I have had the pleasure to be one of the first readers of David Gray-Hammond‘s newest book A Guide to Autism and Psychosis: Personal and Professional Insights From A Psychotic Mind. His previous books are informative, deep and personal. They read like a love letter to the Autistic community and a protest placard to improve our lives. A Guide to Autism and Psychosis is no exception.

The prologue sets out the current understanding of the overlap of psychosis and autism, and the difficulty in fully comprehending this statistic. The book is then split into five further parts; prodromal, active, residual (to represent the three phases of schizophrenia), integration and queering the discourse.

Through Prodromal, Gray-Hammond explores what psychosis is, and how it can be recognised in yourself and others. He also explores how Autistic embodiments, such as pattern recognition, can add fuel to psychotic episodes.

In Active Gray-Hammond argues the importance of a good grounding of Autistic experiences for psychosis teams, especially when so many Autistic people may need to access their care. There is also a reflection on the difficulty of coming out of burnout when you are also ADHD: “Co-occurring ADHD may prevent a person from being able to rest and re-regulate themselves. The constant need for stimulation and strong associative thinking can create a situation where a person cannot simply stop.” (p.67). Throughout Active, Gray-Hammond also reflects on community understanding of AuDHD burnout to psychosis cycles (Adkin & Gray-Hammond, 2023).

Gray-Hammond finishes this section by recounting some of his lived experiences of burnout to psychosis, giving his own advice around what he calls the “three Ds”: Don’t try and disprove a delusion; Distraction; Drown out the voices. This section is finished with the following powerful statement:

Through Residual Gray-Hammond shares his quest for object truth, his experiences of schizophrenia and how these are made more complex (and sometimes more beautiful) by also being Autistic and ADHD. He also sets out the complexities of getting antipsychotic medication to fit a person’s needs across their lifetime. Residual is where Gray-Hammond really hits his stride – what he shares is powerful, interesting and neuro-affirming with regards to psychosis and mental health more generally. This is summed up perfectly on page 137: “I know myself to be a person with some inherent value, and to take away any part of that risks altering the measure of me in this world.”

In Integration Gray-Hammond outlines that neurodivergent people “Are not a collection of diagnoses, rather we are a single bodymind that meets multiple criteria.” (p.169). Through this lens, he outlines the need for psychiatry to take a collaborative and holistic approach, helping clients to fix their environments. He also appreciates that people of the global majority are at greater risk of harm from others during psychotic episodes (also explored by many Black therapists and advocates including Ceeka the Art Therapist, Neuro By Nature, Black Minds Matter, The Black, African and Asian Therapy Network)

In the final chapter Queering the Discourse, Gray-Hammond takes a broader look at Autistic experiences of mental health, outside of the usual conversations of anxiety and depression. Psychosis, personality disorders and other mental health issues are still stigmatised, he argues the need for us to “Recognise that distress from traditional “Psychiatric conditions” is as much of a reaction to our environment as an Autistic meltdown is.” (p.195). Outlining the need for the neurodiversity paradigm to cover all neurodivergence, including acquired psychiatric embodiments.

Gray-Hammond finishes the book with a reminder that to understand ourselves we must first understand the systems of normativity which we live under:

A Guide to Autism and Psychosis: Personal and Professional Insights From A Psychotic Mind is Gray-Hammonds’s most structured and “academic” book to date; however, this does not reduce its readability or ability to be used for quick reference. I will proudly display this on my bookcase and will recommend it to those who work in the field and/or have this lived experience.

You can buy Gray=Hammond’s book here. I have been lucky enough to review some of his other books Unusual Medicines, The New Normal.