My only experience is with an old friend of mine. And she does reason herself out of her delusions.
The hallucinations seen very real to her, the voices do not sound as if they are in her head, but she is rational enough to realise that, say, the tv presenter is not really talking directly to her, or the chances of really having a greek chorus commentating on her every action are close to zero.
Did you see my last post?
The book The Professor and the Madman provides an interesting perspective on this question. It tells the story of a man who was hospitalized for schizophrenia at the end of the 19th century. At that time, his delusions centered around small children who were sneaking into his room through the roof and sexually molesting him. Thirty years later, he was still hospitalized, but now his delusions centered around people who flew down in airplanes and took him away to sexually molest him. Clearly the invention of the airplane shifted his perception of his delusions. If he had been hospitalized in the late 1950’s, when stories of alien abduction first hit the media, I’m sure his tormentors would have become aliens in spaceships.
The term “schizophrenia” encompasses several different mental disorders with their own distinct features. Many do not include delusions or hallucinations. A person who believes the CIA has put a mind-control chip in their brain may be schizophrenic (although not for sure, there could be other causes), but it does not follow that all, or even most, schizophrenics suffer from similar delusions.
The common themes in the delusions of paranoid schizophrenics are not government conspiracies or science-fiction technology, but rather the beliefs that others are spying on them (or can read their minds) and that others wish to harm them. These general fears seem to be caused by the disease itself, but the way they manifest themselves varies from person to person. Now, if you were convinced that you were under constant surveillance, who would you place the blame on? The CIA seems a likely candidate. Devious relatives or neighbors are also a popular choice, as are aliens. Paranoid schizophrenics may be delusional, but they aren’t stupid. They tend to come up with explanations that seem possible, if completely implausible. I remember reading one case study about a man who believed the IRA was videotaping his sexual encounters and selling the videos as porn to fund their activities.
It’s hard to say, since people living in cultures where Western psychiatric practice is unheard of are unlikely to be diagnosed as schizophrenics in the first place. But, as others have said, delusions of a magical or religious nature are probably the most common. These are seen even among paranoid schizophrenics in the US.
Again, someone in a “primitive” culture is unlikely to be diagnosed as a schizophrenic, but I do not believe there are any known cultural causal factors.
Ultrafilter please excuse me if this is out of place, but I’d like to ask couple of questions. When you say, “over the course of the last four and a half years”, are you implying that these symptoms just sort of popped up, or was the onset a gradual thing? Do the symptoms seem completely real, and require a conscious mental effort to realize they aren’t real, or is it clear that they’re unreal from the beginning. How hard is this to live with?
I quote from DSM-IV:
Hmm…
The symptoms probably built up gradually, but I didn’t really notice them until a certain point in time (just after the beginning of winter break of my freshman year of college). At that point, they became kinda hard to ignore.
Fortunately, I don’t generally hear voices, and when I do, they tend not to say things that make any sense. That didn’t stop them from being terrifying at first, but I got used to them. There was a brief time where they started imitating the voices of the people around me, and saying stuff that I knew better than to respond to. Honestly, if they’d been mimicing normal conversation, I wouldn’t have been able to tell the difference.
The last time I really heard them, they were screaming about how lemony-fresh floor cleaner doesn’t taste as good as it smells. It was all I could do to keep from laughing.
Even then, I could tell they weren’t real. I did hear them, but I could tell that they were coming from inside my head. Does that make any sense? It’s kinda hard to explain to someone who’s never had the experience.
I do have some delusions, and I’m not quite comfortable sharing those on a public messageboard. When they’re going, they do require me to put some effort towards disbelieving them. But otherwise, it’s patently obvious that they’re false, because they’re ridiculous. They aren’t classically paranoid–nothing about the CIA or or aliens or my neighbors reading my mind or influencing my behavior.
I deal more with the negative symptoms on a day-to-day basis: the flat affect, the depression, and the disorganized thoughts. It makes work hard, and personal relationships can be a bit of a strain. I think that not being terribly emotional probably is worse than anything else. I can function in society, though. It doesn’t help that I have ADHD–it’s a bad combination.
In all, it’s not such a huge problem that I’m going to seek therapy for it, but if my condition were to get worse, I would.
I suppose that going by the DSM-IV criteria, I’m not strictly schizophrenic, but have a related disorder. No matter the name, it’s still unpleasant.
I imagin its because they think and do things that even they can see are irrational, and not something they ‘should’ be thinking or doing. and so the assume someone must be doing it TO them, and who could possibly have such advanced technology? aliens or the government.
If your thinking is largely in step with that of the rest of the world surrounding you*, you do not experience disorientation and the sense of conflict that you would if the rest of the world held to several shared opinions and ways of looking at things that made no sense to you and you could not understand why they didn’t see the world as you did.
What you don’t realize, if “reality” for you is pretty much the same as “reality” for other people, is how dependent we are on the confirmation of other people’s observations. It is reassuring to be able to do the many different variants of “Did you see that?” and get a quick little reality-check from your neighbor. We do it all the time.
I see “we” guardedly. I was diagnosed schizophrenic. I don’t see the world as most people do, and have found it frustrating all my life that others don’t see the world as I do.
One weird way that this conflict has of manifesting itself is that the voices of people (can be a specific person like your Dad, or, more often, a kind of composite, like an informal archetype rolled out of all the teachers and other authority figures you’ve ever known who could shame you and berate you and make you feel like you had done something wrong or unforgiveably silly), parroting back the kind of non-reinforcing messages that you do get from your neighbors and whatnot, can start talking to you as if an actual person were right there speaking inside your head. These voices are almost always, exclusively, chewing your butt out, yelling at you, explaining how you are wrong wrong wrong and often also culpably blameworthy for how you’ve affected other people in the process of being wrong.
owlofcreamcheese is therefore pretty damn close, except that there is a value judgment inherent there which I do not make. (I am a radical schizzy and don’t think that the contents of the worldview that constitutes “sanity” is an accurate reflection of reality, except that it does predict the behavior of other people fairly effectively as a result of being shared).
Oh, and the other problem with being conceptuallly isolated like that is that you don’t have anyone to say the variations of “Did you see that?” to (because no one is on the same channel as you), so you are deprived of the reality check that you have ceased to be able to rely on. That means that if you (the weirdly thinking person) and your neighbor (a conventionally minded person) each have a peculiar morning on which you reach an invalid conclusion that seems real to you at the time, your neighbor is more likely by far to get grounded on it the first time he or she talks to someone and discovers that they don’t draw that same conclusion. You, on the other hand, can much more easily step out into weirdsville. Notice that I’m drawing a distinction between thinking thoughts that are not shared by other people, including thoughts which contradict those which are, but which are essentially valid, and thoughts that are not shared by other people because you’ve (at least temporarily) lost it and accepted as valid something that ain’t, and don’t realize it yet.
If you’re gonna function as a schizophrenic at large, i.e., as a person whose thought systems are largely incomprehensible to the world and who rejects and/or completely does not understand the thought systems shared by the culture around you, you aren’t gonna make it without a hell of a lot of resiliency and a sense of humor about the times that you do cease to make sense, which is going to happen, which is a real arrogance-piercer and in-your-place-putter although it doesn’t invalidate the rest of your head’s contents when it does.
Gee ultrafilter, you could be an “If They Made it” (a la Conan O’Brien) of me and my housemate/good friend; I’m ADHD, he’s schizoaffective.
and BTW, your experience with the lemony-fresh floor cleaner is just priceless. ROTF!
Can I hijack this thread a wee bit? I know someone who is not schizophrenic, but is Paranoid (as a medical diagnosis) according to her doctor. Does this- the condition of suffering paranoia unrelated to schizophrenia- have a name? I’d like to learn more about the condition.
Could be Paranoid Personality Disorder. You can read about it here.
I’ll also join in that people in a severe or advanced episode of
mania or depression can
also have visual and auditory hallucinations
and paranoia.
One way psychiatrists differentiate between the schizophrenia and bipolar disorder or manic-depressive illness
is to ask the patients if they hear voices, smell odd smells, etc.
And I guess people with schizophrenia would also not respond to
medication for bipolar disorder, unless they are schizoaffective (schizophrenic with a mood disorder).
It looks like the spectrum of mental disorder has overlapping conditions.
Possibly interesting and informative article here about a virtual-reality simulator designed to superficially impart the experience of schizophrenia to people who don’t have it. Supposedly it’s so powerfully suggestive that its creators recommend that people who have struggled with the illness not use it, lest it trigger a relapse.
It is characteristic of schizophrenics that they develop ideosyncratic explanations for their delusions and hallucinations. As several contributors have already suggested, the CIA and
the activities of space aliens are readily available means of rationalizing many feelings and beliefs which are common to schizophrenics.
It is interesting to speculate how many common elements of mythology, both ancient and modern, derive at least in part from hallucinations
commonly brought on by schizophrenia or other, less severe, conditions.
For instance, recently while surfing the net I found various references to “dark men” or “shadow men”, who are supposed to be natives of some parallel universe of whom people occasionally catch glimpses.
A few years ago I had a schizophrenic client whom I represented at a disability hearing. One of his problems was that he frequently went into panics as he drifted off to sleep, convinced that faceless dark figures were attacking him.
Many people who are not schizophrenic have likewise experienced “seeing” shadowy figures as they drifted in or out of consciousness, but are generally able to distinguish these as imaginary. Similarly, a quite ordinary and rational-seeming friend of mine relates that he occasionally hears a mysterious voice call out his name as he drifts off to sleep, but he is untroubled by it, recognizing it as a dreamlike experience.
Meanwhile, thousands of UFO enthusiasts insist that space aliens abduct them as they go to sleep. An example of a myth devoloping to rationalize a common delusional experience? Just maybe.
In the same way, otherwise rational people occasionally “see” tiny figures walking in a straight line. And in Ireland people used to spot the “trooping dwarfs” walking single file.
A schizophrenic I knew believed that people exuded a radiation he could see, and which differed in color according to their overall goodness and sincerity. This sounds a lot like a lot of parapsychological talk about “auras”.
Lastly, it might be worth noting that much of the early literature about UFOs grew out of letters a man named Richard Shaver wrote to science fiction editor Raymond Palmer. Palmer rewrote the letters about robots in the center of the earth who “spoke” to Palmer through his welding equipment into stories for his pulp science fiction magazine and, when the first flying saucer sightings were making the rounds in the late 40s, Palmer claimed, almost certainly tongue-in-cheek, that Shaver’s detrimental robots or “Deros” were responsible for them. Palmer later acknowledged that Shaver was a paranoid schizophrenic who had spent large parts of his life in mental hospitals.
The schizophrenics I have known had a very wide range of delusional elements. One thought his father had been feeding him LSD secretly for years. Another did have delusions about the CIA, but he thought he was working for the CIA, and the bad people were communists, trying to keep him from reporting his “observations.” He kept his observations recorded in notebooks, which he left lying around all over the place. If you looked at one, obviously you were one of the communists.
I was not schizophrenic. I was delusional, though. And I did know that the delusions were not real, at least for some of the time at first, and toward the end of my illness. But they were still quite real to me, in a non intellectual way. I could still feel the things that my mind was creating, even after years of therapy, and recovery. Reality is not nearly so clear cut as you might wish.
Don’t tear down the signposts. You might need them if you get lost.
“We better get back, cause it’ll be dark soon, and they mostly come at night, mostly.” ~ Newt, Aliens ~
I’ve always suspected that the Bible characters who claimed God talked to them were schizophrenic. “They were not,” you say. Well, then, perhaps those who now claim that God speaks to them are not also. 
:o I forgot to mention that tidbit of information. Yes, “positive” symptoms are positive mostly because they are far easier to treat than the negative symptoms associated with chronic 'phrenia.
You can even turn schizophrenic delusions into a livelihood. Ladies and gentlemen, may I present Mr. Whitley Streiber.
I think a lot of what I’ve read are common misconceptions that the general public has about the mentally ill. Mental illness is not like diagnosing dibetes or cancer, it’s vague and generally runs along the lines of “patient exhibits five or more of the following symptoms for a two weeks period” so what happens if that patient exhibits four? Does that make them absolutely NOT mentally ill? Or just a little mentally ill? What if they exhibit those symptome for one week and not two? There is no difinitive test for specific diagnosis and many symptoms of different diseases mimic symptoms of others. Bipolar, schizophreniz, schizoaffective, adhd - all share similar traits. To further complicate matters, many time a person with one disorder will have other disorders as well. that is called comorbity.
As far as patients being the same, ask any psychiatrist -THEY AREN’t! And that is what makes accurate medication prescription so difficult.
If some people have the same sorts of delusions, it is because schizophrenia is not a BEHAVIORAL disorder. The symptoms are behavioral but it is a NEUROLOGICAL malfunction. Basically everything we do (standup, sit down, breath, eat, scared, mad, think the CIA is watching you) is a chemical reaction in the synopsis of the brain. With someone who is mentally ill, those chemicals are slightly altered causing different reactions. Sometimes it’s as simple as getting madder than the situation merits or not getting over being sad as quickly. Sometimes it’s that hair raising on the back of the neck feeling that “someone” might be watching you. (who better than the CIA)
As far as hallucinations, seeing and the processing of what you see is also a chemical reaction. Someone very close to me has these hallucinations and they are very real. Real enough that he talks to them and they talk back. Mostly he knows they aren’t really there so he hides it from other people but when those chemical s get really off balance, he doesn’t know they aren’t there and you will not be able to reason with him. That’s when things get scary for the caretakers (you don’t know what these people are telling him to do)
Someone who is very delusional has their chemical reactions very off balance like how the quality of your pool water gets very off balance sometimes and you simply have to correct that before y ou take a swim.
Keep in mind - they didn’t ask for this, they can’t help it, and they would love to be able to perceive the world like “normal” people. It is a daunting struggle. Is anyone really “normal” anyway?