Saturday, April 21, 2012


I have written often about paranoia, right from the start, and you can get more detail by entering that word on my search bar.

I have a new and interesting update.  One of my claims is that the paranoia strikes the brain first - both in the psychotic illnesses and in the milder political forms of paranoia - and the human then goes in search of the explanation.  Feeling precedes data.  The paranoid is sure that "something is up," and tends to draw on whatever culture floats his way after that.  Thus the focus of the paranoia can change, albeit very slowly, over time.

I have a favorite story about a patient who came in around 2007, complaining that everything had been going fine until the government implanted that chip in his head after the First Gulf War.  I called his family and community providers to get some background information.  His mother told me everything had been fine until the government had implanted that chip in his head after the First Gulf War.

That's when I knew it was going to be a long day.

The patient and his family were involved at the edges in a few paranoid causes - the Ed Brown Tax-Protest standoff, for example - but had been rejected by nearly all because he was just too crazy and threatening for them.  When the people who are into colonics as an adjunct to their dentistry find you too ill...

His case is fascinating in itself, and I could disguise the information well enough to protect his confidentiality (far better than he protects it himself), but that's not my point.  He was brought back to the hospital, accompanied by a different group of visitors who come in and mutter with him now.  His mother is still part of the mix, but the rest of the crowd has changed.  He is still paranoid, and has a theory about why he was brought in now, involving powerful forces arrayed against him that he is going to expose - but no more implanted chip.  Now the story is that Special Forces subjected him to brain experiments while he was in Iraq, and the government has been trying to silence him with "state-sponsored terrorism" ever since. Similar, but not the same.  There has been a migration in the delusion.

His mother has also dropped the chip idea.  She now hears "them" talking about her son from all over America when she is on conference call every night.  The other visitors come from categories of believing other paranoid things about the government* or other world forces, and have concluded that if my patient is being so persecuted, then he must be very near the center of this whole battle, and what he says must therefore be correct, and they should get involved with his battle against the state because clearly, important things ride on it.

That this is entirely circular they cannot accept.  If you tell them that the patient's condition is not that uncommon, his symptoms not that unusual, and the whole thing rather small, they take it as proof that it is big - because clearly the hospital is trying to hide something.  You can refresh your memory on anosognosia if you wish by throwing in that search term up top as well.

*The breakdown seems to be about one-third sounding rather right-wing/libertarian, a few sounding very green/WTO left, but most caught up in their own personal persecution by the various towns they live in.


Sam L. said...

So. Full-spectrum delusionists helping to maintain his delusion.


Donna B. said...

"That's when I knew it was going to be a long day."

Reminded me of one very long day of mine, though somewhat off-topic otherwise.

I was sent as a 2-week temp receptionist many many moons ago to a small non-profit agency that dealt with housing and case management for severely mentally ill people.

I got there at 8, was given a quick lesson in how to handle the phone system (it was already familiar to me) a list of extensions, and told to simply take messages until everyone else got there at 9.

The very first call: a nice, polite lady who sounded elderly to me, asked for so and so, and when I told her I'd need to take a message, she very calmly told me that her roof was falling in and that she was worried it was going to rain some more.

Now, we'd had a big storm move through the area the night before and her problem sounded entirely plausible to me.

I was appalled when no one seemed concerned about this poor woman's roof. I asked if I should find someone to at least go place a tarp until it could be fixed and was told "No, she's all right. I'll go see her tomorrow afternoon."

Do you have any idea how agitated a 'normal' person has to be to get some attention from a gang of overworked 'mental health' workers?

Finally, the only other administrative employee explained to me that afternoon that the very sweet lady called every morning with some seemingly catastrophic problem and that someone had checked the night before to make sure that all the houses were OK.

Texan99 said...

When I was 12 or 13, a friend and I stumbled on a woman on the sidewalk who said she was lost. We'd never heard of Alzheimer's, so it was a long time before we figured out what was up. At one point the lady said one of the nearby houses looked familiar, so we took her there. She opened a Bible and was amazed to see her name in it. Her son found us standing in the parlor and shooed us out rather ceremoniously. Evidently he'd explained the situation too many times and was too overwhelmed to try to explain it to a couple of kids.

AVI -- would your patient be much different, do you think, if his mother and his companions didn't share his delusions? In other words, does it particularly help if the people around such a fellow try to keep him grounded? Do people afflicted in this way often respond to pharmaceuticals?

Assistant Village Idiot said...

Pharmaceuticals is the only thing I would suggest.

People do get by even with serious paranoia, but they don't thrive. I don't know that things would be that different if he were flying solo. The illness does what it does to your brain.

The family rather huddles together for support. Paranoids can attract other supporters because their sincerity is great, which makes them believable.

Donna B. said...
This comment has been removed by the author.
Donna B. said...

"Paranoids can attract other supporters because their sincerity is great, which makes them believable."

If we substitute "candidates" for "paranoids" in that sentence, is it any less accurate? Or terrifying?

Or am I being paranoid?

james said...

Do the paranoid tend to cling to one interpretation, or change their fears from time to time?

Assistant Village Idiot said...

I can't think of an example of a paranoid person whose basic style and understanding changed much at all. That would be related to the lack of activity in the anterior cingulate gyrus and other "storytelling" parts of the brain, I suppose. But I think the pressure of the everyday world and the constant remaking of memory dents that very slowly over time. A similar, but related variation that is getting more attention in popular culture may take over. The Illuminati may be replaced by the Freemasons, and then the Jewish bankers get added in, to take examples from the 19-20th C. But it's still pretty similar.

james said...

I just tried the link at the top and it didn't work.

Assistant Village Idiot said...

Fixed. Thanks, James.

karrde said...

In reviewing the first post, I wonder...

How much paranoia is normal in American political discourse? Is there a base level that will always be present?

Has there been a change in that level? Rarely will people notice that the paranoiacs have gone away, but often they will notice when the paranoiacs have suddenly begun attacking their favorite candidate/cause/party.

On the international scene, it is easy to spot certain groups that appear to act as if they are paranoid. (The original, linked post includes Hezbolla and Hamas. Do other groups count? What about individuals in positions of power?)

Is there more or less such behavior now? Or does it appear to impact the United States less now?

Anonymous said...

I HEARD that he gets paranoid from time to time because he got pissed a long time ago, flipped reality, and then flipped it back.

Sometimes, when he's 'home' again for a while, he'll get paranoid.

I don't think he wants a power struggle, but I'd say he has had a lot of time lately to find his path in life.

Let's all stop spewing problems into space.

3:49 AM like button and yall are way more paranoid than me