How we walk with the broken speaks louder than how we sit with the great.
― Bill Bennot
Psychosis can feel like a constellation of stars—scattered, distant, and untethered from the present. The person may seem a thousand miles away, lost in fragmented thoughts and altered realities, struggling to piece together their sense of self and connection to the world. - Rachel Fairhurst
Psychosis
The DSM-5 (American Psychiatric Association, 2013) outlines psychosis as a condition characterized by one or more of the following symptoms:
Delusions – Fixed, false beliefs that persist despite contradictory evidence. These can be persecutory, grandiose, referential, nihilistic, or bizarre in nature.
Hallucinations – Perceptual experiences occurring without external stimuli, typically auditory but can also be visual, tactile, olfactory, or gustatory.
Disorganized Thinking (Speech) – Impaired thought processes reflected in incoherent or tangential speech, derailment, or loose associations.
Grossly Disorganized or Abnormal Motor Behavior – This can range from unpredictable agitation to catatonia (a marked decrease in reactivity to the environment).
Negative Symptoms – These include:
Avolition (lack of motivation)
Alogia (diminished speech output)
Anhedonia (inability to experience pleasure)
Asociality (lack of interest in social interactions)
Blunted Affect (reduced emotional expression)
For a formal diagnosis of Schizophrenia, at least two or more of these symptoms must be present for at least one month, with at least one being delusions, hallucinations, or disorganized speech. Additionally, functional impairment must persist for at least six months.
Psychotic symptoms can also present in Schizoaffective Disorder, Delusional Disorder, and Brief Psychotic Disorder, among others, depending on symptom duration and co-occurring mood disturbances.
Psychosis
Psychosis is a multifaceted condition characterised by significant disruptions in perception, thought processes, and emotional regulation. Before expanding on its complexities, I want to clarify that my clinical approach is specific to individuals who experience psychosis alongside a trauma history. Through extensive experience working with this demographic, I have developed a specialised intervention strategy that employs a structured mapping system aimed at reducing symptom clusters associated with psychosis.
Diagnostic frameworks, such as the DSM-5, outline the core symptoms of psychosis, which include delusions, hallucinations, disorganised thinking and speech, grossly disorganised or abnormal motor behaviour, and negative symptoms such as affective flattening, avolition, and anhedonia (American Psychiatric Association, 2013). Within my approach, I focus on systematically addressing these clusters, integrating trauma processing with tailored stabilisation techniques.
An often-overlooked aspect of psychosis, particularly in individuals with complex PTSD (cPTSD), is heightened sensory sensitivity. Emerging research suggests that trauma-related alterations in neural circuitry may contribute to increased perceptual sensitivity, which, in some cases, aligns with psychotic symptomatology (van der Kolk, 2014; Read et al., 2020). Many individuals with a history of severe trauma report an enhanced ability to perceive subtle environmental stimuli, sometimes interpreted as extrasensory perception or heightened energetic sensitivity. This phenomenon, though frequently dismissed within traditional psychiatric paradigms, may play a role in the subjective experience of psychosis (Mosquera et al., 2014).
In my clinical practice, I work to harness and regulate this sensory sensitivity, helping individuals distinguish between trauma-related perceptual distortions and intuitive awareness. By integrating trauma-focused processing with physiological regulation techniques, I aim to restore cognitive coherence while fostering a balanced internal state. The therapeutic goal is to empower individuals to engage with their perceptions in a way that enhances self-regulation rather than exacerbates distress.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Mosquera, D., Gonzalez, A., & van der Hart, O. (2014). Trauma-Related Dissociation: Theoretical and Clinical Implications. Journal of Trauma & Dissociation, 15(3), 265-283.
Read, J., Fosse, R., Moskowitz, A., & Perry, B. D. (2020). The Traumagenic Neurodevelopmental Model of Psychosis Revisited. Schizophrenia Bulletin, 46(5), 956–968.
van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking.
Rachel is like a surgeon, she has the keen ability to see exactly what is happenning and exactly what is need. Her precision is like an archer and her knowledge her arrows. I fully reccommend working with her even if you feel like no one knows what to do, Rachel does.
— Maxi G
Rachel’s approach has changed my life more in the 3 weeks we have worked together than in a lifetime of mental health services and medication. I do not understand why her programmes are not the first port of call for all trauma victims and BPD diagnosis
— Amy R