My brother‘s fall into psychosis, and his reemergence
It’s Thursday night at the Hills District Martial Arts Taekwondo gym in the outskirts of suburban Sydney, where my 33-year-old brother, James, is undergoing his black belt grading. Sweat pours from his black curls down his reddened face. His feet move masterfully across the pastel pink and blue floor as he performs his fourth and most complex poomsae of the night — a long sequence of strikes, kicks, and blocks. Each time he performs a move, James lets out a short sharp cry called a ‘kihap’ to focus his energy.
Our dad, forever tall, and mum, with glasses and greyish hair, watch eagerly on. Small tears form in mum’s eyes.
You would have no idea just by looking at him that, 20 years ago, James suffered a terrifying psychotic breakdown that inexorably altered the course of his adult life. It is a story of wild decline, complete collapse and vigilant reinvention — one that James has only recently felt comfortable enough to share, and ask for help to tell.
“How do you feel?” I ask, fumbling with the voice recorder.
“Good. I feel good,” James answers. “I’m glad we’re doing this.”
We’re sitting at the family dinner table, a chunky wooden disc plonked in the sunniest room of the house. It’s at this same table that I first observed James’s psychosis emerge. He was 17, and I was 12.
He would sit opposite me at dinnertime, warm candescent light above us, and I would watch him close his eyes every now and then, and twitch a little. ‘Shut up’ he would whisper, then a bit louder ‘Go away!’. Over time he would flick his hands as though swatting away a fly. Then he’d hit his head with his palm. At night I would hear him in the bedroom next door, close to crying, ‘shut up shut up shut up shut up shut up! SHUT UP!’. When I asked mum what was happening, she said he wasn’t hearing voices — he was having bad thoughts.
“Is that where it began for you?” I ask James.
“No. It began with the bullying,” he says.
James had always been a bright boy, drawn to vast fictional worlds like Men In Black and Star Trek and MechWarrior in his youth, and hefty philosophical concepts in his teenage years, through films like The Matrix. He says now he “always latched on to parts of the collective subconscious.” At high school, a group in his cohort assigned him their plaything and began to pick on him unrelentingly. James recalls being under intense psychological scrutiny, day in and out, for a year — “Whenever I’d walk past them at school they would say something about me. They would jeer me. They knew how to push my buttons,” he says. “I gave the people who were bullying me a type of control — a road into my mind.”
The map to psychosis is not mystical. All it takes is a few factors. Being traumatised by his peers, so consistently for so long and at such a neurologically formative age, seemed to lock James in a state of hyper-arousal and constant self-surveillance. It’s as though his bullies’ bullying became internalised, and a part of his own inner monologue became dissociated or detached from the rest of his mind, treated by his body like a cancer cell — it began talking for them, teasing him, taunting him, deep into the night. As James says so understatedly yet profoundly, “That’s what bullying does — it turns you a bit against yourself.”
This is what I had observed at the dinner table as a 12 year old boy. Unfortunately, things got far worse over the following year. At home he would punch holes in the plasterboard walls. His grades waned. He’d stay up all night and refuse to go to school. When our parents took him to the doctor he was prescribed anti-depressants, but was afraid and didn’t take them. At this stage, James fell into religion (specifically, evangelical Christianity), which he “soaked up like a sponge” in the fresh wake of 9/11 — but far from water, this was kerosene on a raging fire, for his bad thoughts now had a metaphysical flame.
“I was under attack from the devil,” James says. “It would taunt me and make me think things like, ‘I wish I wasn’t Christian’, or ‘I wish I was gay’,” which at that time was shunned by the particular brand of Christianity James had assumed (and is not something he now maligns). “I couldn’t stop thinking about it. It drove me further into Christian, Christian, Christian. Which only made the thoughts louder.”
“It blew my head apart like Chernobyl,” he says.
With a demon loosed upon his mind, James’s traumatised soul sought escape in increasingly unhealthy delusions. He explains that through a concept he dubbed ‘mind over matter’, he thought he could control events in the physical world just by thinking about them (a common symptom of severe psychosis). “[The church] had got it in my head that prayer can move mountains, and so I would pray for things to happen in the real world, and when they didn’t I thought ‘Oh no, what have I done wrong? Why is God punishing me?’”
“That’s such a vicious cycle,” I say.
“A lot of terrorist stuff was happening then.”
“And you were blaming yourself for it?” I ask.
“Yep,” he says. “I became the bearer of the world’s sins.”
Unable to continue at school, James dropped out and fell further into paranoia and delusion. My mother tells me when he was home alone he would take the big silver knife from the top drawer in the kitchen and wait by the bedroom window in the dark of the curtains. On a roadtrip she took him on to try get away from it all, she went to get food, leaving him in the hotel room for a few minutes, which he barricaded and wouldn’t let her back in, screaming “You can’t come in! I can’t let you in!!” Later that night, unable to sleep, he ran into the ocean and came back soaked in saltwater, saturating the bed, panting, in long cosmic weeps.
“I couldn’t relax,” James says now. “I was under attack 24/7.”
Desperate, he started some anti-anxiety medication administered by the juvenile psychiatric practice at our local hospital, but this had a devastating side effect. “It gave me eye seizures,” James says, “My eyes would lock in an upward looking position. And that really fucked with me because it was like I was looking up to God, being fearful of God. Coupled with the hell I was going through mentally, with the devil, it only reaffirmed the thoughts.” (He soon stopped the medicine but is still haunted by this symptom to this day.)
I tear up thinking about the sheer escapelessness of the torture my brother went through, made worse by the fact that when people enter psychosis, they are unaware that they are entering psychosis, meaning it is very difficult to intervene. It was only a matter of time before his breaking point came.
The night of the tree has a fabled existence within my family. My brother’s recollection of the night is hazy, involving some argument with mum and dad. “I was feeling so stressed out,” he says. “I thought, I’ll go climb the tree out the front, you know, like a kid.”
My mother’s recollection is far sharper — before I recount it, please practice empathy and reserve judgement (no one was at their best, and a messy confrontation like this is an inevitability among psychosis sufferers). She recalls that James was “so manic”, so fraught, that he took the big silver knife from the kitchen drawer and held it up to his throat. “I can’t do it, I can’t fucking do it!!” James cried. Mum and dad tried to talk him down. I, having being largely shielded from my brother’s descent, was told to stay in my room as the argument intensified. It was the inevitable crescendo of the past two years of psychological torment, such a moment of desperation for my brother, my father and my mother, that in that moment, my mother let seven words — seven helpless, uncharacteristic, at-her-wit’s-end kind of words —float out into the atmosphere…
“If you’re gonna do it, do it,” she said. And she walked past him, her heart ice hot in fear.
My brother dropped the knife, ran down the staircase, into the black suburban night, and up the tall tree at the bottom of our driveway. He sat on a high branch for an hour, alone, feet dangling, heart racing, devil yelling, hand against his head, “Shut up, shut up, shut up, SHUT UP!!”
Eventually he came back down. But as he did, he slipped on a branch and fell from the tree, whacking his head hard on the pavement and breaking his toe.
I remember him coming up the stairs mumbling “Mind over matter, mind over matter, mind over matter, mind over matter…”, as dark blood dripped on the grey carpet and white bone jutted out from the tip of his foot.
Better that than blood from his neck.
“That was my psychotic break,” James tells me.
He was rushed to hospital. Given anaesthetic and Valium. But at this point, he was elsewhere.
“I felt like I was awake and normal. But it was like a dream world,” he explains. “I was in a purgatory state between subconscious and conscious. And I was seeing things I’d seen in movies. The Matrix. Men In Black. And I was thinking ‘Oh yeah, this stuff is happening for real’.”
“Like what?” I ask.
“You know, like aliens walking around in human suits. And thinking this was all a computer simulation.”
At one point I remember James threw his medicine at the nurse tending to him, yelling “That. Does not. Assimilate!” a reference to the Borg on Star Trek. Jung describes the subconscious as the deep water in the base of a stone fountain — by breaking his toe, my brother had cracked his fountain and it was gushing out everywhere.
Soon he was transferred to the psych ward.
“I thought [the psych ward] was a top secret Black Ops recruitment centre where they would push your mind to the breaking point. It had to be disguised as a hospital to avoid suspicion” he says. Describing the medicine he was forced to swallow, having being put into custodianship of the state, James says he thought “they were pouring napalm down my throat to line it, and then seal it with black napalm, so I could ingest anything on undercover intelligence missions. I was living in a fantasy world,” he adds.
My parents’ first impressions were starkly different. On entering the ward they saw a man run into a wall, screaming, his carers chasing after him. Not the sort of place you’d want your firstborn to spend the night, let alone the next few months.
“J lost a lot of weight. He was so skinny. He was like a POW, and dad had to hold him to shower him. We brought him food, Sustagen, anything, to build him up,” my mother painfully recalls. “I dunno what happened one night — we were there, and they wanted to do something and he retaliated or something and they put him in this little room… And he was running up the wall and bouncing back, and they said ‘You’ve gotta go, just go’. ‘Mum don’t leave me here!’ — oh that was so hard.”
A large part of the effort following someone’s first admission to the psychiatric ward of a hospital is to try establish a regimen of medicines that abate the most harmful symptoms of psychosis — the irrationality, the dangerous behaviour, the aggression, the lack of sleep — to first calm down the patient, make them more sedate, well-rested, and then slowly bring the dosage down. The trouble is that most psychotropic medications have wildly different results person to person, and can induce all sorts of allergic reactions and unfortunate side effects.
“When they were guinea-pigging me with all different medicines, that was hell,” James says. Time felt faint. He felt extremely hot, then extremely cold. The world melted into an amniotic swirl. Behind a fish-tank. “My soul was weak then, doing CPR. I was getting lost,” my brother describes. “But when they found the right mix of medicines and they started working, getting me back into chemical balance, giving my soul a break. And then my soul and the medicine started working in tandem.”
Three psychotropic medicines, in extremely high but carefully proportioned dosages, were to thank for my brother’s return to earth. And the man behind this pharmaceutical cocktail, Dr Kev, the head of the psych ward, would become to James like “a second father”. “He’s a good man. Very good man,” James says. “He helped me realise where I was, that I was in the hospital and I was sick. He said we have a very good family in a time of crisis. Not all families would come together like ours did.”
James put on a lot of weight very quickly, gaining a pot belly common to psych ward patients as a side-effect of the medicine. From a semi-catatonic state of drooling and farting, James gradually became more alert — his eyeballs slow, his speech soft, but his mind, silent.
After a couple of months, James was discharged out into the world again.
“I was flat. I was quiet.”
In the pink and pastel gym, James reaches the halfway point of his Taekwondo grading. Three of the blackbelts who have been quietly watching, now walk on to the floor and take positions in a triangular formation around him. They each hold out a thick wooden board with stick-straight arms.
James knows what to do. As the master gives him the okay, James effortlessly breaks the first board with the butt of his palm. In a fluid transition, he swings his body around to the second board, and uses his other hand to break it with a short, sharp crack. Then, almost without looking, he launches his leg into a back-kick and strikes the third and final board behind him — crrrrrack. James returns to the centre of the triangle and bows.
The master approves. He has passed every challenge the night has thrown at him thus far. But there are still a few more trials ahead…
James was discharged from the psych ward when he was 21. But how does a young man with a now strange and unknown life ahead of him, come to re-enter ‘sane’ society, to re-piece himself and his frail sense of reality?
“What were those first few weeks like, out of hospital?” I ask.
“Shaky,” James says. “I’d been whacked off my horse really badly. I had to pick up all the pieces and learn how to ride again.”
Big life plans had to be put on hold in favour of more pragmatic, day-to-day concerns — namely, medicine, which became a big piece of James’s new life. There were great benefits to the medicine, the quietening of the thoughts (It’s important to note that the thoughts never fully went away. They’re still there, just more in the background. James attests to this saying, “The medicine does dull. After you take it, in about half an hour, forty minutes, you can feel those thoughts kind of settle down and drain away.”).
But the medicine came with costs too. For one, this ‘dulling’ had a blanket effect across his whole mind, making him feel mentally slow, lethargic and forgetful. It zonked him out — he would sleep for upwards of 16–18 hours a day, making it hard to stick to a schedule or hold a job. He had several severe epileptic seizures, requiring hospitalisation. But perhaps the most significant side-effect was that the medicine compromised his immune system. James now had to have regular blood tests, to check his levels of white blood cells, as their depletion is a consequence of his small yellow tablets. New rituals had to be established around the taking of medicine, at morning and at night — but also the filling of scripts, James’s attendance at a monthly clinic with Dr Kevin, regular therapy sessions with a psychologist, and an outpatient support group organised by the hospital (though James quickly stopped attending this group, something common among psychosis outpatients, as he found he would absorb too much of his cohort’s emotions). Life became highly structured around his condition and the medicine needed to keep it quiet.
“What helped you the most at that time?” I ask.
“The people,” James says. “Mum and dad, and the family. That’s important. That you had people living in the same house as you. You weren’t doing it alone. I had the whole psychiatric health team at the hospital. I did still have bad weeks, and I would disagree with them from time to time, but deep down I was always thankful for them.”
In gratitude for the new life the psychiatric team had given him, James volunteered at the hospital. He helped deliver Meals On Wheels and do small office admin tasks. He undertook a consumer advocacy course to help people who had gone through similar experiences to him, though found, as with the outpatient support group, that this would bring back the trauma of his own experience, and so ultimately abandoned it. He eventually did join a new support group through the Early Psychosis Intervention Service at the hospital, and would go on social outings to the movies or ten-pin bowling, making two friends whose friendship he has kept to this day. Through one of these friends he met a girl and fell in love, though like many love stories it fizzled out after several years.
Very decidedly, James avoided returning to the Evangelical church. But as a still highly spiritual person, he got deeply but fleetingly involved with Catholicism in the years immediately following his discharge. He found the ceremony reassuring and the community refreshing for its lack of emphasis on proselytisation. He even volunteered for World Youth Day, getting “5 metres away from the Pope” — but that’s a whole other story.
Eventually, James left the Catholic church and developed his own spiritual beliefs based off the Ancient Greek pantheon of gods, collecting lavender from our parents’ garden and burning it for Athena — though this too has evolved and lessened. Computer games and video games kept him occupied as they had throughout his childhood. He found MMORPGs like ‘Star Wars: Knights Of The Old Republic’ and developed friendships through the game.
Employment during this time was touch-and-go. James picked up several customer service jobs in the years after his discharge, though in saying yes to too many things, often found it too stressful after a couple of months. He would bounce between stints of paid employment and volunteering for various organisations — including a local United Nations spin-off which he was drawn to by its promise of “making a better world, like Star Trek”, but soon discovered it was more of “a paper tiger”.
Each passing preoccupation became a small stepping stone for James to place his feet — standing safely on one for a while, then delicately and tentatively stretching toward the next, leaving the last stone behind. Recovery from psychosis is by tippy-toes, not strides. It is the gradual process of relearning to trust one’s mind. This long period of medicinal, social, and spiritual healing lasted a decade and was punctuated by periodic assessments by the psychiatric health team to lower the amount of medication James was on.
With all the support in place and against impossible odds, James had managed to pick up the pieces and reassemble a life for himself — and it might never have happened had the night of the tree happened differently.
But this story would be incomplete without a brief telling of how James almost lost it all again.
The sun is passing as my brother and I talk at the table.
“I was approaching 30, and wanted to get off my medicine completely,” James says. “I’d heard that when you get to 30, everything starts locking down, you know, physically, mentally, intellectually, so I wanted to change for the positive before that happened.”
At his lowest dosage in ten years, his mind was whirring back into action. He felt inspired to start a business, undertook an events management course at technical college, and began losing weight. But beneath James’s efflorescence was a more sinister operant — he had mistakenly started taking 800mg tablets of one of his medicines instead of the prescribed 1800mg. “Because I was taking the wrong dose of medicine, the safety net fell too quickly,” he explains.
This put him back on a fast path toward psychosis. His thoughts undullened, loud again, this time not as a devil but as the stuff of sci-fi — a “bloody quantum computer”. Wrapped up in it, he stopped taking any of his medicine at all.
“I was analysing everything, looking for synchronicities and patterns — why the sun shines, why it’s at that position in the solar system, why is this happening in this time-space continuum, why does this intersect here, why does this intersect there, why do the birds fly,” James explains it didn’t stop. It kept him up, awake for days, no sleep for weeks, slipping in and out of lucidity and sanity. In the thick of it he slept for just 15min, dreaming of a fiery night in which everything was shifting vertically, sliding, and woke up drenched in sweat. That night he went into our mum’s bed and said — “I need to go to hospital.” He wore his best suit the next morning.
This is a blip, but also leap in James’s recovery — because he still held onto ‘insight’ even in his ragged mental state. And in the ten years James had been out, adult mental health treatment had made leaps too. Less trial and error, more sophisticated control of patients and their symptoms — plus a basketball court and piano and flowers outside. James’s recovery was far quicker and smoother this time around. He was treated in the acute ward on very high dosages to bring him back to reality, and on the sub-acute ward he was a drooling farting mass — but quite quickly, brought back down to more functional levels of medication.
“The world says I’m crazy,” he said in a stupor during one of my visits. “But it’s the world that’s crazy.”
Discharged a second time, he spent the next few months on eggshells. However he was striding much sooner, discovering new hobbies like cosplay, falling in love again, getting a new job and not blindly saying yes to everything — eventually being drawn to Taekwondo and the regimen and discipline of it all. In other words, James not just resumed but expanded on the life he had pieced together for himself over the past decade, spending more time on less stepping stones. It was an embattled but truer reflowering than the one he’d instigated as age 30 first loomed.
“Why do you think it was so much easier to get back on your feet the second time?” I ask.
“I listened to myself, the medication,” James says. “I thought, maybe my brain needs this medicine for the long term, to work properly, until I figure myself out, and then I can come off them, slowly, after I’ve figured myself out.”
“What have you figured out so far?”
James sits back and closes his eyes.
“After I was sick the first time, my guardian spirit came down in a dream and held me. Defeated my demons for me. Gave me a double-bladed sword. And she said ‘the enemy’s behind you, stab him’. And I did it, without turning around.”
He pauses. “I now realise, that if I’d turned around, I would’ve seen that the enemy was me all along.”
“It was veiled for a long time,” he continues. “As my bullies. As the devil. But it was me all the time. My ying yang. My shadow self. My soul trying to rescue me, giving me CPR. It wasn’t god or the devil. It was that part of me that never forgot who I was, the part that I’d abandoned, become ashamed of. It was trying to shock me back into who I was. That’s why it never went away. I was fighting it for so many years before I realised you can’t hide from yourself. You can’t stick your head in the sand from yourself, no matter how hard you try, because it will keep you up at night until the itch has been fixed. I’ve finally gotten rid of the human imprint, of the other things people were trying to make me be. And now I can start being myself again, knowing what I have gone through, knowing what I have learnt, about how things work and myself, on all different levels — mind, body, spirit. And how to stay mentally healthy and balanced. So that one day, I can help others.”
The sun in the sunniest room sets.
James finishes his final poomsae with a bow toward the masters. There’s a smattering of applause, but none louder than my family on the sidelines.
At the end of the evening, James is called to the front of the class. He walks up to the masters and is handed his black belt, ceremoniously, with his name embroidered in gold thread. He goes back to his spot on the floor as the class recite their creed:
“To achieve happiness through a balance of life;
My mission; to improve all that I am,
And to always help others.
To forever seek to develop,
Knowledge in the mind,
Honesty in the heart,
And strength in the body.”
There’s a sense among us that in this small suburban gym on a quiet Thursday night, something monumental has happened — a testament to the strenuous reinvention and everyday heroism exhibited not just by James, but all those who live in the wake of psychosis and severe mental illness.
“What’s next, J?” my mum asks.
“I might start Hapkido next week,” he says.