Psychotic Disorders

Visual representation of psychotic disorders

Few diagnoses carry as much stigma as those involving psychosis. The word itself evokes fear—images of violence, incomprehensibility, and hopelessness that have little to do with the actual experience of the many people living meaningful lives with these conditions.

Psychosis is frightening—both to experience and to witness in someone you love. But psychotic disorders are treatable, and recovery is not only possible but common. Many people with schizophrenia and related conditions live full, productive, connected lives. They work, maintain relationships, pursue their interests, and contribute to their communities. What they need is appropriate treatment, support, and clinicians who see them as whole people rather than as diagnoses to be managed.

Understanding Psychosis

Psychosis refers to a cluster of symptoms that involve a loss of contact with shared reality. This typically includes hallucinations (perceiving things that aren’t there), delusions (fixed false beliefs), and disorganized thinking or behavior. These experiences can be terrifying, confusing, and isolating.

But psychosis is not a single disease—it’s a syndrome that can arise from many sources: primary psychotic disorders like schizophrenia, mood disorders, trauma, substance use, or medical conditions. Understanding the context and meaning of psychotic symptoms is essential for effective treatment.

Contrary to popular belief, psychosis doesn’t mean someone is dangerous, unpredictable, or beyond help. Most people with psychotic disorders are far more likely to be victims of violence than perpetrators. And while psychotic experiences can be bizarre or incomprehensible to outside observers, they often carry personal meaning and logic for the person experiencing them.

I approach psychosis with curiosity and respect. The content of delusions and hallucinations often reflects important psychological material—fears, wishes, conflicts, and attempts to make sense of overwhelming experience. Understanding this content, not just eliminating symptoms, is part of genuine recovery.

Common Symptoms

Hallucinations: Seeing, hearing, or sensing things others don’t perceive
Delusions: Firmly held beliefs not shared by others
Disorganized thinking: Difficulty organizing thoughts or following a train of thought
Disorganized behavior: Unusual or unpredictable actions
Negative symptoms: Reduced emotion, motivation, speech, or pleasure

Conditions I Treat

I provide psychotherapy for individuals living with various psychotic spectrum conditions.

Schizophrenia

A chronic condition involving psychotic symptoms, cognitive difficulties, and often negative symptoms that affect motivation and emotional expression. Schizophrenia typically emerges in late adolescence or early adulthood and requires long-term treatment. With proper support, many people with schizophrenia achieve significant recovery and lead meaningful lives.

Schizoaffective Disorder

Combines features of schizophrenia with a major mood disorder (either depression or bipolar disorder). People with schizoaffective disorder experience psychotic symptoms alongside significant mood episodes, but also have periods of psychosis without mood symptoms. Treatment addresses both the psychotic and mood components.

Brief Psychotic Disorder

A short-lived psychotic episode lasting between one day and one month, often triggered by extreme stress. While brief, these episodes can be terrifying and disorienting. Understanding what precipitated the episode and preventing recurrence are important treatment goals.

Psychosis in Other Conditions

Psychotic symptoms can occur in the context of severe depression, bipolar disorder, PTSD, dissociative disorders, and other conditions. When psychosis is secondary to another disorder, addressing the underlying condition is essential. I work with the full picture, not just the psychotic symptoms.

A Different Approach to Treatment

Conventional treatment for psychotic disorders often focuses narrowly on medication and symptom suppression. While antipsychotic medications are frequently essential and beneficial, they’re not the whole story. Many people continue to struggle even when their most florid symptoms are controlled. And many want more than symptom management—they want understanding, connection, and a meaningful life.

My approach integrates evidence-based psychotherapy with respect for the person’s subjective experience. This means:

Taking Experience Seriously

Hallucinations and delusions aren’t just “symptoms” to be eliminated—they’re experiences that often carry meaning. Understanding why your mind produces these particular experiences can be part of recovery. I’m curious about what your experiences mean to you, not just how to make them stop.

Addressing the Whole Person

Psychosis doesn’t exist in isolation. It interacts with your history, relationships, identity, and goals. Treatment addresses not just symptoms but also the impact of the illness on your sense of self, your relationships, and your life trajectory. Recovery involves rebuilding, not just stabilizing.

Supporting Medication Decisions

As a psychotherapist, I don’t prescribe medication, but I support informed decision-making about it. I help you understand your options, communicate effectively with your psychiatrist, manage side effects psychologically, and navigate the complex feelings many people have about taking antipsychotic medication.

Building Real Relationships

People with psychotic disorders often experience profound isolation. The therapeutic relationship provides a real human connection—a place where you’re known, understood, and valued. This relationship itself is therapeutic, not just a vehicle for delivering techniques.

What Recovery Looks Like

Recovery from psychotic disorders is real and achievable. It may not look like what you expect.

Symptom Management

For many people, symptoms decrease significantly with treatment. For others, symptoms remain but become less distressing and intrusive. Learning to live with residual symptoms without letting them dominate your life is a valid form of recovery.

Functional Recovery

Many people with psychotic disorders work, maintain relationships, live independently, and pursue education or creative interests. Functional recovery is possible even when symptoms persist. The goal is a life worth living, not a symptom-free existence.

Personal Recovery

Beyond symptoms and functioning, recovery involves rebuilding identity, hope, meaning, and agency. It means defining yourself as more than your diagnosis, developing a story that makes sense of your experience, and creating a future you look forward to.

“Recovery is a process, not an endpoint. It involves developing new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.”

— William Anthony, Boston University

Collaborative Care

Effective treatment for psychotic disorders typically involves a team. As a psychotherapist, I provide psychotherapy—the relational, meaning-making, skill-building component of treatment. Most people with psychotic disorders also benefit from psychiatric care for medication management.

I work collaboratively with psychiatrists and other providers to ensure coordinated care. This might include:

Regular communication with your psychiatrist (with your permission)
Coordination around medication changes or concerns
Integration with case management or other support services
Family consultation when appropriate
Collaboration with vocational or educational programs

If you don’t have a psychiatrist and need one, I can provide referrals to colleagues who share a recovery-oriented approach to treatment.

What Therapy Offers

Understanding your experiences in context
Developing coping strategies for symptoms
Processing the trauma of psychotic episodes
Rebuilding identity and sense of self
Improving social functioning and relationships
Managing stress that can trigger episodes
Finding meaning and purpose
A consistent, accepting relationship

For Families

When someone you love experiences psychosis, it can feel like losing them. The person you knew seems to have been replaced by someone you don’t recognize. Their beliefs make no sense to you. Communication breaks down. You may feel frightened, frustrated, grieving, guilty, or exhausted—often all at once.

Some things to know:

Your loved one is still there. Psychosis changes perception and thinking, but the person underneath remains. They need your connection, even when connection is difficult.
You can’t argue them out of delusions. Delusions are not simply incorrect beliefs that can be corrected with facts. Arguing usually makes things worse. Expressing care while not confirming false beliefs is possible with practice.
Recovery happens. Many people with psychotic disorders improve significantly. Early intervention improves outcomes. Hope is appropriate.
Your wellbeing matters. Caring for someone with a psychotic disorder is demanding. You need support too—your own therapy, support groups, respite. Taking care of yourself isn’t selfish; it’s necessary.
Family involvement helps. Research shows that family support and involvement improve outcomes. Family therapy and education can help everyone cope more effectively.

I offer family consultation for loved ones who want to better understand psychotic disorders and learn how to support recovery while caring for themselves.

Common Questions

Can people with schizophrenia really benefit from psychotherapy?

Yes. Research consistently shows that psychotherapy improves outcomes for people with schizophrenia and other psychotic disorders, including reducing relapse rates, improving social functioning, and enhancing quality of life. Psychotherapy works best in combination with medication, but it adds significant benefit beyond medication alone.

Is psychosis dangerous?

People with psychotic disorders are far more likely to be victims of violence than perpetrators. While psychosis can occasionally lead to dangerous situations, proper treatment dramatically reduces any risk. The stigma linking psychosis to violence is harmful and inaccurate.

Do you prescribe medication?

No. As a psychotherapist, I provide psychotherapy, not medication. Most people with psychotic disorders benefit from antipsychotic medication, and I support you in working effectively with a psychiatrist. I can provide referrals if you need one.

What if I don’t want to take medication?

I respect your autonomy and your right to make informed decisions about your treatment. We can explore your concerns about medication, discuss risks and benefits, and consider alternatives. That said, I’ll also be honest if I believe medication would significantly help you. Ultimately, the decision is yours.

How do I know if therapy is working?

Progress in therapy for psychotic disorders may include reduced frequency or intensity of symptoms, better ability to cope with symptoms that persist, improved relationships, return to work or other meaningful activities, better communication with treatment providers, and an improved sense of hope and agency. We’ll regularly review how things are going.