Duration of Untreated Psychosis (DUP)
The Duration of Untreated Psychosis (DUP) is the term for how long someone goes through an altered state experience before they officially start effective treatment for it. In Western Lapland in Finland, where Open Dialogue is practiced, the time between someone starting to have very uncomfortable experiences until they start effective and supportive treatment is 3 weeks. In the US, it is 74 weeks. That is a very big difference. Being able to look at how this initial time period in your life went and how things have gone since then can be a big piece of working through grief at how difficult that time might have been. No matter how long it took for you to engage with supports that feel good to you, please know you deserve compassion and gentleness at all times.
-Seikkula, J., Aaltonen, J., Alakare, B., Haarakangas, K., Keränen, J., Lehtinen, K. (2006). Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies. Psychotherapy research, Taylor & Francis
Journaling:
How did your own personal experience of altered states start? What did you notice first and what was your reaction? Did you tell others about it? Why or why not?
Have you talked about that time with your family or friends? Do they feel that they noticed you going through that experience also? Did they try to talk to you about it? Did they try to bring it up with compassion and kindness?
How long did it take before you were involved in some type of treatment? Was it a caring form of treatment? Was it scary? Did you feel the first treatment you received was helpful?
Is this a topic you feel comfortable sharing with others? What suggestions might you offer others who experience altered states?
Do you feel able to tell your treatment team (could be a therapist, peer support worker, nurse, psychiatrist, wellness class teacher, etc) about this initial time period in your experience? Do you feel they listen well and offer compassion? If you want changes in your treatment are you able to express that comfortably?
Changing our focus:
Please have a look above you. If you are in a building, please notice all details of the ceiling. What parts are dim vs lit up? Are there any aspects that you hadn’t noticed before like a different pattern or an unusual shape? Is it all one color or does it change? If you are outdoors, look at the sky and notice if there are clouds, planes or birds? Does the color shift at any point? Is it easy to look all around or are there spots that are hard to focus on because of the light or hard to see clearly because of darkness? Remind yourself that being able to just notice is a thing we can do at almost any time. And taking a short break just to be mindful and aware of details sometimes can allow us to feel relaxed no matter what we were just thinking about. Please spend a minute or two savoring just the details even if they are boring.