When delusional beliefs are present which are bizarre in nature, clearly implausible, have no basis in fact and are not derived from ordinary life experience, a person may be diagnosed with schizophrenia. This criterion is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a book used by psychiatrists to assess various types of mental illness and reflects a Western view of reality.
Delusions may be viewed differently in traditional cultures, where folk explanations or spiritual causes may be attributed and tolerated. Robert Whitaker, in his book Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill, reports that the World Health Organization has found that schizophrenia outcomes in the United States and other developed countries are worse than in many poorer countries, such as India and Nigeria.
Schizophrenic Thinking is a Part of Everyone’s Personality
Manfred Bleuler, a Swiss psychiatrist whose life work involved observing patients with schizophrenia, wrote over 50 years ago that schizophrenic thinking occurs in everyday functioning for normal humans as daydreams, art, fantasy, fanatical thinking and nighttime dreaming. Normally, these thoughts occupy a small part of life and are under control. In a schizophrenic, such thoughts seem to become the predominant way of communicating with oneself and others.
John Watkins, author of Unshrinking Psychosis, states that a dream is a psychosis of short duration. On average, humans dream about two hours every night, and dreaming apparently serves an important psychological purpose. Watkins reports that normal subjects who are kept awake will dream more when they can sleep, while acutely psychotic individuals do not experience this rebound effect. It may be that waking delusions and hallucinations take the place of sleeping dreams. Watkins theorizes that psychotic symptoms may be understandable exaggerations of normal mental functions.
Psychosis Involves an Imaginary World Not Shared by Others
In his autobiography, Carl Jung, the founder of analytical psychology, said that it is difficult to distinguish the dreams of people diagnosed with schizophrenia from those of unaffected persons. In an acute psychotic episode, it seems that fragments of dreams intrude into waking consciousness. Thinking and behavior can be so strongly influenced by inner images and feelings that they completely over-shadow the waking world. Think of the difficulty in trying to function in the outer world, while experiencing an inner, altered dream-like state.
A person with psychosis is undergoing a profound psychological, social and emotional experience, which should be responded to with as much understanding as possible. Normal sleeping dreams can be likened to the world of schizophrenics.
References:
- Mad In America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill; Robert Whitaker; Perseus Books; 2002
- Unshrinking Psychosis; John Watkins; Michelle Anderson Publishing; 2010
- American Journal of Psychiatry; On Schizophrenic Psychosis, Bleuler, M, 136(11); 1979
- Memories, Dreams, Reflections; Carl Jung and A. Jaffe; Collins; 1962
Mary Earhart - Mary Earhart, RN, BSN, is a Licensed Midwife. She has written articles for professional journals and grants for non-profit agencies as ...
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