The Secrets of Delusion

The Secrets of the Delusion

By Christine Johnson

The idea that delusions hold insights into the causes of a patient’s mental illness is not new. However, the notion has fallen to the wayside as psychiatry has become more convinced that all mental illnesses are biologically based. I wish to revive and explore the interpretation of delusions because the better we understand a patient, the more likely it is that we can find a way to lead them back to reality. They may have had some genetic precursor to the illness, but events in their human experience triggered the disorder. We need to find out what those events were.

I like to try to interpret delusions like one would interpret dreams. A common delusion is that one is descended from royalty but somehow tragically separated from the throne, or simply waiting to inherit it.. This delusion reminds me of the very common “flying dream”, which is usually interpreted to mean that the dreamer seeks freedom. Both the royalty delusion and the flying dream are variations on the theme of escape.

Of course, not everyone agrees that the flying dream symbolizes escape and freedom, and in a way they are right. Dreams, like delusions, are often very personal and intricate, defined by the dreamer’s life experience. This is where dream and delusion interpretation becomes very complicated.

A person’s psyche can be compared to that of a mathematician who works at the highest levels of his field. If you were to walk in on the room where the mathematician was working, you would find the chalkboards covered in a dense tapestry of incomprehensible symbols in highly complex arrangements. In order to bring you up to speed on what it all meant, the mathematician would have to bring you through years of diligent study on the subject before you could even begin to understand and appreciate his thoughts, ideas, and problems.

People’s dreams and delusions are similar to the mathematician’s elaborate calculations. It has taken a lifetime for each of us to create the complicated tapestry that is our thoughts, dreams, opinions, and, for people struggling with mental illness, delusions. In order to bring someone like a therapist or doctor into our world, we must bring them through a lifetime of learning the dense language of our personal mental calculus before they can truly understand us.

There is hope, though. There are common symbols, or symbols that often carry similar themes

for many individuals. My grandmother, for example, held a delusion that there were snakes crawling on her body and wrote often of her husband “putting the snake” on her. Because she received no psychotherapy at all in Pilgrim State Hospital, no one even bothered to try to interpret her delusion. She became so desperate that she even wrote in a letter, “You know what snakes symbolize, don’t you?” Maybe they did and maybe they didn’t, but they didn’t care so it didn’t matter. There were fewer than one hundred psychiatrists for about seventeen thousand patients, so no one had the time or inclination to understand her delusions or dreams.

That is the real reason we gave up on delusion interpretation. It was far too expensive to spend the years “getting up to speed” on a patient’s psychological calculus. It was cheaper to develop treatments that were quick and easy. It didn’t matter if they made the patients better or not, and it didn’t matter if the science behind the treatments was questionable at best, and criminal at worst. The medical establishment just had to find fast, cheap ways to subdue the psychotics.

When I first recovered my grandmother’s records from Pilgrim State, I noticed that in all of her letters she signed herself by her delusional name, “Gena Gladstone”. She was very insistent that the name was spelled “Gena” as opposed to the usual “Gina”. However, there is no place in her records, no place in her doctor’s notes, no place at all that this name she had for herself was explained or explored. It seemed very significant to me. So I began to search online, and it took me about five minutes to learn that the playwright Eugene O’Neill’s middle name was Gladstone. Eugene Gladstone O’Neill = Gena Gladstone. My grandma had renamed herself after the writer of dark tales. I would never know which work meant the most to her.

The saddest part of this discovery was that I was the first one, the only one, in fifty years to unravel the mystery of her name. What if her psychiatrist had asked her what Eugene O’Neill meant to her, which of his works were her favorite, and why? They might have been able to gain important insight into her troubled thinking. However, it was far more expeditious to give her numerous shock treatments, lobotomize her, and keep her zonked on thorazine for twenty years.

A delusion that has become common in modern times revolves around technology. The fear usually revolves around some sort of an implant, a spy satellite that is attempting to control them, or an unseen machine that is taking over the earth. The obvious symbol behind this delusion is loss of control and power in one’s life, or the fear of, or rebellion against, being controlled by others. Again, there can be very personal calculus behind this delusion, but there is a theme that can be interpreted and used as tool toward understanding the jumble of the ill person’s mind.

The technology delusion is especially interesting when we consider that the most common delusion of

the pre-industrial age was the religious one: the idea that the person is in touch with God and acting on his direct orders. While some people today certainly have the “God delusion”, it is not as common as it once was, having been displaced by the fear of technology, the all-mighty god of our tangible world.

When discussing religion-based delusions, it can be difficult not to offend anyone. President George Bush believes that the hand of God guides him. So did Abraham Lincoln. While we may agree or disagree with these president’s policies, no one claims they are delusional. The line between what is sane and what is not is sometimes very thin and hard to define. Once upon a time, if you insisted that the world was round, you ran a chance of being locked away as a dangerous, delusional lunatic. David Koresh is considered insane, Jerry Falwell is not. It’s enough material for a whole other essay.

If we work from the assumption that a person is having religious delusions and is not really in touch with God, I think the common theme is plain. Once again, it revolves around control over the world, over life, and the desire to be a better, more pure human being. If one decides that he is Jesus Christ, or the reincarnation of Buddha, or an angel of the Lord, one is transformed into a person who is good, special, and powerful. Who among us does not wish to be described this way? Using religious delusions, a person becomes what they wish they were.

In the coming months I will be looking into common delusions by culture and religion. Do devout Italian Catholics suffering from mental illness tend to stick to religious delusions? Do Pakistani Muslims? Are people in Japan more prone to technology delusions? Or is the language of delusions far more complicated and not so easily pigeonholed?

Because of psychiatry’s current focus on biological treatments, there are few currently investigating this area. It seems to have fallen in to the realm of social science - something to muse upon instead of act upon. However, all things run in cycles and one day society will again return to attempt to unlock the secrets of delusions. Maybe I can have a body of work waiting for them when they come back my way.

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Christine Johnson is the founder of Psychosurgery.org. She currently works as a medical librarian.

Christine@psychosurgery.org