ON MENTAL ILLNESS: How Delusions Become Reinforced

Jack Bragen
Friday November 29, 2019 - 04:50:00 PM

Psychotic delusions, in some instances, seem to fill an emotional need. At other times, delusions produce fear. Both phenomena imply to me that the mechanisms that create psychosis are related to the pain and pleasure mechanisms in the brain. They may also be an attempt of the brain to feed serotonin or other neurotransmitters to some area of the brain that lacks enough of them.

Delusions are almost never emotionally neutral, and because of this, they can be very hard to overcome.

When we wake up out of a delusional system, sometimes we feel a lot of disappointment that the things we were imagining are not real. In other instances, emerging from delusions is a very welcome return to safety following tremendous fear and the perception of danger. 

If delusions did not have an emotional charge connected to them, the task of recognizing and negating delusions would be far easier. This brings us to the concept of mindfulness. 

If you are an experienced meditation or mindfulness practitioner, and if you have learned how to neutralize some of the stronger emotions, this can help with gaining an upper hand on some of the delusions. So far as I can tell, Zen masters are not very prone to having psychotic episodes. Gaining an upper hand on emotions will produce leverage in the struggle against delusions. 

In some instances, delusions can produce pleasurable emotions that provide relief from looking at bleak realities. This could be thought of as a form of denial, but one facilitated by a bad neural route. If you imagine that all the bad things happening are just a test to find out if you are qualified to be a millionaire, this is going to feel better than just acknowledging that everything sucks. 

When "decompensating" (and this, to me, is a derogatory term that I probably shouldn't use) the fear and pleasure mechanisms cause delusions and/or delusional systems to become reinforced. 

Upon going heavily into delusions, the entire content of the brain is haywire, and the initial cause of this may not matter as much. 

When delusions take over the mind, following a period in which they have reinforced themselves, things become worse. The brain starts running too fast. This can cause damage to brain tissue. The damage following a full psychotic episode (once you are on medication and stabilized) is very slow to reverse, if at all. The more psychotic episodes a patient has, the harder it is to function when stabilized. People become very impaired. 

{It is worthy to note here that, to a psychotic person, delusions and hallucinations are taken very literally by the mind, and they present to us as if they are very real facts. If we could distinguish between realities and illusions, we would be daydreaming, not psychotic.} 

The above is preventable for some people. I've had good luck with remaining medicated and in therapy. Yet, I've experienced a lot of problems despite this. 

Medication is the prerequisite but not the full solution. Environment is very important. I am not sure what the ideal environment is for someone with schizophrenia. When one's environment reinforces a perception of safety, it is a good thing. Yet, in order to have the brain working at its best, upon us becoming stabilized, maybe we need challenges. If we remain too comfortable, it is possible that we will become stagnant. 

However, if the environment is excessively challenging to the point where we feel threatened, it may increase the likelihood that delusions will return, even while we are medicated. 

Jack Bragen lives in Martinez. His most popular book is "Instructions for Dealing with Schizophrenia: A Self-Help Manual."