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Saturday, January 19, 2013

When Is a Crazy Thought a Crazy Thought?

The other day I was reading a chapter-in-progress from Sally's schizophrenia memoir. It's a chapter describing "a day in the life" from her most florid psychotic period twelve years ago. In it, she describes seeing "coded messages" in the arrangement of everyday objects (like toothbrushes and bars of soap), "messages" that were being crafted just for her by nameless spies intent on messing with her head.

(By the way, if you want to see the book chapter I'm talking about, in draft form, Sally and I will be sending it out in a few days to everybody who has signed up for book updates. See the form at the bottom of this page if you want to be on our mailing list.)

Sally's cognitive parsing process, when she was in the midst of psychosis, was undeniably bizarre, but there was always logic behind it. Her delusional thoughts weren't just random, fleeting figments. They were reasoned thoughts. The schizophrenic mind puts a huge amount of effort into trying to decipher sensory reality according to rules (rules that make sense to the schizophrenic mind).

Many of Sally's delusions were persecutorial in nature: They're out to get me. The idea that a nameless, invisible "them" (or "they") might be "out to get you" sounds laughable to those of us who consider ourselves "sane." And yet, this type of thinking is actually quite common. When you listen to far-right-wing rhetoric on talk radio (or coming from commentators on the Fox News Channel), what do you hear? Quite often, you hear paranoid rants about how "the government" is trying to take away your basic freedoms (or your money, your gun rights, your right to worship, or what have you). If it's not the government that's out to get you, then it's those pesky secular humanists, or perhaps the Trilateral Commission, or maybe the Freemasons acting in concert with the Illuminati, or maybe nameless, faceless forces sympathetic to the New World Order.

Paranoid thoughts of this general type are extremely common. A 2006 study by researchers at the Institute of Psychiatry, King's College London found, in surveying 1,200 "normal people," that 
  • over 40% of people regularly worry that negative comments are being made about them
  • 27% think that people deliberately try to irritate them
  • 20% worry about being observed or followed
  • 10% think that someone "has it in" for them
  • 5% worry that there's a conspiracy to harm them
These sorts of thoughts are qualitatively no different than thoughts that someone with paranoid schizophrenia would have. They're "crazy thoughts."

When do paranoid thoughts become pathological delusions? For someone with schizophrenia, paranoid thoughts tend to be greater in number; more frequent in occurrence; more elaborate; and more believable, than for the rest of us. A person with schizophrenia usually believes fervently in the factual basis of his or her most bizarre thoughts, to the point of becoming obsessed with them; and the overall effect is to leave the person confused and full of fear, to the point where the person might be terrified to step into the next room, let alone leave the house.

One of the things I've learned from talking to Sally (and reading her book manuscript) that has fascinated me is the extent to which "normal people" think crazy thoughts.

Perhaps it shouldn't be so surprising. After all, societal norms establish the limits of "normal" thinking and behavior (by definition). Sanity is thus, to a degree, socially constructed. Words like "sane" and "insane" are artificial constructs that have no objective meaning. We all live somewhere on a sane/insane continuum.

Consider the fact that schizophrenia sufferers often associate specific meanings with individual numbers (perhaps associating "anger" with the number four, say). Many clinicians consider this sort of illogical association to be a hallmark of psychotic ideation. And yet, most "normal" people believe thirteen to be an unlucky number, which is fundamentally no different from a schizophrenic person believing that four means anger. (There are hundreds, perhaps thousands, of very tall buildings in the United States that have no thirteenth floor, precisely because so many people are convinced of thirteen's potential for evil.) Believing thirteen is "unlucky" doesn't make you mentally ill. Western society accepts the idea that thirteen is unlucky, even though it's a profoundly bizarre concept, qualitatively no different from a "crazy person's" thoughts. But if you believe that all whole numbers from one to fifty have specific individual meanings, that doesn't fit with society's norms. And if ideas about numbers are coming into your head all the time, out of control, causing you to feel so much anxiety that you can't go about your daily business, that's a problem; that's mental illness.

I thought I knew a lot about these sorts of things before reading Sally's book, but as I read each freshly written chapter, I find I'm still learning new things, making fresh associations, filling in the gaps of (mis)understanding; having new ideas. Some of them a little crazy.

It's exciting to see Sally's book coming together. When she finishes it, it'll be quite a read.

7 comments:

  1. Ugh, all the recent complaining was bad enough, but then you had to accuse "far-right" of being "paranoid".

    Maybe this sounds familiar. Get off your high horse. You don't know half as much as you think you do.

    I liked reading this blog at some point. Oh well.

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  2. Thank you so much for your whining.

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  3. Harper's Magazine did an incredibly interesting article on this exact topic about two years ago: "Which Way Madness Lies" (subscription required).

    What was fascinating about that article is that they described a time when the schizophrenic person seemed able to distinguish between the psychotic thought and the real stuff. The person could really say, "okay that's not real." And then some kind of tipping point is hit and the real and the psychotic blur. They're trying to figure out at what point that is, to help schizophrenics better manage their disease.

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  4. Great post. The socially constructed 'norm' is the basis for our learned reality and behavior. Anyone who has altered their mind chemically (e.g. with LSD) knows reality is highly subjective - in a shockingly expressive way. Reality becomes as morphic as one's imagination. Schizophrenics seem to magnetize towards that mallability when most people shy away from it. I could theorize why endlessly but I will put forward one thought: perhaps there is a basic curiosity, present from youth, that combines with chemical (brain or otherwise) and cultural factors to create an exaggerated and excessive/obsessive habit of 'toying with reality'. That it can become a subconscious component to the building of one's worldview makes the combination a mental illness.

    Maybe conquering the walls that hide the fact of the habit can be the key. From Sally's more lucid post-treatment view, she is in the best position to begin to objectify the socially agreed realities and those that tend to be seen as psychotic. With your help, and some love and trust, she can learn to properly label every aspect of her reality without effort or fear.

    She can learn to use her excellent curiosity and imagination and intelligence in concert to shine her light on the life she wants, rather than being blinded by the light of infinite possibility.

    My love and respect to you both. -MP

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    Replies
    1. Thank you for this thoughtful comment. Sally did LSD four or five times in her teens. (She didn't become psychotic until a few years later.) She has told me many times of the similarities (and differences) of an LSD trip vs. florid psychosis. Both, she said, have their pleasurable components, although psychosis is ultimately exhausting due to the peculiar (and unstoppable) hypercognition that accompanies it. Thank you for taking time to post, and thanks for the kind sentiments; back at ya.

      KT

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  5. Eliz772:19 PM

    We do write our own movies in this world. Looking at the present corporate media can convince one of societal madness. Deciding that it is ok to commit the murder and terror of war for any gain is madness. The poet lives on the edge looking at the world's madness. Below is a poem I wrote:

    Ole!
    the crowd cries
    as the red cape of the
    toreador
    flashes to draw
    the brave bull
    dumb to the
    blood on sawdust
    and ears to the
    prettiest woman there.
    And the bull breeder
    proudly counts his
    blood money
    in a tradition of
    ceremonial violence
    and death
    like all blood ceremonies,
    just more orderly
    and less profitable
    than the constant war
    on whatever works for
    profit and power
    to drive the dumb
    bulls of mass hysteria
    called patriotism.

    And the blood
    in the arena
    is ours.

    Will
    the prettiest woman
    refuse the bloody ears?
    Will the profiteers
    stop selling murder?
    All the arenas
    with national names,
    lost on dark press floors:
    Oaxaca, Iraq,
    East Timor
    Afghanistan, Chesnia
    Darfur
    are flowing with blood
    that fattens the faces
    of the pundits
    greasing the wheels
    of TV fencing
    in the stockyard of lies,
    because the truth is
    not pretty ,
    where the children
    are being trained
    to slaughter friends
    as they stand on
    the stinking offal of profits

    buying the power
    to fill arenas with
    our blood.
    2010 Eliz Barger

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  6. Eliz,

    Excellent! Sally (a poet herself) and I (poetignoramus) both think this is a powerful, wonderful poem; and we're happy you posted it. The "stockyard of lies" and arenas filled with (our) blood -- terrific.

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