Delusion — noun. an idiosyncratic belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument, typically a symptom of mental disorder.
What makes delusional thinking so scary? Well, from the outside we can’t understand the logic of the delusion. The delusion itself causes the individual to feel distress and behave erratically. And their belief in something that is unreal distresses everyone around them.
Listening to a recent episode of “This American Life” I had an aha-moment. A 26-year-old student, Alan Pean, explains the delusions he was suffering when he entered a Texas hospital last August. As the sister of someone suffering with schizophrenia, Pean’s description was eye-opening. Pean’s mind is more composed today and he talks about his delusions with a candor and clarity my brother Pat has never displayed in the 10 years since his diagnosis. (Word of warning, the episode “My Damn Mind” is about Pean’s hospital stay, during which a Houston police officer allegedly shot him. It is a startling and disconcerting story.)
Last August, Pean believed that he was a trained impersonator of President Barack Obama. “Because if he is taken out, they don’t know where he is. But they need someone to speak out as though the government is still functioning as normal,” he said. Pean thought he was some kind of “Cyborg robot agent” that was created (presumably by a government agency) to morph into Obama. But assassins were out to get him. His life was in danger. Standing in his Houston apartment, he thought the place was surrounded by snipers.
He was on the phone with his father, who was trying to convince him to go to the hospital. Pean calls his father “Pop” and when he said the word “Pop” he became convinced that the phone was about to explode. He chucked his cell phone into the toilet and ran onto his balcony. He claimed to have leapt from the third floor to his neighbor’s balcony on the second floor. “All my muscles must have been — you’re like high,” he said. “Adrenaline pumping … Like an adrenaline high.”
Then he proceeded to jump from the second floor balcony, onto an AC unit on the ground, to the sidewalk. He hit the ground running towards his car, entirely convinced that his use of Google Maps had called in a drone strike and his apartment building was about to be blown up.
“I keep telling myself, ‘Just remember your training. Your trained for this,’” Pean said.
“And that refers to nothing, right?” host Ira Glass asked.
“What, my football training? No, I don’t know. I never trained for anything,” Pean explained.
He then got into his car and had a lucid thought — Get to the hospital. He remember that he needed help. “I need my medication.”
Once he was at the hospital, however, a nurse said he was being inappropriate and non-compliant. He allegedly refused to put on a hospital gown after a shower, he was dancing around and repeatedly walked out of his room naked.
“I don’t remember,” Pean said. “I don’t recall dancing, but I do know that I was going out there because whenever I finished taking my showers, ‘Well, where’s the suit?’” He was expecting a presidential suit that would help him morph into President Obama.
“I’d expect other people to be there that would help me with the changing process, just to look professional or to hand me my script,” he said.
Meanwhile he believed the television in his room was sending him secret messages and the IV in his arm contained the serum to begin the morphing process. “They’re putting the serum that I needed in order for the morphing process to begin, to morph, to look more like Barack Obama.”
That’s the thing about delusions. They morph. A delusion can use any external information to support itself. Even though I knew this from personal experience, it was still startling to listen to Pean explain it.
When my brother Pat was first diagnosed, he was convinced that a coworker bugged his phone, was skimming his emails, stealing his clients, and generally plotting to ruin his career. He worked in a large insurance office and the man he believed was plotting against him had never even met Pat.
I lived with Pat during this time, so I experienced first hand the futility of trying to convince a person that their delusion is unfounded. You can offer evidence to the contrary, you can ask for evidence from them, but it doesn’t matter. For a delusional person, feelings are facts. It was better not to fight Pat’s delusions because it only made him skeptical. He might have begun to wonder if he could trust me. In fact, he thought some of our relatives were in on the conspiracy.
Without trust you can’t get help for your loved one. Without trust Pat never would have accepted treatment. His therapist taught me to empathize instead and try to partner with him to make him more comfortable.
It’s not easy. When my brother tells me that he believes his neighbors are spying on him, I have to say, “I can understand why you would feel that way.” But many times I just don’t understand. Although, listening to Pean’s story makes me think it will be easier to accept my lack of understanding in the future.
While it’s a mystery to me, whatever Pat’s delusion may be, it makes perfect sense to him. His actions may be surprising or even frightening, but there is a straight line there that I’m just not aware of, I don’t have access to it. His evidence may be shallow and shoddily put together (i.e., Pat once removed a light fixture from the wall and claimed that the electrical wires behind it were proof that it was bugged), but his mind is trying to work it out nonetheless. It’s just working on something that isn’t real.
At some point we’re all convinced that our feelings are facts. When someone snaps at us, we take it personally, we feel bad because we think they’re mad at us. However maybe the person was just having a bad day. When we feel anxious about a presentation, the fear of making a mistake and looking dumb overtakes the possibility that we’ll do well. When we feel worried during airplane turbulence, we buy into the idea that there is imminent danger because our heart rate has skyrocketed.
Trusting our feelings sometimes means believing something that isn’t true. Knowing that removes some of the menace that is active psychosis. I may never be able to fill in the blanks, but I’m not responsible for that. I’m responsible for supporting my brother and other people like him. Rather than trying to make sense of it, it’s more important to recognize: This person feels threatened and they need help.