Where psychosis and autism meet: The bitter pill to swallow

I am Autistic.

I also have a psychotic condition.

One might wonder why these two things are even related, and yet they share an intimate relationship.

As an Autistic person, I have a monotropic bodymind. I hyperfocus into a subject, and find it very difficult to switch tracks, even when those tracks are taking me barrelling towards those I love, or towards the cliff edge.

Some may have heard of the term “monotropic spiral”. This, to me, describes the way the Autistic bodymind can falk down a rabbit hole of looking into a topic, regardless of where that rabbit hole may lead.

In the same field of concept, the psychotic bodymind obsesses over it’s delusions and constructs a reality. It does this (in my experience) because it feels unsafe.

Why might an Autistic person feel unsafe? There are a million answers to this question, and I only have so much storage space on this website.

The psychotic bodymind uses something called “confirmation bias”. This is where it seeks out evidence to support a conclusion it has already reached, and then to avoid cognitive dissonance, effectively shreds all evidence to the contrary.

Throw away comments, subtle changes in body language and microexpressions, tone of voice. They all get twisted by the mind into something that is not real. This can be further complicated if you are the type of Autistic who struggles to read intent and emotion in other people.

The truth of the matter is, recovery is complicated for Autistic people. We are monotropucally focused on fine details, but when psychotic will often misinterpret them.

It is vital for this reason that early intervention psychosis teams have a good grounding in Autistic experience because it plays a huge role in the roadmap of the psychotic experience.

And, oof!

If you think that your executive function is bad as an Autistic, consider then tackling that while auditory and visual hallucinations are disrupting your reality.

It is not pleasant.


  • David Gray-Hammond

    David Gray-Hammond is an Autistic consultant and trainer, educating on the topics of Autistic experience, mental health, and drug and alcohol use. He has several years experience in this area as well as personal lived experience. He is the author of "The New Normal" and "A Treatise on Chaos" that consider how we might evolve and grow as a society and individuals. You can find out more about his consultancy services at http://www.dghneurodivergentconsultancy.co.uk