Trusting Your Perceptions After a Psychosis

18 Jun

Editor's Note

This transcript has been lightly edited for clarity, readability, and flow. Repetitions, filler words, and transcription artefacts have been removed while preserving the original meaning and perspective.

Introduction

One of the least discussed consequences of psychosis is what happens after recovery begins.

Most conversations focus on symptoms, treatment, medication, and relapse prevention. Much less attention is paid to a deeper psychological question:

How do you trust yourself again?

Psychosis creates a unique challenge because it undermines one of the assumptions most people take for granted: that they can generally rely on their own perception of reality. During a psychotic episode, a person may feel completely certain that their beliefs are accurate, only to later discover that those beliefs were profoundly distorted.

What happens after that?

How do you rebuild confidence in your own judgement? How do you distinguish healthy caution from endless self-doubt? And what happens when you've experienced psychosis more than once?

In this video, I reflect on my own experiences of learning to trust myself again after psychosis, including the challenges of recovery, relapse, insight, and the complicated relationship between self-trust and external validation.

Key Concepts

Recovery after psychosis
Insight
Delusions
Relapse
Self-trust
Perception of reality
Psychosis recovery
Uncertainty
Mental health stigma
Lived experience

Watch the Video

https://www.youtube.com/watch?v=325GQQtNf5o

Transcript

The Problem Nobody Talks About

One of the strangest consequences of psychosis is what it does to your confidence in your own mind.

Before psychosis, most people move through life with a relatively straightforward assumption:

If I think I'm okay, I'm probably okay.

Psychosis disrupts that assumption.

During a psychotic episode, you may feel completely certain that nothing is wrong. In fact, that certainty is often part of the problem.

Then, after the episode ends, you realise that certainty can be misleading.

And that's where the real difficulty begins.

Because afterwards, you're left asking:

How do I know when to trust myself again?

The challenge isn't simply recovering from psychosis.

It's recovering your relationship with your own judgement.

Becoming an Unreliable Narrator

Before psychosis, I trusted my perception of reality.

Not because I had carefully evaluated it, but because I had never had a reason not to.

Then I experienced psychosis.

And suddenly I found myself in a position where I had been completely convinced that my understanding of reality was accurate when it wasn't.

That changes things.

You move from:

"I trust myself."

to:

"Can I trust myself at all?"

The difficulty is that psychosis doesn't simply challenge specific beliefs.

It challenges the process by which you form beliefs in the first place.

Afterwards, you can start doubting everything.

Not just your past perceptions, but your present ones as well.

It's a profoundly destabilising experience.

Recovery Takes Longer Than People Expect

The first thing I'd say is simple:

Give yourself time.

Psychosis is exhausting.

It's psychologically exhausting.

It's emotionally exhausting.

It's physically exhausting.

Whatever combination of biological, psychological, and social factors contributed to the episode, the aftermath often feels like recovering from a major assault on the mind.

In my experience, genuine psychological recovery can easily take six to twelve months.

Not symptom recovery.

Not discharge from services.

Psychological recovery.

The point at which you begin to feel confident enough to re-engage with life, trust yourself, and move forward again.

That process cannot be rushed.

The Trap of Endless Self-Monitoring

After psychosis, it's very easy to become preoccupied with questions like:

Am I getting ill again?
Is this normal?
What if I'm relapsing?
How would I know?

These questions feel sensible.

But they can become a form of rumination.

The more you monitor yourself, the more uncertainty you discover.

And the more uncertainty you discover, the more you monitor yourself.

Eventually, you can find yourself trapped in a cycle where your life revolves around checking whether you're becoming unwell.

I don't think that's healthy.

At some point, you have to stop comparing your current self with your psychotic self and simply start living again.

You have to give yourself permission to move forward.

Starting Again

The advice I usually give is surprisingly simple:

Start again.

Treat recovery as a fresh beginning.

Instead of constantly asking:

"Can I ever trust myself again?"

try asking:

"What happens if I decide to trust myself anyway?"

That doesn't mean ignoring symptoms.

It doesn't mean refusing help.

It doesn't mean pretending relapse is impossible.

It simply means accepting that complete certainty is no longer available.

You move forward without it.

And in many ways, that's what everyone does.

Psychosis just makes the uncertainty impossible to ignore.

My Second Episode Changed Everything

For years, I assumed that if psychosis ever returned, I would recognise it immediately.

That seemed reasonable.

After all, I'd experienced it before.

I knew what it felt like.

Surely I'd see it coming.

The reality turned out to be much more complicated.

Several months before my second admission, I became concerned that I might be relapsing.

I went to my GP and explained that I thought something was wrong.

I'd been off antipsychotic medication for years, but I asked to restart treatment because I felt I was slipping into psychosis again.

At that stage, I was taken seriously and prescribed medication while waiting for specialist review.

Insight Isn't Everything

When I eventually met with specialist services, I encountered a problem that taught me something important.

The assumption seemed to be:

If you have insight, you can't be psychotic.

I wasn't convinced.

I was trying to explain that recognising some symptoms doesn't necessarily mean you're completely well.

Psychosis isn't always all-or-nothing.

Insight can fluctuate.

Awareness can coexist with emerging symptoms.

Unfortunately, the situation was interpreted differently, and I was advised that psychosis wasn't the issue.

Several months later, I was admitted to hospital under section after a full relapse.

Why Previous Experience Doesn't Guarantee Future Insight

One of the biggest surprises of my second episode was how different it looked from the first.

The first time, my delusions were broad and expansive.

The second time, they were much more focused.

Because the presentation differed, I repeatedly told myself:

"This can't be psychosis. Psychosis looks different."

That turned out to be a mistake.

The underlying process was similar.

The content was different.

This taught me something important:

Having experienced psychosis before doesn't guarantee you'll recognise it the next time.

Sometimes previous experience helps.

Sometimes it doesn't.

Reality is messier than we'd like it to be.

Don't Hand Your Mind Over to Other People

One risk after psychosis is that people stop trusting themselves altogether.

They begin relying entirely on external judgement.

Family members.

Clinicians.

Friends.

Support workers.

Feedback from other people can be incredibly valuable.

But there's a danger in abandoning your own perspective completely.

After psychosis, your inner voice may feel less reliable than it once did.

But that doesn't mean it becomes worthless.

You still need to listen to yourself.

You still need to pay attention to your own experiences.

Recovery isn't about replacing your judgement with somebody else's.

It's about learning how to integrate both.

The Unreliable Narrator

One metaphor I often return to is the idea of the unreliable narrator.

Before psychosis, I assumed I was a reliable narrator of my own experience.

After psychosis, that certainty disappeared.

But I don't think the solution is to throw the narrator away.

The narrator may be imperfect.

The narrator may occasionally make mistakes.

The narrator may sometimes misinterpret events.

But it's still your narrator.

You still need to hear what it has to say.

The challenge is learning to balance self-trust with humility.

To recognise that you can be wrong without concluding that you're always wrong.

That's a difficult lesson.

But I think it's one of the most important parts of recovery.

Final Thoughts

If you've experienced psychosis and find yourself wondering whether you'll ever trust yourself again, my advice is simple:

Give yourself time.

Accept uncertainty.

Start again.

And don't spend your life trying to solve an impossible question.

You may never regain the kind of unquestioning certainty you had before psychosis.

But certainty isn't the same thing as trust.

Trust can return.

Not because you've eliminated every possibility of error, but because you've decided that living requires some degree of faith in yourself.

Recovery begins when you allow yourself to move forward despite the uncertainty.