Tuesday, May 31, 2011


One of my paranoid patients uncovered the site Are You Targeted in his searching the internet for proof that he is being harassed by Hollywood and popular music, with messages directed specifically at him. He takes the existence of this site as evidence that his paranoid delusions are true: See, this is happening to other people, too! That different things are happening to those people, and they each have different experiences from each other, with only minor overlap, fazes him not. It's all tied in together somehow.

(The photo is from Ocala, FL)

My other really bright paranoid patient - she was a software developer up until a decade ago - has a different, nonelectronic set of delusions. A homeless person has been stalking her for at least three years, across three states, and recently revealed his existence by mistakenly leaving a purse she had lost in 2007 in a box in her apartment.

Here's the saddening, infuriating, and fascinating part. Both of them are now on medication, and are far more organised and relaxed. Both are able to coherently put on paper or into speech what they were unable to only a month ago. Then, additional notes up the side of the page, or between lines, or underlined and arrowed onto the back made their work unreadable. Now they can write in sentences and paragraphs. (I am overdrawing that somewhat, but the difference is dramatic.) Yet their delusions are absolutely untouched, with the possible exception of the fact that no new material is being added.

So there are two - at least two - parts to the illness, one which is treated by the medication and another which is untouched.


Jeremy said...


One problem with publicizing something that is intended to look like mental illness (see: 'Tricking targets into exhibiting the symptoms of mental illness') is that the publicity is going to attract people who are mentally ill.

Note that I'm not making any judgements about your patient - I have no idea what his situation is.

By the way, even when my alleged "illness" was at its worst, I never lost the ability to write coherently or reason about my situation.

Just saying.

Lelia Rose Foreman said...


Retriever said...

The site is very interesting but I have a spouse who doesn't need more to obsess about! :) Even when a person isn't mentally ill (or hasn't been diagnosed), paranoia endures. Because of random reinforcement. Because sooner or later if you suspect everyone, someone will harm you, confirming your paranoia. Also, just because you're paranoid, doesn't mean your government or wicked corporate types might not spy on you if it suited them. A certain degree of paranoia is adaptive. But vis a vis patients, I think it lingers after some of the more horrific delusions fade because paranoid thinking is a pattern worn into the lawn during daily walks. A habit. Hard to break. More of a personality disorder than a mood or delusional state. Personalities are hard to change. You stop seeing soul eating demons and become obsessed instead with identity theft and abuse of your credit card. You can't medicate away fear and suspicion(except temporarily w beer, perhaps, not recommended for people on heavy meds.

Thinking also of multiple diagnoses. The atypicals are helpful in reducing some obsessive and weird thoughts and agitated behaviors in autism as well as schizophrenia, as well as at rapidly controlling mania in bipolar. But they tackle symptoms, not disorders. Enough.

Assistant Village Idiot said...

Jeremy - thanks for taking the time, but I am unconvinced. You do write coherently, and you should be grateful that your illness did not affect that. "Reasoning" bout your situation is more problematic. Some types of reasoning do remain intact, and even hypertrophy in illness. GK Chesterton said, quite wisely, that a madman is not one who has lost his reason, but has lost everything else: perspective, ability to see alternatives, character understanding. Whether your paranoia is of the delusional or personality disordered sort I could not hope to guess, but it jumps off the page.

Because of anosognosia, that will likely never change. But even in the personality-driven forms, confirmation bias is very powerful, as retriever notes. I'm begging you to consider even a 1% possibility that you are wrong (not the same as being 1% wrong, notice.)