Psychosis and its conceptualisations: a journey from pathology to difference

Various conceptualizations of psychotic experience are evaluated on the basis of a year-long extra-therapeutic relationship between the author and a 15-year-old teen diagnosed with a psychotic disorder. Perspectives ranging from the clinician’s sign-based neo-Kraepelinian classification of ideational pathologies to the ethnographer’s hermeneutic interpretations of symptoms are considered, providing ethnographic and auto-ethnographic data to argue that crystallized explanatory systems fail to account for all instances of psychotic experience. Reductionist approaches thus perpetuate the mystification of socioeconomic and cultural aspects of madness and social control, further limiting the range of the sanctioned discourses on normalcy and sanity. Recovering the narrative voices of the afflicted is highlighted as a necessary step to help redefine concepts of madness beyond the dominant biologicist/psychologicist stigmatizing labels, emphasizing the need to construct and facilitate supportive environments rooted in reciprocity, horizontality and peer-to-peer guidance in which expert and popular knowledge can be better integrated and command equal weight