I have discussed before the surety that psychotic people feel in their delusions. I may not have mentioned how intense it can be, that they cannot allow you to get even two words into a sentence where you are disagreeing - as if they cannot even endure that an opposing view exists. It is a little puzzling. People who disagree even violently about political or religious points can usually make themselves at least listen until another person completes a sentence. Guys getting into bar fights about nothing usually at least get complete idiotic sentences out, which are responded to with at least some minimal comprehension. People with OCD can at least hear you ask "What is the bad thing that will happen if you don't count the squares again?"
My only theory is that because the place in their brain which makes and compares alternative narratives is so thoroughly broken that any bumping up against it is psychically painful, like bright light in the eyes of a person coming from complete darkness, it is perceived as a denial of reality at impossibly levels. It is not a questioning of whether the sky is blue, but of whether there has ever been a sky.
4 comments:
I've been fortunate enough to have had essentially no interaction with psychotics, so this is all news. Is this true for narratives large and small, or is there a spectrum of significance?
Exclusively connected to the delusional material. They can discuss sports, politics, literature, or whatever with give-and take. But any suggestion that the information they want from Joslin Clinic will have no bearing on their mental health treatment, or that they are not people coming into their apartment and leaving the gas on, is met with furious, threatening denial.
So they feel that when you try to contradict them you are trying to pull a mask over their eyes and take away their hard-earned insight.
And I suppose that asking them to explain how it works (as a favor, to warn you) just ends with them accusing you of trying to confuse them. Can't win.
I think it's also seen in people particularly deep in depression. Even when the thoughts aren't florid or obviously "crazy" certain fixed beliefs that life is hopeless, that one is worthless, that everyone hates one, that the world would be better off without one, that nothing can be done, that the agony will never end, that one will never love again, etc can't be pried open with a crowbar.
The brain is literally sick and getting happier, more hopeful thoughts or feelings into it is temporarily impossible. Meds just tranquilize or take away the oomph from the immediate impulse to off oneself. Only love, patient care by a good shrink, the grace of God and time can begin to heal. Feeling held in the love of a warm community like a church can help. Being useful to others, and reaching out to help them is even more healing.
Family, at least spouses, are usually NOT helpful. tLeaden insanity was not what they signed on for. They just want the sick one fixed and back to work and enough already withese obscene psychiatric bills...
Loving one's children is usually the last to go, so can sometimes be worked w by the clinician to help motivate the despairing. Telling a potential suicide that their choice will determine future agony or hope for their kids' lives usually brings people up short.
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