Treatment that looks to individuals with psychoses being safe for themselves and others is the optimal treatment approach. There are steps that individuals with psychoses can take to ward of impending personal apocalypses where such steps would not survive rational criticisms. Demanding than individuals with psychoses stop various ways that are employed by such individuals to address the World crowding in, or the encroachment of the liminal, a term used by Esmé Weijun Wang in her terrific book The Collected Schizophrenia, that are not rational but do stave off personal apocalypses brings personal apocalypses closer which is bad for individuals with a psychoses and bad for everyone. The demand that individuals with psychoses have insight into their illnesses rather than that such individuals be safe for themselves and others has been a treatment catastrophe.
If individuals with psychoses realize they are ill but do not want to talk about how they are ‘cracked’ or their psychological symptoms though can be talked to about being safe for themselves or others that is more than enough for treatment. Very, very frequently family stories about how there must be more services of every kind to get our very ‘cracked ‘ relatives uncracked are disaster stories.
Pushing Individuals with psychoses to examine how they are ‘cracked’ is worse than pointless from a treatment perspective, infinitely boring for both patients and therapists, unless the therapists are sadists, and increases greatly the likelihood of catastrophes. The surface attractiveness of the ‘sensible demand’ that individuals with psychoses have insight into their illnesses is a trap all too many individuals have fallen into.
In a word individuals with psychoses are anti-psychologists and that must be respected to deliver optimal treatment.