Psychosis, when people lose touch with reality, is not a rare occurrence — as many as three in 100 people will experience it at some point during their lives. Psychosis typically includes hallucinations, which consist of seeing, hearing or feeling things that are not actually there. A common example is hearing voices. It can also include delusions, which are beliefs that are not likely to be true and that seem irrational or nonsensical to other people. A typical example involves believing that outside forces are controlling your thoughts, feelings, and behaviors.
An interesting study from England published in the December 2017 issue of The Lancet Psychiatry delves into the issue of how psychotic experiences are perceived by different groups of people. What is so interesting about this study is how varied people’s reactions to psychotic experiences can be. For example, some people hallucinate and have delusions but are not seemingly bothered by them. They just go on living their lives. Other people who have similar experiences are so debilitated that they need support, medical and/or otherwise, just to get through the day.
For purposes of the study, the researchers separated the participants into three groups:
- Those who were clinical psychosis patients (under a doctor’s care). This was the clinical group.
- Those who had symptoms of psychosis similar to the first group, but were able to function well without medical care. They were known as the nonclinical group.
- Those who showed no evidence of, or history of, psychosis. This was the control group.
If you’re wondering, as I did, how the researchers found the participants in the second group, they reported finding them via “specialist sources, such as online forums for psychic and spiritualist activities, mediums, and other special interests.”
In the study, the researchers performed a series of “magic tricks“ to see how each participant reacted to so-called psychotic symptoms. While this series of games held the potential for anyone to lose their connection to reality, the researchers designed it to not be too distressing for the participants.
Following the “testing” each participant was questioned in a long interview to record how he or she interpreted the recent events. The nonclinical group tended to view their experiences as more benign and nonthreatening than the clinical group did. They made comments such as, “It is because of the way the human mind works, just part of normal human experience,” to explain what they had just gone through. Participants in the clinical group were more likely to see something more sinister behind their experience, compared with the nonclinical and control groups. Some of their comments included, “Someone is speaking to me,” or “It was done on purpose to trick me or make me look stupid.”
The study is long and detailed and can be read here. In a nutshell, the researchers suggest that the results might indicate that the most severe effects of psychosis don’t come from having the strongest delusions, but from being more likely to interpret them in disturbing and dangerous ways.
These results bring to my mind what those with obsessive-compulsive disorder are often told:
It’s not your actual thoughts that are the problem, but how much weight you give them and how you react to them.
I find the above study interesting, and think this topic deserves more attention. While I believe there is typically more to debilitating psychosis than just having the wrong attitude toward what is happening, perhaps cognitive behavioral therapy similar to what is used in treating OCD could still be helpful.