Coping With Delusions

It would at first appear contradictory to give advice on how to cope with delusions. The argument is that persons with delusions by definition believe their irrational ideas to be both real and true; therefore, they cannot be argued or reasoned out of them. This is correct. Nonetheless, persons with delusions often recognize their borderline and impossible character. Although they will usually resist outside reasoning, they often struggle within themselves against delusions. They psychoanalyst Robert Lindner points that it is incorrect to believe that in every instance persons with delusions are so "far gone" that they do no knowo they are mad. Lindner notes that, for the most part, deranged persons are suffering or because they are made to suffer for it by others.

Also, it should be noted that the severity of delusions waxes and wanes. Persons with schizophrenia often experience a spontaneous remission of symptoms, sometimes for prolonged periods of time. Antipsychotic drugs also bring about a reduction in the severity of symptoms. During periods of increased mental clarity, disturbed individuals are accessible to rational thinking, including their own.

If you suffer from delusions, you may find value in the following list of practical coping strategies:

1. In some cases, delusions have a quality similar to the experiences in a lucid dream. A lucid dream is a dream in which you become aware that you are dreaming. It is then possible to break out of the dream or control it. This often happens with delusions. A part of your consciousness whispers,"This can't be real. These ideas are impossible." Under these conditions, it is possible for you to take some control over the delusions.

2. When you are in good reality contact, when your delusions have retreated to the corners of your mind, take advantage of a behaviour therapy technique called stress-inoculation training. Stress-inoculation training involves preparing yourself ahead of time for a stressful situation. Play a mental movie of future situations in which a delusion interferes with your ability to function effectively. Visualize how you will cope in a practical manner, and work around the delusion. Stress-inoculation training can forearm you against your own unbidden delusional tendencies.

3. Make sure that your nutrition is adequate, that you obtain enough protein, carbohydrates, vitamines, and minerals. There is a substantial amount of evidence suggesting that clear thinking is associated with a healthy brain and nervous system. One way to look at the mind is to think of it as the brain and nervous system in action. A healthy mind requires an equally healthy body. To be more specific, certain chemical messengers in the brain (Eg. norepinephrine) are required for rational thought. These are synthesized out of substances provided by food. The B-complex vitamins have been found to be of particular importance.

4. Do not act on the basis of an idea that you think is true and that most other people think is false. Consider that it just might be a delusion. Do not jump from a roof just because you think you can fly. Do not try to live without food just because you think you are immortal and do not need it. Listen to the small voice within you that says,"I might hurt myself. May be other people are right."

5. Avoid the use of psychoactive drugs. These include amphetamines, cocaine, morphine, heroin, cannabis, and lysergic acid diethylamide-25. These drugs interact with a tendency to have delusions and sometimes greatly increase the level of irrational thought.

6. Be aware of the concept of consensual reality, that is, the way a well-defined group (eg. a family, a tribe) sees the world. Although from a strict philosophical point of view one cannot say that the group's perception of reality as a fact, be practical. Work with their reality, not against it, if you want to reduce your level of conflict and suffering.

If a partner, child or other person close to you suffers from delusions, below are coping strategies that may be of some value:

7. Do not challenge a delusion directly. Do not tell the troubled person such things as, "That's silly" or "That's nonsense." Do not discount the delusion and attempt to minimize its importance. Such blunt frontal attacks tend to galvanize resistance and push the individual farther into the delusion.

8. Try to encourage the other person to be as practical as possible in spite of the delusion. Describe the logical consequences of actions. Orient the individual toward reality by pointing out that a given behaviour may lead to imprisonment, bodily injury, or property damage. Working with the assumptions of the delusion, help the person steer clear of its buried dangers.

If you find that you cannot cope adequately with delusions, there are a number of ways in which the professions of psychiatry and clinical psychology can help you.

Causes Of Delusions

One of the principal mental disorders associated with delusions is schizophrenia. Schizophrenia is a severe mental disorder characterized by illogical thinking; often there are other signs and symptoms such as hallucinations. However, it is important to understand that a mental disorder such as schizophrenia is not in and of itself a "cause". The important question is: What causes schizophrenia? There is no single or simple answer to the question. Instead, a number of causal factors appear to play a role.

First, studies of identical twins and other siblings suggest that genetic factors play a role in the disease. Second, these genetic factors may contribute to an inherited brain defect making it difficult to process information in a conventional way. Third, there is evidence that the neurotransmitter dopamine, a chemical messenger, is overactive in the brains of schizophrenic patients. Fourth, emotional wounds inflicted in early infancy may aggravate the likelihood that the disease will appear later in life. Fifth, parents who confuse a child and who are emotionally distant may also aggravate tendencies to develop schizophrenia. Sixth, environmental triggers such as going bankrupt, getting divorced, or losing a loved one may be necessary to "light the fuse" of the disease.

All of these causal factors, interplaying with each other in a complex way, may play a role in the disease and, in turn, its delusions. One important way to explain delusions is to appreciate that they frequently have a meaning. Often, a delusion, or delusional system, represents a psychological need for power in the form of wishful thinking. Waldeman T., the man who said he could walk through walls, was a mild-mannersed, financially unsuccessful salesman for a plumbing company. Kirk Allen had been emotionally crushed in many ways in his early childhood. And he had been sexually abused by a governess. He felt weak and powerless in his actual life, but in his life a great star king, he ruled a galaxy.

Frequently, delusions can be understood as metaphors. Sawyer, who said he was a walking, talking corpse, was in essence saying that he felt as pressing itself. Delusions, if their meanings are sought, provide a kind of window into the troubled person's state of mind.

Delusions can be caused by an actual pathology of the brain and nervous system. Alzheimer's disease, brain tumours, strokes, general paresis(caused by syphilis), and alcohol amnestic disorder is "Korsakoff's psychosis" in honor of the Russian neurologist who first studied it. In alcohol amnestic disorder, there is damage to the brain caused by years of alcohol abuse.

The toxic effects of drugs can induce delusions. Irrational ideas are often present in the altered states of consciousness induced by such drugs as morphine and heroin. Some drugs are actually called psychedelics or hallucinogens because of their ability to greatly alter normal brain processes. Examples of these drugs are cannabis (ie marijuana), hashish, mescaline, psilocybin, lysergic acid diethylamide-25, and phencyclidine. Finally, it should not be forgotten that alcohol is a drug. Not only can a person have delusions when intoxicated, delusions are a common symptom of delirium tremens, which is caused by withdrawal from a dependence on alcohol.

Delusions

Waldemar T. is convinced that he can walk through walls. Phillipa M. believes that she has six fingers, one of them invisible to others but visible to her. Orson L. thinks that in the year 2001 Earth will be destroyed in a collision with an enormous comet, that a great ark of space will be built that he will be one of its passengers, and that he will help set up a colony for humankind on Mars.

What do Waldemar, Phillipa and Orson all have in common? They suffer from delusions. A delusion is believing in something that most members of an individual's family or culture regard as irrational or false. One of the words used by ancient Greek writers to identify delusions was phantasia, and this is the root of our word "fantasy". A delusion may be regarded as a fantasy that is taken to be a reality.

In some cases, delusions seem to come and go without apparent rhyme or reason. As indicated above, Phillipa believes today that she has an invisible finger. Yesterday, she said that her head was made out of a pumpkin. Tomorrow, she may insist that she is only 2 inches tall. She is a hospitalized mental patient and suffers from schizophrenia. Her thinking is very disorganized and confused.

On the other hand, it is possible for an individual to have a highly organized, consistent delusional system. When this happens, a diagnosis of delusional disorder, also known as paranoid disorder, is made. An example of this kind of disorder is provided by a case history entitled "The Jet-propelled Couch", reported by the psychoanalyst Robert Lindner in his book The Fifty-Minute Hour. Kirk Allen, a physicist, believed that he led a dual existence. One existence was his mundane Earth life. In a second, more important existence, he was the lord of a planet in a distant universe. In this second existence, arrived at through telepathic means, he ruled an interplanetary empire and wore important robes of office. Kirk had accumulated 12000 pages of "records" documenting his role as a star king. Maps, charts, and biographical data were amazingly consistent.

A highly organized system such as Kirk's is relatively rare. Much more common are the more or less inconsistent delusions associated with such mental disorders as schizophrenia and organic mental syndromes.

Three common kinds of delusions are bizarre delusions, nihilistic delusions, and delusions of being controlled. Bizarre delusions are those that are ridiculous to most people -- Madge says that her eyes are made out of grapes, that her hair is cotton candy, and her ears are fashioned from leftover stew meat. Nihilistic delusions stress the themes of death and decay -- Sawyer says that he is a walking, talking corpse brought back to a sort of half-life by Dr. Frankenstein. Delusions of being controlled are characterized by the idea that external forces in the form of energies or persons are running one's thoughts and behaviour -- Tyrone has told his psychiatrist more than once that invisible wires held by the Puppet Master make him do things against his will.

Other signs and symptoms of Delusions frequently associated with the general symptom of a tendency to have delusions are :

• Irrational thinking
• Inability to use facts to modify the delusion
• Hallucinations
• Confabulation
• Distortions of body image
• Disorientation
• Magical thinking
• Distress

People with delusions sometimes have distortions of body image. These can themselves be kinds of delusions. Persons with more or less normal bodies may think they are withered, shrunken, gigantic, misshapen, wrinkled or obese.

Disorientation suggests that the person is poorly oriented in time and space. Individuals displaying this condition may not know what day, month or year it is. They may not know where they live or how to find their way home.

Magical thinking is characterized by a tendency to ignore the importance of natural causes and their effects. Thus, a person thinks that an airplane flies because he or she wishes it into the air, or that it will stop raining because he or she turns counterclockwise three times.

Finally, it is important to realize that distress is commonly associated with delusions. There is a myth that mental patients are happy with their delusions, that they provide an escape into a pleasant fantasy world. This can, of course, be true in some cases. However, it is more common for a patient to feel tormented and controlled by delusions, which the patient perceives as real and as beyond the control of his or her will. Consequently, the patient often feels like a victim of the delusions.

Coping With Boredom

If you suffer from boredom, you may find value in the following list of practical coping strategies. The list has applications to both situational boredom and chronic boredom.

1. Make a systematic attempt to introduce more frequent and regular changes into your life. These should be changes that you can implement readily without too much effort. Here is an example: over a period of several weeks, Anatole R. called an old college friend he had not talked to for years, took a short vacation to a place he had never been to before, and visited for the first time a large, well-known used-book bookstore about 100 miles away from his home. The general idea is that if you are in something of a rut, try to break out of it.

2. Find something important to do. Much boredom is associated with the idea that one's work or other activities are meaningless. Your life should not be seen as an endless round of routine with no long-range purpose. Rediscover meaning in your work, or consider making a career change. You might consider offering your services as a volunteer to a hospital or a school.

3. Learn something new. Take an evening course at a community college in almost anything that presents a challenge and a mild psychological threat. By a psychological threat is meant something at which you just might fail. You will be forced to rise to the occasion, to use your intellect. The introduction of different ideas into your life helps to counter boredom.

4. Take a child to a movie. Kay G. took her seven year old granddaughter to see the Walt Disney version of Snow White and the Seven Dwarfs. Kay saw the film in the 1930s and remembered it with fondness. She would have not enjoyed seeing it alone. However, taking her granddaughter to see it allowed her to share a memory and re-experience the story vicariously through a child's eyes.

5. In general, learn to use fantasy in a constructive, creative way. Madame Bovary acted on her romantic fantasies in a destructive way. Instead, think of your fantasies as a kind of second psychological life, as a source of rich gratification. You do not have to insist that they materialize in the real world; the individual with a healthy personality makes a clear distinction between fantasy and reality.

6. Recognize that feelings come and go. Some boredom is natural. Learn to tolerate it. Go on with your daily activities in spite of the boredom, and it will often lift and vanish.

7. Think of boredom as coming from your child self. Imagine that you are the parent of an actual child who says, "I'm bored. There's nothing to do." How would you answer? Apply the answer to yourself.

8. When you are bored, do not just sit and stare. Get up and engage in some motor activity. It can be almost anything from taking a short walk to sweeping a kitchen floor. Motor activity is antagonistic to boredom. It is much more difficult to be bored when you are moving. You cannot will away your boredom, but you can will your actions. The activity will feed back on the boredom, reducing its intensity.

9. Use your intelligence. As earlier indicated, it has often been observed that intelligence is associated with boredom. It is possible that you have used your mind destructively to throw yourself into a psychological pit. The intelligent things to do is certainly not to passively accept the pit as a trap. If your intelligence got you in, it can get you out. The really bright person realizes that the trap of boredom is a self-made one, and it can be dismantled with intelligence just as it was constructed by intelligence. Brainstorm the problem. Make your own list of coping strategies that are likely to work for you.

If you find that you cannot cope adequately with boredom, there are a number of ways in which the professions of psychiatry and clinical psychology can help you.

Causes Of Boredom

A major cause of boredom is lack of variety. Human beings appear to have a need for changes of stimulation. Imagine yourself confined to a small room with no windows, no telephone, no television set, no books to read, no interesting pictures on the wall, and no visitors. You probably would soon find yourself unbearably bored. As Robert S. Woodworth, a leading motivational theorist in the 1920s and 1930s, put it, "The eyes want to see and the ears want to hear." Various experiments in sensory isolation have demonstrated that if volunteer subjects are deprived of changes of stimulation, they will begin to have mild hallucinations. They may see spinning, glowing patterns or hear odd sounds.

Although a bored person may not be physically confined to a small room or systematically deprived of changes of stimulation, there are parallels. A young homemaker with three children and no car of her own commented, "I feel like I'm going stir crazy. Some days I'm so tired of it all I could scream." A woman who worked on an assembly line said, "When I go to work, I feel like I'm going to prison." If you perceive your life as greatly deficient in change of stimulation, if there is too much sameness, you are bound to be bored.

In some cases, unlike those cited above, boredom is associated with affluence. Galvin C. has no meaningful vocation, and he hires most personal services. He and his wife live well from the income of a large trust fund. He has time on his hands. He tries to cope with boredom by turning to popular entertainments such as luxury cruises and vacations at gambling resorts. Basically he is simply bored with life and knows it.

It is important to note that an interesting, varied environment is a matter of perception. Melanie thinks of a trip to an antique store as exciting and interesting. Paula, Melanie's sister, thinks of the same activity as boring. In contrast, Paula finds it stimulating and exciting to shop for clothes and look at the latest colours and styles. Melanie might as well be looking at gray uniforms. She takes no interest and is bored when she accompanies Paula.

A great deal of experimental evidence suggests that human beings have an inborn curiosity drive. This is true not only of human beings, but also of animals. Rats will actively explore areas of a maze that contain walls with vertical stripes and avoid areas that display gray walls without patterns. Apparently, as the rats run by the vertical stripes, they experience changes of visual stimulation. Infant's eye will spend more time gazing at a black-and-white checkerboard with nine squares than at a more simple one with only four squares. As the infant's eye scans the checkerboard, each shift from black to white or from white to black is a specific change of stimulation. The curiosity drive seeks as its goal changes of stimulation in the same way that the hunger drive seeks food. If the curiosity drive is not met adequately, boredom is the result.

Of course, in adult human beings, the curiosity drive is selective. This is because they have interests. Travel to faraway places will not satisfy the curiosity drive of an individual who finds it boring to leaf through the pages of an issue of National Geographic. An astrophysicist might be curious about the latest past data supporting the theory that there are black holes in space. The same information might bore someone else. However, both persons have a curiosity drive. And both persons need the kinds of changes of stimulation that will satisfy them.



A personal factor that may cause boredom is high intelligence. The psychoanalyst Eric Fromm said that the human being is the only creature that can be bored. This is not strictly speaking correct. On of the principal problems with the care of some animals in zoos is that they become bored. This is particularly true of relatively intelligent animals such as apes and bears. However, snakes and crocodiles do not appear to have a problem with boredom. Very bright individuals often take most of the information out of a stimulus before others do, and they are ready to move on when others are still interested. Informally, they get "saturated" with objects or other persons quickly and become bored with them.

A final factor in boredom is the "too much too soon" phenomenon. An individual is treated in youth like a prince or a princess. He or she has "had it all" or "seen it all". The good things of life are not earned but obtained with little or no effort. Boredom may set in at an early age. Diana Barrymore, daughter of the famous actor John Barrymore, wrote an autobiagraphy with the very title Too Much, Too Soon in which she describes a self-destructive life style arising in part from boredom. The motion picture actor Errol Flynn in his autobiography My Wicked, Wicked Ways portrays his life in a similar manner.

Boredom

Madame Bovary is a novel by Gustave Flaubert that was attacked for obscenity by public prosecutors when it was first serialised in La Revue de Paris between 1 October 1856 and 15 December 1856, resulting in a trial in January 1857 that made it notorious. After the acquittal on 7 February, it became a bestseller in book form in April 1857, and is now seen as one of the first modern realistic novels.

The literary classic Madame Bovary, by Gustave Flaubert, tells the story of a woman who is bored with her husband, bored with her fellow townspeople, and, in general, bored with her life. Her days are too tedious and predictable, and she is filled with romantic, idealistic fantasies. In order to escape from boredom, she enters into two love affair, both of them disastrous. In the end, she commits suicide by taking arsenic. First published in 1857, Madame Bovary illustrates that boredom is no newcomer to the human race as a psychological problem.



The novel, Madame Bovary, focuses on a doctor's wife, Emma Bovary, who has adulterous affairs and lives beyond her means in order to escape the banalities and emptiness of provincial life. Though the basic plot is rather simple, even archetypal, the novel's true art lies in its details and hidden patterns. Flaubert was notoriously perfectionistic about his writing and claimed to always be searching for le mot juste (the right word).

Boredom is an unpleasant mental and emotional state characterized by discontent and lack of interest. Physiological arousal is low -- any sense of excitement is completely absent.

A distinction can be made between situational boredom and chronic boredom. Situational boredom is specific, and everyone has experienced it. Examples are being bored with a classroom lecture, a movie, a book, another person, a long ride without interesting sights, a repetitive task, and so forth. Chronic boredom is general and pervasive. It is the kind that Madame Bovary suffered from. It is pathological and destructive. People who suffer from chronic boredom tend to be bored with significant others in their lives such as partners, parents and their children. They also tend to be bored with their day-to-day routines and their vocations. This second kind of boredom is a sort of psychological cancer that eats away at the heart of one's existence.

Boredom is always boredom with. As already shown, there can be boredom with a lecture, a person, or a situation. Thus, boredom is often perceived as having a source. And the individual is often convinced that if he or she could escape form or avoid the source of boredom, then boredom would go away. Consequently, there is often a lot of blaming associated with boredom. The bored individual thinks,"He bores me," or "She bores me," or "It bores me." The psychological contribution that one makes to one's own boredom is often missed.

Other signs and symptoms of frequently associated with the general symptom of boredom are :

1. Frequent drowsiness
2. The slow passage of time
3. Vanity and self-absorption
4. Listlessness or fatigue
5. Moderate to severe depression
6. Lack of commitment to goals and plans
7. Wishful thinking
8. Preoccupation with romantic or heroic fantasies
9. Vague discontent

Drowsiness or sleep is one way to escape from a boring situation. Situationally bored people might struggle to stay awake during a long lecture on a subject of little personal interest. Chronically bored poeple often sleep 10 to 12 hours a day if they have the opportunity, or they may take frequent naps.

Listlessness or fatigue may be so pronounced that the individual suspects that he or she has an illness. (If there is real reason to believe that an organic problem is present, this should, of course, be evaluated by a physician)

Depression overlaps with boredom, and depression is itself a major psychological symptom. Although they can coexist and do affect each other, they are not identical. It is useful to look upon boredom as a major symptom in itself and to identify it as an important causal factor in depression.

Boredom in and of itself does not call for the prescription of a drug. There is no such thing as anti-boredom medication. However, it is true that there are antidepressant drugs; and if boredom is a secondary complaint associated with a major complaint of depression, then one of these drugs may be prescribed and in turn may be helpful.