ON MENTAL ILLNESS: Reality Checking and Beyond

Jack Bragen
Friday June 19, 2020 - 02:26:00 PM

"Reality checking" is a highly effective and recommended method for delusional people to help get our minds on track. This method, however, relies on the willingness of the patient to accept a result that doesn't match what we want to believe. However, I am going to speak of a deeper type of reality finding, one in which we are confronted with non-debatable truths, that are powerful enough to completely replace specific delusions. 

It was an "aha" moment when I was at a doctor's office, and I viewed the MRI of a family member who complains of chronic pain. It was a moment of truth when I compared hypothetical causes of people's attitudes toward me. It entered the equation that my behavior was "off," and people were reacting to that. The competing belief system was very different and was bizarre. 

When a psychotic person incorporates some very basic truths into her or his thinking, it is a step forward. It is astounding that my functioning has been quite good, while at the same time, my mind has struggled under a load of psychotic beliefs. Therefore, something unknown is working in my favor. 

A person can be substantially delusional yet pass for normal. Society doesn't measure how much a person's mind is connected to reality. Instead, people look for behavior that matches what they've learned to expect. Additionally, reality is subject to debate and so is truth. There is no one on Earth against whom we can gauge our minds to be accurate. People watch television evangelists and believe everything they say. Yet, if they can still function in society, they could be considered among the functioning delusional. 

Science is considered by most informed persons to be closer to the truth. Yet, science doesn't automatically make a person in touch with reality. If an individual can sync their mind to the minds of people around them, it is probably a safe bet that they won't be considered psychotic. Isolation is one of the factors that can contribute to psychosis. A person can be psychologically isolated even while physically among people. 

I'd like to elaborate on the paragraph above. When someone lacks the ability to be social, is unable to bond or "gel" with people and perceives that they are separate from the people around them, it creates a psychological and mental disconnect. When someone lacks social skills and cannot relate to people or open up to people, it is as though on a mental level, they are surrounded by a barbed-wire fence. This situation prohibits syncing one's mind with the minds of others. 

It is through person to person connections that a person subject to psychosis has a chance to get well. This must happen in combination with being medicated. 

In a work setting, if a mental health consumer has a job, filling the mind with the details of the job can be quite grounding, and can be highly effective at crowding out the delusional content. If you are deciding on which drill bit to use on your electric drill to make a pilot hole in wood, you are not thinking about extraterrestrials speaking in your head. Although this is not absolute, it could make a substantial difference for the better. 

A person does not have to be totally without delusions. If the delusions are lower in quantity and in intensity, and if you have compensatory mechanisms, it is probably good enough. 

If delusions are minor enough, you are entering the category of normal, in which a proportion of your beliefs will be incorrect. This is a major accomplishment toward recovery. Yet it does not mean that treatment should be discontinued, because treatment probably got you to this point, and maintains you there. 


Jack Bragen is author of "Instructions for Dealing with Schizophrenia: A Self-Help Manual," and several other books. He lives in Martinez with his spouse.