Assistant Village Idiot

Sorry to be sucking up all the oxygen in the room at present, but my Paranoia post struck a nerve and I will be adding at least one more after this. Cross-posted at Assistant Village Idiot, so comment in either place, depending on which comments you feel more at home with.

Deevs asked for recommendations of books about paranoia.  I thought this worked better as a separate post. I used to psychblog from 2005-2009, but I haven’t put in so much since then. As there as been interest in the first post on paranoia and some questions asked, I will have another go later – with anecdotes.

The classic in the field is Surviving Schizophrenia, by E. Fuller Torrey. Checking up to see if it had come out in a fifth edition, I found that it is now in its seventh edition. Xavier Amador has written the very readable I’m Not Sick, I Don’t Need Help, and is an engaging speaker as well.  He has a series of talks on Youtube, of which this is the best introduction.  He was studying to become a psychologist when his brother was diagnosed with schizophrenia.  The battle over medications and having to confront that “lack of insight” is a frequent symptom was very painful for him.  He eventually became his brother’s guardian, agreed to forced long-acting injectable medication to keep his brother alive, and was relieved that his brother was consistently treated and nonpsychotic for decades. However, even at the end, he would ask his brother if he needed the medication.  “Nah.  I just take it to keep you happy,” said his brother, with mild affection. You can see what a bind that creates. People have rights, and the idea of the government giving permission for guardianship, allowing someone to force treatment on you that you don’t think you need has obvious problems. You can find complaints about this all the time on civil libertarian websites and in comment sections of both liberal and conservative sites. Horror stories are recounted, at which I nod my head and think “I’ll bet I know the other side of that story.”  Sometimes there are real horror stories, of people being railroaded who are not particularly ill. But in most places, psychotic folks are getting too little treatment, rather than merely annoying people getting forced treatment they don’t need.  I can imagine how some trends in mental health could create a situation, decades down the road, where inconvenient beliefs are medicated against the person’s will.

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For most of you, people with paranoid disorders are encountered more frequently online than in regular life. Not for me, of course, but my situation is unusual. I would like to explain them to you a bit. Parts of their thinking that seem strange are quite reasonable once you understand what they are starting from. They may end up in a crazy set of ideas, but the reasoning to get there often makes an internal sense. This is part of why you can’t argue them out of these ideas.  It’s not that their reasoning is broken, it’s that something else is broken. Chesterton’s first chapter of Orthodoxy goes into the idea quite well from the perspective of a nonprofessional writing over a century ago. And fun.

First, they retain most of the knowledge and abilities they had before, not necessarily impaired in any way.  If she knew horses well, she still knows about horses; if she played the cello well, she can still play well.  She may have developed suspicions about people in the horse barn or the orchestra.  These may grow until she can no longer manage to stay involved with either. She may or may not be attracted to new theories that explain things to her and decide that horses or music are far more important in the cosmic scheme of things than others have noticed.

There is a sense that some things are important that others have overlooked.  In the same way that theme music plays in a movie, telling us that the villain has arrived, (cue Darth Vader music) the person with paranoia has a sense (quieter, though no less sure) that something ominous is occurring when they hear the news or even just go to the supermarket.  The number 7 is occurring too frequently, there are people who have Russian names, or look Russian, the cashier exchanges a look with the bagger that tells the person she knows something. They wonder for a time what it all must mean, but settle quickly on an explanation.  The brain will not allow events to stand unexplained.  They must be fit in somehow. The insignificant data that is regarded as significant continues to accumulate.  This is supplemented by real data , sought or unsought. The ATM has twice not been available when you needed it most.  A guy who you met just last week and told about these growing plots has a car accident.  There must be a Russian (or more frequently, a Jew) behind this.  Those forces are signalling to you to back off.  They know you are onto them and will punish you.

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I just want to mention my gratitude to Trent for tracking down good information and getting it to us in quantity. I have not commented because I have no particular expertise, neither on the medical nor the political side. As I work in a psychiatric hospital I may end up over time knowing things that most people don’t, but at the moment I am dependent on those who know more and those who do their homework. Thank you.

Update:   There is likely something in this of why black males are defecting to Trump much more than black females, but I can’t quite see what that is.  Offer suggestions you think might fit.

As I developed this, I think I came upon an explanation of the Sanders/Biden split in the Democratic primaries as well. I almost made that into a separate post because I am striving for shorter essays these days, but the one topic just flowed into the other. Bear with me, and be charitable.

James the Lesser uses the word “perverse” to describe the elevation of feelings over actual sickness and safety in the comments under Protecting Feelings, just a few days ago. It is also revealing of the motivations of those folks.  No one who has been sick near death would say having their feelings hurt was worse, nor would we say that if we had had the experience of watching another go through a terrible illness. It is rather like those people who tell us that various verbal oppressions are just as bad as physical abuse, or that sexual harassment is just as bad as rape.  Those who have been abused or raped might give a different answer, don’t you think? These must either be people who do not believe that the danger is real, or are vulnerable enough that the social death of hurt feelings is the worst they can imagine.

This latter came up in reference to Jonathan Haidt’s The Coddling of the American Mind, which I discussed about ten weeks ago. He identifies the highschool classes of 2013 and 2014 as a sharp break point, with anxiety, depression, and suicide rising in that group and remaining high.  He attributes this to this being the first cohort which had personal devices starting in middle school. They really do live in a world where social death is more frightening, because it can strike in an instant and there is no effective fighting back.  Those whose personalities were formed outside of internet life have resilience against this.

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