Why Psychosis Is Not So Crazy: A Conversation with Stijn Vanheule

Mad in America: Rethinking Mental Health

Stijn Vanheule is a clinical psychologist, psychoanalyst, and professor of psychology at Ghent University. Trained in the Lacanian tradition, he has written widely on the structure of psychosis, the limits of psychiatric diagnosis, and the importance of attending to the subjective logic of mental distress.

His books include The Subject of Psychosis: A Lacanian Perspective, Diagnosis and the DSM: A Critical Review, and most recently, Why Psychosis is Not So Crazy, which offers a reorientation of how clinicians, families, and broader society might understand and engage with psychotic experience.

Drawing on psychoanalytic theory, case studies, and contemporary cultural examples, Vanheule treats hallucinations and delusions not as meaningless symptoms but as creative responses to existential disruptions. He emphasizes the importance of listening—clinically and socially—not for coherence imposed from the outside, but for the structure and logic within a person’s seemingly incoherent world. His approach challenges dominant psychiatric models that prioritize symptom suppression, calling instead for a therapeutic attitude grounded in humility and collaboration.

In this interview, Vanheule discusses the role of hallucinations in restoring a shattered sense of meaning, the necessity of admitting one’s limitations as a clinician, and the importance of everyday practices—gardening, conversation, shared meals—in building connections that can anchor recovery. Using a depathologizing lens, he discusses that to overwhelming existential challenges that make us all vulnerable, psychosis might not be a crazy reaction after all.

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Find a full transcript of the interview here: https://www.madinamerica.com/2025/06/why-psychosis-is-not-so-crazy-a-conversation-with-stijn-vanheule/

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