Psychosis 2022

"What's unfolding around Russia's conflict with Ukraine bears a striking resemblance to psychosis.

In this context, the concept articulated by the remarkable Italian psychotherapist Margarita Spagnuolo Lobb (2010, 2014) is intriguing. She suggests examining different societal periods through the lens of psychotherapy. She explains why certain reactions, types of behavior and psychopathological states prevail in society at specific times, captivating not only individuals but the entire society. Margarita (and subsequently other authors) describe the sequential movement of society, starting from the 1950s when most modern psychotherapeutic approaches emerged, until the present century...

Society, having undergone traumatic experiences during World War II, became 'neurotic' in 1945-50 (wherein, in response to trauma and the need to feel protected, the need for belonging took precedence, and personal goals were sacrificed for relationship preservation). Then, from 1950-70, neurotic tendencies gave way to narcissistic ones in an attempt to overcome what had become stifling belongingness in favor of autonomy and personal fulfillment. From 1970-90, a new generation, raised by narcissistic parents preoccupied with personal achievements, shaped the society's foundation. It became 'borderline' (filled with tumultuous yet non-warring conflicts, unclear notions of self-identity, and a black-and-white view of the world).

From a psychopathological standpoint, the transition from neurotic experiences to borderline represents a movement towards more severe conditions. The next level of severity is psychosis. Throughout history, such cycles have often been observed, but humanity rarely reached the stage of psychosis. The cycle experienced in Germany after World War I, culminating in the late 1930s with a psychotic outburst that engulfed Europe, is more of an exception. More frequently, after experiencing a borderline state, some traumatic event (war, economic catastrophe, severe epidemic) occurred, initiating a new cycle."

From the 1990s to the 2010s, following the borderline period, there was neither a large-scale war, nor a profound social collapse. Instead, a new form of psychological societal organization emerged. Experts (led by Zygmunt Bauman) labeled it as the 'Liquid society'. During this period, certain blurred psychotic (more autistic) traits became characteristic of society: difficulties in relationships, loneliness despite apparent communication amidst incredible advances in computer technology. Psychotic traits began manifesting on a bodily level as desensitization (loss of sensitivity) and changes in body perception (particularly, incorporating gadgets into one's body, causing anxiety for many when leaving home without a mobile phone). A significantly higher level of anxiety was noted.

I remember in 2017, interviewing people of various professions in Moscow, and being surprised by how many feared terrorist attacks and nuclear threats. Then 'COVID' came. On one hand, the epidemic made the manifestations of the liquid society even more apparent, almost legalizing our isolation. On the other hand, the danger to life and the high death toll evoked many military allusions and was experienced as trauma, though, of course, not like in a real war. Just 2 months ago, in trying to conceptualize the social situation, I speculated that the pandemic would give rise to some new form of societal organization, akin to the 'Liquid society'. But something else happened. And now, right before our eyes, a psychotic scenario is unfolding.

The main symptoms of psychosis include a disruption of reality, distorted thinking and perception of the world (ignoring facts and observations and constructing an illusory picture replacing reality), emotional disturbances (manifesting as empathy deficits, emotional coldness, conflicting emotions), presence of delusional symptoms (including grandiose ideas, magical conspiratorial concepts), and splitting. Splitting consists of simultaneous manifestation of incompatible forms of behavior, fragmented and disorganized thinking, emotional inconsistency, loss of directed volitional processes, autism (breakdown of contact between the individual's inner world and the external), and replacement of one's own mental processes with automatisms (where it feels like another person or entity controls the individual, while their own personality is suppressed).

Psychosis is accompanied by severe distress (sudden feeling of world collapse, loss of boundaries, very high levels of anxiety, uncontrollable terror, feeling of unreality, and loss of sense of self, aggression). Everyone affected by the psychotic field encounters these feelings. Even being near someone experiencing psychosis is difficult, as people become overwhelmed by intense anxiety and uncontrollable terror. When terror abounds, conditions are ripe for mass reactive responses, especially amidst the conflicting messages characteristic of psychosis."

Today, the manifestation is particularly vivid. The population of Russia and the entire world are indeed witnessing endless conflicting messages, especially pronounced since the onset of war. We're told we've initiated a special operation in Donbas, only for troops to be deployed in Ukraine a thousand kilometers away from Donbas. We're informed that war has been declared on us, yet we're not at war, and the word 'war' cannot be uttered. They say, 'We're not at war', yet people are arrested for slogans like 'No to war'. The idea is floated that 'We're bombing another country to save its population'. We're told 'the Russian economy is absolutely protected', yet withdrawals from deposits are prohibited and grocery store purchases are restricted.

They write, 'President Putin has supported the initiative to recruit volunteers for Ukraine'. Then, 'Russian Foreign Minister Sergey Lavrov stated: "we have no plans to attack other countries, we haven't even attacked Ukraine"'. In areas not directly related to war, messages are no clearer. "A person having a large number of rights limits their freedom, while restrictions in the legal system imply freedom of choice," believes Deputy Chair of the Federation Council Committee on Constitutional Legislation and State Building, Elena Mizulina (RIA Novosti).

Equally contradictory messages are seen on the other side of the front. We're told the whole world is siding with Ukraine, yet Ukraine receives only minor arms shipments. We're told closing the skies over Ukraine isn't possible due to the threat of nuclear war, yet nobody fears imposing an embargo - as if there's a magical rule that Russia can't launch a nuclear strike in that case. Russia is threatened with devastating sanctions, yet its main sources of prosperity - oil and gas - remain untouched, while much fuss is made over the cessation of Lui Vuitton bag shipments or the halt in the delivery of jewels to Russia.

Existing in an atmosphere of ambivalent messages undoubtedly fuels people's disorientation, reduces critical thinking, and sustains a psychotic field.

Those most susceptible to the psychotic field are people experiencing intense fear, feeling oppressed and in need of someone stronger, larger. Joining the crowd is a powerful way to cope with a range of complex emotions. As a result, people lose their normal judgment and become caught up in mass-distributed ideas without subjecting them to critical analysis, thereby feeding psychotic tendencies.

Of course, what's happening now activates both traumatic and borderline experiences (as always in a war situation), but all this unfolds against a psychotic backdrop.

Unfortunately, from a psychopathological standpoint, three main scenarios for further developments are possible in the short term."

"The first scenario involves the deepening and chronicling of psychosis (something akin to Orwell's novel '1984'). Sooner or later, this option culminates in one of the two outcomes below.

The realization of annihilative aggression - society's suicide. Self-destruction can take various forms. It might be the unleashing of nuclear war, ending the existence of the world. Or a civil war, leading to the suicide of Russia as a political and geographical entity. We must, of course, hope that such a scenario never materializes.

Prolonged depression following a psychotic episode. The depressive scenario is associated with the freezing or collapse of various aspects of life, including the economy, disruption of human relationships, deepening of autism (predominance of inner life and sharp restriction of contact with the outside world), sharp decline in activity and vitality, and plummeting self-esteem. There's a danger of directing aggression inward into society, feelings of helplessness, and an inability to respond to challenges.

What can we do to endure this? Firstly, it's crucial to remember that nightmares aren't eternal. Even the most terrifying periods in history are eventually succeeded by others. From a human perspective, many patients who've experienced a psychotic episode, even a protracted and severe one, gradually emerge from the painful state, regain functionality, and return to relatively normal life. Secondly, it's important to maintain personal awareness and a connection with reality. When it comes to a psychotic state, critical thinking is a crucial factor that improves prognosis. Reality is maintained, particularly through confronting one's own complex experiences. If we ignore feelings, they don't disappear, but we lose the ability to control them (finding a way to express them, choosing when to present them, and when not to). If we're not aware of our feelings, there's a very high risk of being overwhelmed by them. Therefore, it's important to understand our feelings. In a psychotic field, it's difficult to differentiate feelings. Sometimes special effort is required to understand what's happening to us, what these excitations, anxieties, tremors, and insomnia are about. Currently, the most common experiences are:

a) horror (it's terrifying when people die, when the lives of friends and relatives in Ukraine are in danger; it's terrifying to witness the collapse of life), b) shame (shame to associate with the aggressor, with someone whose behavior seems unacceptable; it's shameful when the country you're connected to is condemned by everyone in the world), c) guilt (even if there's no direct sense of responsibility, guilt can arise from feeling better than those being bombed, with nothing you can do about it), d) helplessness (in reality, it's obvious that direct actions and protests don't lead to the desired result right now, sometimes it's not even possible to change the position of friends or relatives, let alone authorities), e) rage (various forms of anger towards Putin, the government, the security council, the inactive or aggressive Europe, NATO, sanctions, compatriots, relatives, the universe, etc.), g) sense of loss (when your home is destroyed or occupied by strangers, it's a very heavy experience, when ties with loved ones are severed, when there's a feeling that you can't return to the country you considered home). These are all feelings we'd rather not encounter. However, avoiding experiences leads to the emergence and deepening of depression."

Therefore, the correct strategy would be to acknowledge and feel. It's important to do this not in isolation (friends, support groups, like-minded individuals), finding support and outlets for experiences and recognizing areas of personal responsibility, while distinguishing what we can change and what we cannot. This will help us avoid sinking into helplessness, find ways to cope with feelings, and act optimally for the situation. By the way, it's also important not to ignore fear. Recognizing fear gives us the opportunity to choose safer strategies for action.

Thirdly, it's crucial to maintain viability, and overall, everything related to life forces. It's challenging amidst depressive experiences, however, it's necessary. It's important to take care of oneself, sleep, eat, and find things that bring joy. As it's known, even in the most difficult situations, during war, in camps, prisons, occupation, those who survived were those who brushed their teeth, shaved, exercised, allowed themselves to fall in love, and had hobbies.

Fourthly, it's important to maintain subjectivity (the ability to have one's own opinion and to act actively, independently of other people). In a situation where you don't choose what happens, don't agree with it, and can't immediately change it, it's easy to feel helpless and start perceiving oneself as an object. To prevent this from happening, it's necessary to find one's own meanings, find things that you consider important to do even in such difficult conditions.

A wonderful woman once told me that in such times, the forces of good are divided into warriors and keepers (the latter like Kropivnitsky, or Frankl, or Schindler). These are the ones who are primarily able to resist the psychotic field, not to be captured by it. It may be difficult for them. Like the degenerates from "The Inhabited Island." Everyone is talking about this book now. And not for nothing. Maybe it's time to reread it, lest it be banned. Although even if the book is banned, there will always be keepers, that's how it is at all times.