Most people never question the reality they experience. Most people are fortunate to have no reason to ever question it; their reality works well for them. The people who have reason to give up their reality are usually forced into it, either because they are insane, or because life just doesn’t work for them. There is no satisfying measurable definition of sanity or insanity; instead, some people have a reality that works for them, and some people don’t. Some people might be satisfied with their reality but society might not be satisfied with the behaviour their reality causes them to exhibit, and so we sometimes commit the mentally ill involuntarily to mental hospitals.

Even if you don’t feel the need to question your reality or make a new one, I assert it is worthwhile for you to understand this in the event you ever have to, or ever need to try to help someone make a new livable world for themselves. At the very least it will help you to understand why some people are so difficult to get along with, and help you relate to them. It’s not simply that some people hold different opinions, it’s that many people, not just the insane, live in a completely different world from the one you experience.

There is an objective reality, but we cannot experience it directly. It is also without significance or meaning. The reality we experience is drawn from the objective reality but sliced, diced, julienned and pureed by the food processor of our bodies, cultures and minds.

This is a very old idea. But I first came to understand it when I took a course at UCSC called Anthropology of Religion, taught by Professor Stuart Schlegel. Among other things Dr. Schlegel discussed the cosmologies of various cultures, and how they created their worlds. He explained this in a theoretical framework first advanced by the philosopher Immanuel Kant.

Kant referred to objective reality as noumenal reality. Noumenal reality is everything that exists, in all its detail and complexity. It is too vast and complex to experience, and much of it is out of reach of our senses because it is too large, too small, too far away, lost in noise or detectable only with frequencies of light or sound we cannot perceive.

Noumenal reality is also without meaning – it is uninterpreted, because in noumenal reality there is no one to interpret it. From Physics I know that all that exists are subatomic particles interacting in incomprehensible numbers and complex ways. The division of our world into spaces and objects is a fiction created by our minds – in the noumenal world there are no objects, just a continuity of space punctuated by infinitesimal particles.

There is no past and future in noumenal reality. There is time. But the only things that exist, exist now. What once was doesn’t exist anymore and what is yet to come does not yet exist.

Kant called what we actually experience subjective reality. It is created from noumenal reality first through a process of selection and then interpretation.

We can only see the wavelengths of light our eyes can detect, hear the frequencies of sounds our ears will accept, and understand a limited amount of complexity. Complexity is managed through a process of that combines and simplifies the raw material of noumenal reality into the subjective reality of the objects we perceive. We then apply interpretation to the objects based on our culture and our personalities. There is only so much we can pay attention to or even notice at all. In a very real sense we only see or hear what we want to, although the decision might be made at a very primitive level in our brains. Some sights or sounds are scary and capture our attention because during evolution those of our ancestors who gave significance to such experiences survived to reproduce.

Importantly, many of the selections and interpretations involve choices, although unconscious ones, that are influenced first by our biology, then our culture, then our personality. And the salvation of the mentally ill is that although the choices are made automatically at first, we can make new choices. I’m not saying it’s easy, but one can influence one’s reality over time and eventually establish new patterns of automatic choices that can result in a reality that is much happier to live in than, say, the world of fear and despair I used to inhabit.

The objective of psychotherapy is not to provide you with a professional friend to listen to your tales of woe. It is to help you construct a new reality. While you can expect your therapist to be sympathetic when you are in crisis, a good therapist also challenges her client to question their assumptions. Therapy is hard because the answers to such questions are often painful to face.

Everyone who starts therapy hopes to get back to the good old days before they began to suffer, but that’s not what therapy will do for them. Instead therapy helps you to let go of those of your beliefs, even your most cherished beliefs, that led you astray. In the end a successful therapy client may be very different than they ever were before, but if the therapist does her work well the client will ultimately be more truly themselves than they ever have been in their lives.

Therapy alone is enough to treat the neurotic individual. But as I said there is a biological component to the construction of reality. Despite all that therapy has done to help me, my brain is unable to regulate its chemistry on its own. That is why I must take medication. If I didn’t, the power of my chemical imbalances would overwhelm me. Someone with a mental illness whose roots come from biology must take medicine.

But someone with a biological mental illness must have both kinds of treatment – only rarely if ever does one suffer this illness without developing a neurosis. That’s why I feel it is irresponsible for general practitioners to prescribe psychiatric medicine without referring the patient to a psychiatrist or psychotherapist. Giving someone only medicine at best gives them temporary relief from their symptoms without them ever developing the insight they really need to take control of their lives.

So you can see that it is a great benefit that we construct our realities. But it can be terrible too. In Anthropology of Religion Dr. Schlegel also discussed millenarian movements, that is the phenomenon of people believing the end of the world was at hand.

Sometimes a person comes along who has the dangerous combination of being both delusional and charismatic. While of course charisma comes naturally for some people, I feel it can also arise as an unusual symptom of mental illness. After all if manic depressives can experience euphoria as a symptom, cannot the terrible neediness of the paranoid drive them to whatever lengths it takes to attract followers? These people become cult leaders.