By Dr David Laing Dawson
There is a moment for most of us sometime in second year University studying linguistics, humanities, philosophy, psychology when questions of truth, reality and delusions become quite interesting. Is there really a difference between the man who believes the CIA is watching him (assuming they are not) and the man who believes Jesus turned water into wine without the aid of grapes and fermentation.
Is what we call a delusion just a lived experience no different than a thousand other unfounded beliefs the rest of us live by? Is it just a social judgment by which we differentiate?
The answer is no. Though it may not be readily apparent to other than a family member or someone who has spent years treating schizophrenia.
First of all the delusion, the false belief of the schizophrenic is almost always tormenting: being watched, controlled, denigrated, persecuted. And when it is not that, when it endows the schizophrenic with a power to right these wrongs, it is dangerous.
And secondly, most clearly differentiating a delusion from an ordinary unfounded belief is the accompanying cognitive deficit.
This is not a cognitive deficit that shows up on an IQ test. This is rather a more subtle and complex social information processing deficit. It is a deficit in the ability to stay grounded in this social moment including having a governing awareness of the effect we are having on others and of the consequences of what we say and do. It is this deficit that differentiates the disheveled man ranting about God on the street corner and the Jehovah’s witness knocking politely on my door.
Schizophrenia is a brain illness for which we have effective treatment.
And as Marvin points out, stigma is not reduced by railing against it. When the subject of the stigma is a frightening illness, stigma is reduced by naming that illness, understanding that illness, and ensuring that it is treated.