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West Coast Psychosis Care and Connection: A Retreat on Humanistic Approaches

Dangerous Gifts: Rethinking Psychosis as Signal, Sensitivity, and Systemic Distress

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Description

My work begins with a question that has followed me since my first psychiatric hospitalization as a teenager: What if madness is not only a symptom to suppress, but also a signal trying to tell us something important? For many years I've been exploring the possibility that experiences we call psychosis may sometimes function like alarms: intense expressions of distress, meaning-making, and relational breakdown. They can be frightening and destabilizing, but they may also contain insight about the person, the family, and the social systems they live within. This presentation grows out of more than twenty years spent navigating mental health care from both sides of the locked door: first as a patient in psychiatric wards, and later as a community organizer, peer advocate, and collaborator in early psychosis programs. I begin with my own experience of crisis and hospitalization, and how that moment shaped a lifelong search for ways to understand madness that move beyond purely biomedical explanations. That search led to the creation of the Icarus Project, a peer-led network where thousands of people explored the idea that what we call “mental illness” might sometimes be understood as dangerous gifts—intense sensitivities, visionary states, and psychological survival strategies that can become destructive when unsupported, but transformative when held in the right conditions. From there, the talk explores how psychosis often emerges within relational and systemic contexts. Inspired by dialogical approaches such as Open Dialogue, we can begin to see extreme states not simply as brain disorders but as experiences that unfold within networks of stress, trauma, family dynamics, and cultural meaning. Rather than asking only “What is wrong with this person?” we can also ask: What is happening in the relationships around them? What pressures or contradictions are they trying to metabolize? What meanings might their mind be struggling to construct? The presentation also explores how contemporary frameworks like Internal Family Systems offer practical tools for engaging intense beliefs, voices, and visionary experiences with curiosity rather than confrontation. From this perspective, experiences often labeled “delusional” may be understood as protective parts of the psyche attempting to create coherence in the face of overwhelming emotional and relational pressure. Drawing from personal story, clinical collaboration, and community-based mental health work, I introduce what I call a Copernican shift in psychosis care: moving the center of the conversation away from the idea of a “broken brain” and toward the complex systems—families, institutions, cultures, and histories—in which crisis unfolds. Seen this way, psychosis can sometimes be understood not only as breakdown, but as a signal from the edges of the system—a dangerous gift pointing toward truths that individuals and communities may not yet know how to hold. Participants will leave with new ways of thinking about psychosis that integrate lived experience, relational approaches, and clinical insight—while asking how our care systems might evolve to meet people in crisis with more curiosity, humanity, and possibility.

Learning Objectives

Participants will be able to:

  • Describe at least two alternative frameworks for understanding psychosis that move beyond strictly biomedical models, including relational and peer-informed perspectives.

  • Identify how relational, family, and systemic factors can contribute to the emergence and course of psychotic experiences.

  • Apply at least one dialogical or parts-based approach to engaging with voices, unusual beliefs, or visionary experiences in a clinical or support setting.

Educational Goal

The educational goal of this session is to increase clinician competence in applying lived experience-informed, relational, and systems-oriented approaches to psychosis by exploring dialogical, peer-led, and meaning-centered frameworks that expand clinical formulation, strengthen therapeutic alliance, and promote more collaborative, humane, and recovery-oriented care.

Target Audience

  • Addiction Professional
  • Counselor
  • Marriage & Family Therapist
  • Nurse
  • Physician
  • Psychologist
  • Social Worker

Presenters

Sascha Altman DuBrul, MSW
Sascha Altman DuBrul is a writer, clinician, and co-founder of the Icarus Project, an innovative network of peer-based support groups. He has worked in community mental health and early psychosis programs, and was the lead developer of the peer role at OnTrackNY from 2016-2019. He is the co-author of Navigating the Space Between Brilliance and Madness and the author of Maps to the Other Side: The Adventures of a Bipolar Cartographer. Sascha has spent more than two decades developing creative peer-based approaches to mental health and community care. He lives in Los Angeles with his family and has a private practice. (saschadubrul.com)

Financially Sponsored By

  • Ellenhorn