Delusion: de·lu·sion \di-ˈlü-zhən\ 
1: the act of deluding : the state of being deluded
2: a : something that is falsely or delusively believed or propagated
b : a persistent false psychotic belief regarding the self or persons or objects outside the self that is maintained despite indisputable evidence to the
contrary; also : the abnormal state marked by such beliefs.
She stood before me, young 30s, rather slim, smartly put together, hair done up in a tight bun. She was distraught. Her husband you see, how to say this . . .he was dead, had died 3 nights ago, and now because I was questioning this I was trying to steal his soul. I, and the detective who was called to her home earlier today when she reported her husband kidnapped and murdered, and the elementary school principal who “let that strange man” pick up her daughter. The only problem is that her husband died about 3 times a month, and has been doing so for the past few years.
We were not in a crisis unit, sure it looked as such, but this was purgatory and we all were trying to take her husband’s soul. Flashes of Sarah Connor from Terminator come to mind, “You’re Dead! You’re already dead!” Would you fight for your spouses soul in such a situation? How badly would you fight? Like Robin Williams in the movie What Dreams May Come, she was going to fight against the seeming reality she KNEW wasn’t real. She was going to fight dammit.
And she did, and more than once throughout the night, the quiet room was used, and restraints were used . . . and after she’d calm and settle she’d return to the general unit, and after time escalate again and the process repeated. And fortunately no one got hurt, no one physically got hurt, but each time she said her own soul was harmed and in retrospect I’m not so sure she was wrong about that.
She was internally logical and goal-directed, as we shrinks like to say. She made internal sense, meaning, if you crawled into her world and accepted her basic propositions her arguments flowed and were internally consistent. She didn’t stutter, she didn’t stammer, she used big girl words. The rub? She was completely out of touch with her one small segment of reality, and scared shitless about THAT version of the world. If you talked to her at a Starbucks you might not notice this at all, but if stumbled on the topic of her husband you’d be in for a wild ride, and probably finish your coffee quickly and scamper away.
My logical and verbal appeals went nowhere, the man who lived with her was not her husband but a cyborg of sorts, a cloned replica. He had been down this road a few times and was active in our intervention and helpful, so I brought him in and we all talked together. We presented marriage pictures (photo-shopped), a birth certificate (forged, just like the President!), joint check book and credit card statements (identity theft), and even a phone call to her own parents whom she trusted (“they love me so much they’re lying to protect me” and “they obviously got to my parents too!” ). She was polite to him, found him attractive and appealing, but was fearful as well “that’s not my husband.”
She suffered from a Fixed Delusion, which distinguishes itself from the more acute paranoid delusions we often see with Schizophrenia and some Bipolar conditions. In the latter, your thought, your actions, your behaviors and your full functional capacity is markedly compromised. In a Fixed Delusion, you generally can function well, but you have one particular belief which you can’t shake, which you hold on to as if life depended on it . . . and it does. And it creates a self-fulfilling prophecy.
– We were conspiring against her and detaining her against her will- check, technically correct;
– People were treating her strangely and with disrespect; check, also correct stemming from her increasing bizarre behaviors;
– She recently lost her job because of her husband; again, technically correct but due to her increasingly odd behavior not due to some conspiracy;
– No one is listening to her; in essence, yes, check, she had blown credibility and the more others didn’t listen the more she felt an urge to plead her case.
The person with a fixed delusion is a master weaver, who takes whatever incontrovertible material you hand them and weaves it into their pre-made tapestry of delusional belief. I gently confronted her delusions, which is all you can do. For some, the delusional belief can be very strong and imbedded into their fundamental sense of self- to destroy the delusion is to annihilate the self, to paraphrase Heinz Kohut (another shrink). Imagine you woke up tomorrow and some great ruse was played on you, not unlike that played on Michael Douglas in the move The Game. You are convinced of a reality for which others, ALL others, negate. For those of us not in this territory almost need to take the example to an extreme- you wake up, everyone has one eye like a cyclops, they speak a foreign language, they are not hostile but regard you with a sense of curiosity and wonderment, there are 3 Suns hovering in the sky not 1, the day is on a 39 hour schedule, you dont’ know where you are, you’re not sure who you are.
Now, in this predicament you have two choices
a) you can doubt who you are and crawl into a general state of paranoia, avoidance, fear, aggression (in some cases), slowly decompensating and withdrawing from the world; essentially questioning the Self and allowing the discrepant data to slowly annihilate the Self. In this scenario you completely surrender to the “data” coming at you, voices, paranoid thoughts, you have no defenses, no rudder, no main mast to hold on to and thus you lose grip with reality as a whole; or
b) you can remain emboldened about your view of things and sure that everyone else is wrong, still generally able to function but unable to see different on that one idea. In this scenario you completely adjust reality data to fit your view of the world. You are ALL defense, a main mast ONLY but without a sail, cut off from any wind, any influence by the shared reality within which we all live. Your only saving grace is your cut off in one pocket of reality.
The former is Schizophrenia, the latter is more akin to a Fixed Delusion. She is adamant she met and married her husband on the same day in 2010, and he died 3 day ago. We show her a picture of her and her husband at Obama’s innaguration- they are clearly at the Capital, the setting is clearly in the background, you can see the President at the podium behind them in the picture. She acknowledges that IS the President, that they ARE there. Her resolution? “Wow, so my husband was able to time travel all the while and never told me!” Everything is subservient to the fixed delusion, all data is malleable.
It is a very tragic disease, to be in a mental prison that locks from the inside and not yet realize we have the key. Yet, aren’t we all in such a place to this and that extent?
We all suffer from a bit of fixed Delusion, be it in relgious belief, politics, convincing ourselves that our spouse isn’t cheating, ignoring the harsh reality that we will all die, ignoring the cold reality of loose nuclear fissile material in the Balkan States, and so on or whatever your particular poison is. A little self-denial goes a long way and can be a nice buffer against the ugly onslought of daily life. I mean, shit, we can’t worry about all of this stuff all day long, for then we fall into Depression. In fact, a number of recent studies suggest that Depressives have more realistic views of the world and their impact on it then those who are resistant to falling into depression- see, a bit of denial can be helpful. But when it becomes obsessive and starts to take over all of our behavior, then we have a problem. The tipping point is when we start filtering data from the world to support and feed the delusion, vs. allowing data from the world to modify our view of it. So, that is what I’m up against, typically a difficult prognosis. One manages a fixed delusion, you don’t really fix it.
The Archetypal Psychologist, James Hillman, once said “The key to life is seeing the metaphor that you’re living in, and not taking it too seriously.” It’s all metaphor at some level, all of it. From religion to philosophy to quantum mechanics, it’s all a view of the world, a way to approach experience. Yeah it’s real, but again it’s really not real. And when we take it so damn literally, that’s when we lose focus and start shooting each other and blowing each other up, all in the name of God or whatever master we’re serving. And how we view, and through that with which we view, shapes the view itself.
Kevin Spacey’s character Verbal Kint in The Usual Suspects, “The greatest trick the Devil ever pulled was to convince the world he didn’t exist.” At some level it’s all spin and it’s all marketing. In Nazi Germany, and Rwanda, and other times in history the “delusion” became the norm, fueled by genius propaganda machines. Yes, madness can go big and go viral too, and when it does and when it runs unconsciously it gets really ugly.
And one of my favorates, Tyler Durden in Fight Club, “Man, I see in fight club the strongest and smartest men who’ve ever lived. I see all this potential, and I see squandering. God damn it, an entire generation pumping gas, waiting tables; slaves with white collars. Advertising has us chasing cars and clothes, working jobs we hate so we can buy shit we don’t need. We’re the middle children of history, man. No purpose or place. We have no Great War. No Great Depression. Our Great War’s a spiritual war… our Great Depression is our lives. We’ve all been raised on television to believe that one day we’d all be millionaires, and movie gods, and rock stars. But we won’t. And we’re slowly learning that fact. And we’re very, very pissed off.”
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Sophia and Lambros,
This entry is a bit more philosophical, more big picture, and it will be years before you’ll read this and gain some insight or understanding of it (with my writing style, my assumption you’ll have any is itself an illusion), but I hope you take it to heart when your ready.
We all live in layers of delusion, and to me the key to life is deciphering the gradations as we go and coming to peace with them. Allowing the world to enter us, open our perspectives, change our views, but not so much as to render us a rudderless ship. Like so much else it is a delicate balance, and yet so many of us epically fail to find it, instead running and hiding behind ideologies and -isms. That is an easy route and it is paved with a life of self-assurance and easy answers and not too much wading into the deep end of the life pool. It’s like riding the ferris wheel, it’s fun, it’s safe, and it sure is a pretty view isn’t it. And I sincerely hope you say “Fuck that!” and go the other route, and board the roller coaster, and struggle, and strive, and wrestle your angels, and come out on the other end wanting, and open, and deeper, and a better human for it.
“The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. But no price is too high to pay for the privilege of owning yourself.” ~ Friedrick Nietzche
Tuesday Crisis Letters 