Speaker 1: And you can imagine the sort of terror that people who experience paranoid schizophrenia are living in perennially because what happens to them is precisely that they undergo neurophysiological transformations that makes everything that they once depended on disappear and Everything comes back is relevant and that puts them in in the early stages of schizophrenia. That's extraordinarily stressful Neurophysiologically, so they're overwhelmed with cortisol and their brains deteriorate as a consequence of that It's just too much So and unsurprisingly right because you can't deal with you can hardly deal with anything let alone with everything now and often what you see and it's rarely conceptualized this way in the training of Clinical therapists, but often what you see when you are dealing with people who are in crisis Isn't people who have a mental illness in fact in my experience. That's actually quite rare What's far more common is that the person that you're talking to has become overwhelmed by catastrophe So their life has fallen apart in some way that makes what they're doing actually impossible You know so maybe someone very close to them in their family that they were depending on has developed a very serious illness And that's thrown their entire financial state into utter chaos And or maybe they've developed a condition that makes it impossible for them to work Or you know you can you can imagine the potential range of catastrophes and they're coming to see you because they're anxious and depressed, but the reason they're anxious and depressed is because everything they have ignored has popped its head back up and is hell-bent on their destruction and Often you see people who are being attacked by five or six of these monsters at the same time And it isn't their mental illness that stops them from being able to deal with it although that, you know, whatever weaknesses you have are going to interfere. It's the fact that what they're facing is no damn joke, and if you were facing it, you'd feel exactly the same way. So then you're trying to come up with practical solutions to these tremendously complex problems. And that's a very... a very... well, it's extraordinarily difficult, generally speaking. People often don't come to a therapist until they've exhausted their entire range of resources. They cannot figure out what to do. And so you know in a situation like that you can administer antidepressants And maybe that'll help the person increase their stress resistance, but as a And it may be that because they're depressed and have been brought down that they are in fact Exaggerating the danger of some of the smaller monsters that are after them But making the person more stress resilient doesn't give them for example a new job And it certainly doesn't bring back the person they've been living with for two years who has a degenerating Neurological disease or some form of cancer like these things are major. Yeah, I often see people who well They're in a relationship Maybe they're rather isolated older older people one of the partners is dying and their entire financial situation has become catastrophic it's like That's not a mental illness man I mean they may have got into that situation because of one inadequacy or another But you don't even want to push that too far because that sort of thing can happen to anyone and and will in fact happen To most people in one form or another at least at some point in their lives so you want to be damn prepared for that you want to be prepared for that because it's bitter and and harsh and anxiety provoking and painful, but if you're not ready then it's also hell and Often you can stop things from becoming hell even though you can't stop them from being bitter and painful and anxiety provoking and all of that. You can at least delimit the catastrophe enough so that it doesn't permanently bring you and the people around you down. And that's not so bad, right? Or at least it's a lot better than the alternative. you