How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 16
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challenges young people to develop more independence, establish an identity, create intimate relationships and
move away from the nest of the family home. Typically, young adulthood focuses on the external world and
friends, while parents often serve a valuable—but less central—day-to-day role. Yet, if a young adult is having
problems organizing his or her thinking or is distracted by hearing voices, functioning at a high level of
independence will be problematic in many cases. Psychosis often impacts individuals in college years, and the
culture in a college setting is not typically geared towards seeking help. Having a psychotic process separates
the individual from peers and can impair social connections. The loss, or threat of loss, of social contacts adds
stress to the person experiencing these symptoms. It is often scary and activates feeling of shame when one is
having these experiences that are so difficult to discuss. This leads to isolation and may reinforce the power of
the inner experience as withdrawal from external contacts occurs.
With a young adult away at college, parents may think they are supposed to keep some distance in order to
support independence in a college-age child, and may not have adequate information in order to appreciate the
onset of psychosis. Psychosis requires intervention as soon as the person or the family realizes the seriousness
of the situation. University counselling centres are increasingly aware of the need to get support and assessment
to students experiencing this challenge.
Young adults and families can be encouraged by the development of resources intended to help meet their
unique needs. NAMI offers some resources, including NAMI on Campus, NAMI groups on some college
campuses, and StrengthofUs.org, a social networking site specifically for young adults living with mental health
conditions. These both offer young adults access to information and peer support from other young adults with a
shared experience.
Later-in-life New Onset Psychosis
When the first presentation of psychosis is over age 40, this presentation raises the need for intensive medical
evaluation. The probability that there is a detectable medical cause of psychosis increases with age, with
increased use of medications, medical illness and surgical procedures. Delirium, which can present with
psychosis (coupled with change in level of consciousness), is common in individuals who have other risks
(i.e., post-surgery, on multiple medications) or neurologic vulnerabilities ( e.g. dementia, Parkinson’s disease,
cognitive decline). Multiple neurologic and medical conditions can present with psychosis later in life, and
many of these are reversible.
Short-term Psychosis
A brief psychotic disorder that lasts between one day and one month and is typically associated with severe
stress or the post-partum phase is considered short-term. The return to a non-psychotic state is common in the
condition.
Trauma and Its Relationship to Psychosis
Traumatic events impact body, spirit and brain. Research has demonstrated biological as well as psychological
effects of traumatic events. The type of trauma as well as the developmental stage of the person and their brain
also makes a difference in terms of how a traumatic event may manifest in the person’s experience. The field of
mental health has moved towards a more sophisticated understanding of how traumatic events can influence a
person’s experience, and a movement towards trauma informed care has been a focus of SAMSHA for years.
This is an important departure as NAMI was founded in part by mothers who were falsely blamed for the
neglect and reason their children had developed schizophrenia. The “schizophrenogenic mother” theory posited
that cold and neglectful parenting caused schizophrenia. This “one size fits all” conceptualization blamed
mothers and did not rely on empiric evidence. The relationship of traumatic event—of all kinds—and the
development of psychiatric illnesses is emerging and reveals a significantly more complex story. We now know
that the brain is plastic—it responds to its environment and that the way that environmental experiences
manifests in a given person with their genetic makeup remains an important area of inquiry.
The Adverse Childhood Experience (ACE) study demonstrated a relationship between self reported adverse
childhood experiences and multiple adult health problems, spanning both physical and mental health concerns.
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