What Is a Psychotic Disorder?

Psychotic disorders are a group of serious illnesses that affect the mind. They make it hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately.

When symptoms are severe, people with psychotic disorders have trouble staying in touch with reality and often are unable to handle daily life. But even severe psychotic disorders usually can be treated.


There are different types of psychotic disorders, including:

Schizophrenia: People with this illness have changes in behavior and other symptoms — such as delusions and hallucinations — that last longer than 6 months. It usually affects them at work or school, as well as their relationships. Know the early warning signs of schizophrenia.

Schizoaffective disorder: People have symptoms of both schizophrenia and a mood disorder, such as depression or bipolar disorder. Learn more about the symptoms of schizoaffective disorder.

Schizophreniform disorder: This includes symptoms of schizophrenia, but the symptoms last for a shorter time: between 1 and 6 months. Find out more on schizophreniform disorder symptoms to look for.

Brief psychotic disorder: People with this illness have a sudden, short period of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick — usually less than a month. Get more information about the different forms of brief psychotic disorder.

Delusional disorder  The key symptom is having a delusion (a false, fixed belief) involving a real-life situation that could be true but isn’t, such as being followed, being plotted against, or having a disease. The delusion lasts for at least 1 month. Read more on the types of delusions.

Shared psychotic disorder (also called folie à deux): This illness happens when one person in a relationship has a delusion and the other person in the relationship adopts it, too. Learn more about shared psychotic disorder and how it develops.

Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from drugs, such as hallucinogens and crack cocaine, that cause hallucinations, delusions, or confused speech. Find out more on substance-induced psychosis and other causes of secondary psychosis.

Psychotic disorder due to another medical condition: Hallucinations, delusions, or other symptoms may happen because of another illness that affects brain function, such as a head injury or brain tumor.

Paraphrenia: This condition has symptoms similar to schizophrenia. It starts late in life, when people are elderly.


Empathic dysfunction in psychopathic individuals

Introduction Psychopathy can be considered one of the prototypical disorders associated with empathic dysfunction. Reference to empathic dysfunction is part of the diagnostic criteria of psychopathy (Hare, 1991). The very ability to inflict serious harm to others repeatedly can be, and is (Hare, 1991), an indicator of a profound disturbance in an appropriate ‘empathic’ response to the suffering of another. The goal of this chapter will be to consider the nature of the empathic impairment in psychopathy. First, I will consider the disorder of psychopathy and the definition of empathy. Second, I will consider whether individuals with psychopathy are impaired in ‘cognitive empathy’ or Theory of Mind. Third, I will consider the cognitive and neural architecture mediating ‘emotional empathy’. Fourth, I will consider whether individuals with psychopathy are impaired in ‘emotional empathy’. The disorder of psychopathy The origins of the concept of psychopathy probably originate in the writings of Pritchard (1837); see Pichot (1978). Pritchard developed the concept of ‘moral insanity’ to account for socially damaging or irresponsible behaviour that was not associated with known forms of mental disorder. He attributed morally objectionable behaviour to be a consequence of a diseased ‘moral faculty’. While the notion of a ‘moral faculty’ has been dropped, modern psychiatric classifications such as the American Psychiatric Association’s Diagnostic and Statistical Manual (currently, DSM-IV) make reference to syndromes associated with high levels of antisocial behaviour: conduct disorder (CD) in children and antisocial personality disorder (APD) in adults. © Cambridge University Press 2007 and Cambridge University Press, 2009.


The Big 5

The five factor model of personality has significant relationships with the dark triad combined and with each of the dark triad’s traits. The dark triad overall is negatively related to both agreeableness and conscientiousness.[22] More specifically, Machiavellianism captures a suspicious versus trusting view of human nature which is also captured by the Trust sub-scale on the agreeableness trait.[95] Extroversion captures similar aspects of assertiveness, dominance, and self-importance as narcissism.[95] Narcissism also is positively related to the achievement striving and competence aspects of Conscientiousness. Psychopathy has the strongest correlations with low dutifulness and deliberation aspects of Conscientiousness.[22]


Dark tetrad

Vulnerable dark triad

Malignant narcissism

Light triad

Parental Alienator Behaviours

Not a full comprehensive list, I am sure many of you could add many more!!

  • Pathological lying
  • Projection, accusing you of what they are doing
  • Dishonesty, stealing, cheating etc
  • Collecting official letterheads to create fake documents for court hearings
  • Self employed providing fake account’s for court hearings
  • Changing court hearings, using delaying tactics
  • Totally ignoring court orders for access to your children
  • Falsifying documents for courts and to flout in front of friends and family
  • Using other people to carry out criminal damage to your property
  • Non payment of child maintenance
  • Non payment of Tax, VAT and National Insurance
  • Claiming benefits illegally – benefit fraud
  • Claiming benefits whilst still working
  • Financial abuse, building up arrears on mortgage and other bills and debts.
  • Taking your personal possessions and giving them away
  • Hiding the children’s things and accusing you of stealing
  • Damaging items and accusing you.
  • Stealing your household items furniture, clothing etc.
  • Withholding your car keys, passports and other personal documents
  • Criminal damage to personal property, car, house and garden
  • Graffiti on your car and property
  • Making fake statements, complaints, phone calls to your place of work, the police, social services etc.
  • Internet bullying online abuse through fake social media profiles
  • Setting up fake FB accounts in your name
  • Using your name fraudulently to claim benefits
  • Distributing pornographic material and saying its photos of you!
  • Sending family and friends funeral wreaths, pornographic material and any other offensive material.
  • Telling schools, the police, social services and other officials that you have a mental illness.
  • Destroying all family photographs
  • Destroying any gifts, cards or presents you send
  • Destroying official papers, birth certificates, marriage certificates, driving licence etc
  • Removing gift tags and claiming any gifts or presents you send as their own
  • Befriending all your friends, especially of the opposite sex, flattering them, then claim you never liked them.
  • Paying bribing friends to go to court and give fake evidence about you
  • Using blackmail to try and extort money from you
  • Trying to turn all your family against you
  • Making covert contact with long lost relatives and spreading falsehoods about you.
  • Laughing and mocking in from of the children when someone from your side of the family passes away.
  • Trying to get parents to change their wills in their favour
  • Falling out with their own family over wills.
  • Running up debts and committing fraud in your name
  • Threatening you with a weapon
  • Putting drugs and poison into your food and drinks
  • Cruelty to your pets
  • Last but not least brainwashing your children to believe you don’t love them.


Narcissist Becomes Psychotic


The concept of narcissism has a certain connotation in psychiatry and a slightly different one in psychoanalysis. This is similar to the concept’s evolution, over the years, undergoing major changes, defining varied psychodynamic or psychological realities. Therefore, this paper proposes a multi-faceted perspective on the concept of narcissism, from the perspective of multiple psychoanalyst authors belonging to various currents /orientations. The overall objective is to demonstrate that: narcissism involves a particular way of mental functioning, having roots in childhood and in early relational models, but that, in time, a particular type of functioning determines a structure of some kind (of organizing the personality), which can be correspondent to the wide array of enhanced features or to a severe psychiatric diagnosis.


Contribution to the Metapsychology of Psychotic Identifications – Edith Jacobson, 1954

Source: Contribution to the Metapsychology of Psychotic Identifications – Edith Jacobson, 1954

The Loss of Reality in Neurosis and Psychosis

The Loss of Reality in Neurosis and Psychosis

Accordingly, the initial difference is expressed thus in the final outcome: in neurosis a piece of reality is avoided by a sort of flight, whereas in psychosis it is remodelled. Or we might say: in psychosis, the initial flight is succeeded by an active phase of remodelling; in neurosis, the initial obedience is succeeded by a deferred attempt at flight. Or again, expressed in yet another way: neurosis does not disavow the reality, it only ignores it; psychosis disavows it and tries to replace it. We call behaviour ‘normal’ or ‘healthy’, if it combines certain features of both reactions – if it disavows the reality as little as does a neurosis, but if it then exerts itself, as does a psychosis, to effect an alteration of that reality. Of course, this expedient, normal, behaviour leads to work being carried out on the external world; it does not stop, as in psychosis, at effecting internal changes. It is no longer autoplastic but alloplastic.

   In a psychosis, the transforming of reality is carried out upon the psychical precipitates of former relations to it – that is, upon the memory-traces, ideas and judgements which have been previously derived from reality and by which reality was represented in the mind. But this relation was never a closed one; it was continually being enriched and altered by fresh perceptions. Thus the psychosis is also faced with the task of procuring for itself perceptions of a kind which shall correspond to the new reality; and this is most radically effected by means of hallucination. The fact that, in so many forms and cases of psychosis, the paramnesias, the delusions and the hallucinations that occur are of a most distressing character and are bound up with a generation of anxiety – this fact is without doubt a sign that the whole process of remodelling is carried through against forces which oppose it violently. We may construct the process on the model of a neurosis, with which we are more familiar. There we see that a reaction of anxiety sets in whenever the repressed instinct makes a thrust forward, and that the outcome of the conflict is only a compromise and does not provide complete satisfaction. Probably in a psychosis the rejected piece of reality constantly forces itself upon the mind, just as the repressed instinct does in a neurosis, and that is why in both cases the consequences too are the same. The elucidation of the various mechanisms which are designed, in the psychoses, to turn the subject away from reality and to reconstruct reality – this is a task for specialized psychiatric study which has not yet been taken in hand.

There is, therefore, a further analogy between a neurosis and a psychosis, in that in both of them the task which is undertaken in the second step is partly unsuccessful. For the repressed instinct is unable to procure a full substitute (in neurosis); and the representation of reality cannot be remoulded into satisfying forms (not, at least, in every species of mental illness). But the emphasis is different in the two cases. In a psychosis it falls entirely on the first step, which is pathological in itself and cannot but lead to illness. In a neurosis, on the other hand, it falls on the second step, on the failure of the repression, whereas the first step may succeed, and does succeed in innumerable instances without overstepping the bounds of health – even though it does so at a certain price and not without leaving behind traces of the psychical expenditure it has called for. These distinctions, and perhaps many others as well, are a result of the topographical difference in the initial situation of the pathogenic conflict – namely whether in it the ego yielded to its allegiance to the real world or to its dependence on the id.

   A neurosis usually contents itself with avoiding the piece of reality in question and protecting itself against coming into contact with it. The sharp distinction between neurosis and psychosis, however, is weakened by the circumstance that in neurosis, too, there is no lack of attempts to replace a disagreeable reality by one which is more in keeping with the subject’s wishes. This is made possible by the existence of a world of phantasy, of a domain which became separated from the real external world at the time of the introduction of the reality principle. This domain has since been kept free from the demands of the exigencies of life, like a kind of ‘reservation’; it is not inaccessible to the ego, but is only loosely attached to it. It is from this world of phantasy that the neurosis draws the material for its new wishful constructions, and it usually finds that material along the path of regression to a more satisfying real past.


Boundaries and Dysfunctional Family Systems

A boundary is a barrier; something that separates two things. Walls, fences and cell membranes are examples of physical boundaries. Psychological boundaries can be said to exist too, even though such boundaries have no physical reality. Psychological boundaries are constructed of ideas, perceptions, beliefs and understandings that enable people to define not only their social group memberships, but also their own self-concepts and identities. Such boundaries are the basis by which people distinguish between “We” or “I” (group members; insiders; part of “Us”) and “Other” (outsiders and examples of what is “not-self”). Each person can be said to have a psychological identity boundary around themselves by which they distinguish themselves from other people. Like other boundaries, this identity boundary both separates people and also defines how they are linked together. This is to say that the act of drawing the boundary itself provides the basis for saying that one person is separate from another psychologically, but does so only by drawing a distinction between those two people, which implies a relationship, never the less. Self cannot exist without also “Not-self” existing, just as figure cannot exist without ground against which to contrast. Identity necessarily includes social relationships which are built into the self to varying degrees.


Can we really be taught to feel each other’s pain?

 “Empathy extends beyond trying to put yourself in other people’s shoes,” said Ms. Holloway, the student at Oberlin. “Success is not part of that definition, really. The act of listening is a form of that empathy. You’re willing to attempt to understand.” Only by constantly making that attempt — however imperfect — can we learn empathy’s hazards, and its power.