Understanding Delusions

  • Coming out of the last blog entry, a Q&A with two esteemed psychiatrists, I offer a peer's perspective.  At the 2008 NAMI convention, Milt Greek, who self-identifies as a "schizophrenic," lectured on Schizophrenia: Thinking and Feeling.  He gave us an inside view of what goes on in the head of someone in the throes of psychosis.  A computer programmer, he's lived with the illness for 25 years.


    Milt covered three therapies in his talk: work in psychosis, work in early recovery, and therapy for post-psychotic understanding.  The goal is reintegrating into the mainstream.  One idea he suggested: "There is a rational core inside the person with a hallucinatory reality."  Caregivers, professionals and others need to understand why we cling to our delusions.

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    In a hallucinatory reality, we believe people appear and disappear for mystical reasons and that there are no coincidences.  Also, time and space are no longer bound by physical means.  We're fascinated with synchronicity and the coincidence of thoughts and events.


    Something in what he said struck me as true, as I remembered the time when I had gone off my meds, and my mind was becoming unhinged.  I'd look at the faces of models in catalogs and thought they were real, looking at only me in a dead-on stare.  Their expressions scared me; the models alternately glowered and pouted.


    Milt Greek sat down with a dictionary and discovered meanings of words in the Phoenician alphabet.  If he saw a D/ "door," it was a psychic opening if there was a D in the word.  This emotional projection of symbols, or "magical thinking," happens in psychosis, as well as in the bible, cultures in the U.S. and subcultures.


    When he got sick, friends he knew for years abandoned him.  One day he saw a rainbow, and it served him and guided him to making correct actions because people on the other side were helping him.  He talked about his trials and travels on the road with schizophrenia, and how he mentored a friend's young son who had gotten sick.  This person feared the effects of global warming.  One of his persistent mindsets was: "I want to train my mind to split clouds."  Anyone else would've thought this was a bizarre belief.  Milt understood that the man wanted to control the weather to effect global warming by causing it to rain. 


    So he and the young man stared at the sky for an hour.  Milt kept his trust to share his delusions so the guy trusted him.  To acknowledge the good seed was critical: splitting clouds was all a person with schizophrenia could do to stop global warming, when he was unable to do anything else.


    Indeed, we learn our identity and dialogue through conversations with people around us.  All too often, psychiatrists are quick to judge our symptoms, and not see the ironic benefit in them for the person in psychosis.  Milt believes we need to develop a lexicon of how we think and express delusional thoughts.  False perceptions build slowly over time, are realistic and blend in with reality.  The psychiatrist has to take time to interpret and understand the symbolic language that permeates speech.  Milt suggested he or she be open to a different way of communicating with patients to uncover their rational core.


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    One of my false beliefs was that secret agents were spying on me because I created a revolution through music.  A college disc jockey, I spun records "left of the dial," so this delusion wasn't a stretch.  On the night I had my break, two dark figures were looking out the window of the house in back of ours, and I could see them from my window and thought they were looking at me.  This magnification of my importance in the scheme of things was perhaps telling because my grandpa was in a coma and I was powerless to bring him back to life.  I was also conducting a job search, as I had graduated college, and one recruiter was frosty to me and said, "An employer will take one look at your resume and think you're a punk rocker."


    Milt Greek's wisdom, acquired from years of living with schizophrenia, resonated with me.  In his talk, he mirrored the insight of everyone I know in the field: when we choose to take meds, we can have friends, marry and do other things and have a satisfying life.  He feels his psychotic journey helped him become his best self.  We are all the better for what he went through because he is able to speak with clarity about what it's like to be a person in psychosis.  This has implications for treatment.  The audience was mostly family members who were eager to understand and make sense of what was going on in their loved one's heads.





Published On: June 24, 2008