Today's schizophrenics hallucinate different things than those of your grandparents' time

Thanks to that whole "mental" part, mental illnesses are often heavily influenced by the cultures and societies in which people live. Case in point: The way people with schizophrenia interpret their own hallucinations has changed over the course of the 20th century, keeping pace with changes in technology. Where people once believed that demons were speaking to them, they came to think of those voices as emanating from secret phonographs. Today, people with schizophrenia are likely to imagine hidden cameras taping them for a reality show. The paranoid delusions are always there, but the context changes.

Notable Replies

  1. bzishi says:

    Ugg. Too much philosophizing. Schizophrenia, bipolar disorder, and other conditions that cause psychosis are medical conditions, not a philosophical problem. The first half of this essay appropriately discusses how culture affects these conditions, but the author still had to go on and philosophize about it:

    "Leaks and exposés continually undermine our assumptions about what we
    are revealing and to whom, how far our actions are being monitored and
    our thoughts being transmitted. We manipulate our identities and are
    manipulated by unknown others. We cannot reliably distinguish the real
    from the fake, or the private from the public."

    No, no, no! Psychosis isn't a philosophical issue. If it was, then it wouldn't need to be treated. And yes, most people can reliably distinguish the real from the fake, and the private from the public. The problem with psychosis is that it causes distress and disability. When you experience psychosis you can't function. This is why you treat it. I've experienced mild forms of psychosis several times. It was among the worst experiences of my life--complete and utter hell. I wasn't thinking about the philosophy of the Truman Show or the Matrix, like the author wants to discuss. I questioned reality, but not abstractly and calmly.

    I get it that when people talk about psychosis they want to talk about detachment from reality and then go on to the epistemological and metaphysical conclusions. But I can have that discussion right now without losing my ability to function or being in severe distress. I can question whether I'm in the Matrix or on the Truman Show without feeling an ounce of terror. When you are experiencing psychosis, YOU CAN NOT. Psychosis is a medical condition only. It doesn't hide some greater truth.

  2. I remember reading and article in the New York Times a while back that I found through Boing Boing on the americanization of mental illness. The most interesting part of the article was a discussion of how mental illness symptoms are culturally dependent. Society provides us the menu of options for how to express our underlying mental defect or distress. Just because you have a mental illness doesn't mean you aren't affected by culture.

    What this article appears to be describing is that fact that it is increasingly plausible that you are being watched all the time. Emperor Nero, perhaps aprochryphally, believed that he was being watched through the eyes of the painting that hung in the hallways. These days, there are actually wireless cameras that could be hidden behind a painting to send the signal to be watched elsewhere. It is no wonder that when justifying themselves delusional people use the most reasonable explanation.

  3. miasm says:

    Perhaps growing up in and being conditioned by a society more educated and compassionate about mental health might make more possible, a kind of informed self-diagnosis.

  4. It strikes me as interestingly analogous to what we've learned about how vision works (ie. virtually everything contradicts the naive 'well, the homunculus just sees image data as it comes in and interprets it accordingly' model, and it turns out that all kinds of specialized subsystems are at work, facial recognition, verbal priming improving the ability to distinguish stimuli against low-contrast backgrounds, all sorts of odd complexities).

    The hallucinatory counterpart to the 'naive theory of vision' would be that when you hallucinate you experience false inputs on the video stream, exactly analogous to the real ones except not actually corroborated from your eyes. Since that isn't at all the case, though, and people hallucinate all kinds of things (albeit in a number of genres that do seem to be fairly stable), it suggests that you don't actually hallucinate the aliens, or the CIA mind control chips, or the demons, or the Air Loom; the pathological experience is something lower level, more affective, an intense feeling of 'malignant control at a distance' and then you end up doing your best to fill in (according to the tech level of your time and surroundings) the implementation of the pathological experience that you can't shake(I would imagine that this also makes 'treatment-by-refutation' essentially impossible: If somebody's belief that the CIA planted a chip in their brain, and that belief was the root problem, it might be possible to demonstrate to them that an MRI workup revealed no chip and they must be in error. If, however, the root problem is the inchoate feeling of malignant external control, trying to disprove one hypothesis or another about how that control is being handled is pure whack-a-mole. Even if you can talk them out of one theory, they still have something that cries out for explanation which you haven't even touched, so they'll be back with another one in short order).

Continue the discussion

12 more replies