By Victoria Harris, MD, MPH
In the Fall 2020 issue of the Advocate, I told my story of experiencing psychosis for over a year and finding myself incarcerated in a small county jail. To survive, I relied on the principles of neuroplasticity, my brain’s ability to adapt and change its neural wiring.
When I was released from jail for the fourth and final time, I was no longer in the midst of psychosis, but I was incredibly vulnerable. I was released with only two weeks’ worth of medications and was on my own to find follow-up care.
I had been ill for the better part of a year, had unintentionally damaged relationships with family members and had terrified my neighbors. I no longer had a home or a place to stay. All my belongings, except my dog and a few things carefully set aside by a friend, were in storage. I had serious outstanding felony and misdemeanor criminal charges. Finally, in the chaos leading up to my last arrest, I lost my cell phone that had all my contacts and passwords to various accounts.
I was filled with shame and horror as I realized some of the things I had done. I was overwhelmed at the tasks ahead of me. And I was terrified that I was going to be arrested and incarcerated again. So, I reminded myself that:
- I am decent and compassionate person and that I was doing my best to both repair and move forward.
- I could now plan and follow through on my goals and that the first attempts might be unsuccessful.
- This point in my life was an opportunity to intervene — to change moving forward.
I knew my brain needed to continue to re-wire some circuits (especially around social connection), and I needed to continue the newer pathways that I forged while in jail. I used Erik Erickson’s long-used and well-established model based on 1) work, 2) love and 3) play as the basis for my psychosocial recovery, with an added dimension of spirituality.
My Recovery Model
In the early days after release from jail, I was tempted to languish in what I didn’t have and things that had happened that were beyond my control. However, I mindfully resisted because focusing on the negative aspects of my life seemed to suck hope, motivation and purpose from me. I chose instead to acknowledge the realities of my life and maintain my fundamental beliefs and optimism.
To do this, I focused on work, love, play and spirituality as the required elements for recovery. The exact amount of time spent on each of these dimensions varied, but I knew that my balanced recovery required time and attention to each.
While this dimension of life usually refers to volunteering, being in the paid workforce or attending school, these were not my focus in the early weeks to months of the transition period to recovery. My work was focused on safety in terms of housing and food. I am fortunate that I had resources I could eventually access but, even still, I was homeless for about two months after jail.
Once I decided to move across the state to be near family, my work of finding mental health follow-up became even more complicated. Managing the criminal, civil and administrative legal issues were also complicated — in part because they are foreign systems to me and because of the outstanding complexities unique to my situation.
Other pieces of work that I faced had to do with the chaos that I had created while ill. I had to change all my social media accounts as soon as I could access them. I had to address mounting bills as well as ones that had gone unpaid. I had to navigate through red tape for weeks with my cell phone carrier just to get a replacement for the one I had lost. In the interim, my attorneys and family were having a difficult time trying to get a hold of me.
These are just a few of the logistics that I spent time having to work through. While many of these situations proved challenging, they were all necessary steps to maintain my mental health and give me a sense of direction and purpose while on the path to recovery.
I paused here many times to give myself the love, caring and respect that I needed. This was an important step because without a way to access self-love, it would have been easy to slip into self-loathing based on some things I had done and what others had said about me. I also sought to repair relationships with family members that I damaged during my psychosis episode. Finally, I cautiously reached out, as appropriate, to a handful of my old neighbors.
Moving forward through recovery, this portion emphasizes my need for ongoing social connections with peers. The pandemic has complicated this component of my recovery because of the necessary restrictions on community activities. Ordinarily, I would have relied on shared interests through platforms like meetup.com. Until it is safe to resume in-person engagement, I am content meeting people online through opportunities such as support groups, book clubs and religious activities.
Fortunately, my dog reminded me daily to walk and play. It was difficult at first as I faced issues of food and housing insecurity. It was hard to remember that some level of physical activity was as important as showing up for my next appointment. While I struggled with a sense of worth and purpose, my dog constantly reminded me that he (and I) needed fresh air and a chance to stretch my legs.
As I slowly regained my habits and preference for daily physical activity, I was struck by the change in my body. Compared to pre-incarceration, my sense of balance was impaired. In addition, my glutes, hamstrings and hip flexors used for long-distance walking or running no longer had the same girth or stamina. I tried to maintain my physical health while in jail by jogging in place or stretching. But it took much play, with my dog as my coach, to regain my overall sense of balance and strength.
Spiritual practice for me holds the promise of the future, while providing a supportive, compassionate frame for what has happened. It requires that I practice in community and must, therefore, also continually address social isolation as a potential risk factor for relapse. In mindfully building and strengthening new religious ties, I will also eventually be able to soothe some of the pain of the relationships I’ve lost as the result of being so ill.
My model for my survival and recovery relies on neuroplasticity, or my brain’s ability to rewire in response to chaos and crisis. While this happens at the level of neurotransmitters or chemicals in my brain, I knew that I could actively intervene and direct some changes. Both in jail and after my release, I used the concept of building foundations to provide relief and growth. It seems likely that I will continue with this model to retain the balance needed in my life.
Victoria Harris is honored to have worked as both a general physician and a psychiatrist. She is the parent of two young adult children who are courageous, brave and a source of inspiration for many. Victoria now lives in Eastern Washington and can be found enjoying the trails with her Diggity Dog.