is given below;
The change in core identity is instigated at a trigger point. After this thoughts occur which are derived from two main sources. The intensity and frequency of these thoughts will vary from person to person and from episode to episode. These sources are;
1. From Changing to an inappropriate core identity: When the person subconsciously tries to change their core identity, they do not know what is going on and put little cognitive thought as to what new group they should belong to. There is a bias to belong to the highest regarded group and this often leads to an inappropriate powerful group being selected as their core identity. This gives rise to delusions of grandeur. The mind can become confused, as one part of the brain is now saying they belong to that group, and the rationalising part of the brain is saying this can not be true.
2. From Plotting by previous core identity group: Thoughts are generated in the mind that are negative towards the previous core identity group, possibly to facilitate the transfer of core identity. This usually involves the previous core identity group (usually friends and family) plotting against them.
The rational part of the mind makes sense of the world around them by a series of beliefs, with the cornerstone of those beliefs being core beliefs. Core beliefs are well known in psychology; they are difficult to change and other beliefs are rationalised from them, but core beliefs are also not rationalised from other beliefs. For most people the appearance of the thoughts described above which are persistant and intruding are unexplainable within their existing set of beliefs. A breakdown occurs when the mind tries to change its belief structure to accomodate the existance of the above thoughts. The mind changes the belief structure by introduing a new belief. It could be a belief someone is putting the thoughts in their head, or it could be a belief that the thoughts are arising from past experiences, or it could be that the thoughts are based on a true reality (e.g. the person really is a demi god, with friends/family plotting against them) etc...
As the new belief is based on experience rather than rationalised from other beliefs, these new belief attains the status of a core belief. Other beliefs are generated derived from the incorrect core belief. For instance, if one believes he is an angel, then it is quite logical to believe he is following a path of destiny or laid down from a higher authorityor if he believes the thoughts are being put into his head, it is not too far fetched to believe it might be mobile phones are acting as the transmitter. And soon a reality is created in which to others it appears he has lost touch. These beliefs are usually generated subconsciously.
The mind is constantly trying to rationalise and understand the world with its belief structure as its reference. When a core belief is incorrect, their are gaps in the explanation and rationalistion which are mostly impossible to resolve. The mind is trying to fill these gaps and grasps ideas and thoughts that could start explaining the inconsistencies. These thoughts/beliefs to a normal mind seems irrational.
Drugs and brain chemistry: The evidence is there that drugs reduce/increase the liklihood of psychosis. In the context of this theory they could;
i) increase the natural resistance to a core identity change,
ii) Reduce the intensity and frequency of the thoughts that arise from identity change, or
iii) Increase the resistance of a core belief change.
It is easier after the first change to change core identity again, on account of the brain chemistry has not settled down. Several changes of core identity might occur in one episode.
All the above takes up the brain resources, and can cause some chemical imbalances in the brain. Secondary effects like lack of sleep, bad short term memory, lack of awareness of date, time and current affairs and lack of concentration can result from this.
Other types of psychosis
The author also believes that psychosis can result if a person modifies a core belief to try and understand events in their life, to an even more incorrect assumption. This type of psychosis should have a much reduced pre modal phase symptoms. I have had one episode of this type of psychosis.
Hallucinations are not really explained by this theory. They might be as a result of stretched brain chemistry, the mind's attempt to fill the gaps in its belief structure, or might be due to an entirely different cause of psychosis. Hallucinations can be directly induced by drugs and therefore more likely to be attributed to a chemical imbalance. Other symptoms could follow as the person changes his core beliefs to try to explain those symptoms. They did not occur during any of my episodes.
The negative symptoms of schizophrenia are also not explained by this theory. It is possible that there is some personality traits that are common in people susceptible to psychosis and that in the longer term mental illnesses psychosis has a different cause.