Today, most people with a mental illness are out in the community and the scandals reported in the press are no longer about the bad treatment they receive in psychiatric hospitals but about attacks by them. As a result, journalists regard them as being quite different from the rest of us. This is an issue all over the world.
I remember reading what Ralph Emerson said; ‘Sanity is rare. Every man and almost every woman has a dash of madness.’
Aristotle wrote: ‘Nobody is exempt from a mixture of madness.’
Nietzsche wrote; ‘Insanity in individuals is rare, but in groups and in nations and epochs, it is the rule.’
So the idea that bizarre beliefs are not common in normal people is incorrect. If you follow the horoscope in the Sun Newspaper, you might have read under Aquarius somestatistics on insanity saying that one out of every four Americans suffers from a mental illness. Well, I am Aquarius, so I decided to do a simple test. I thought about three of my best friends …. and as they were not sufferingfrom a mental illness, I realized that the the fourth one could be me.
II asked a psychiatrist to explain a hallucination to me. I was told that it was something one hears in the absence of a stimulus. ‘So,’ I asked, ‘does the Pope hear the voice of God or, is a person who hears the voice of God only hallucinating?’ No reply.
Then I asked whether a delusion were a false, fixed, unshakeable idea in which people invest a great deal of emotion; like ‘My mother is poisoning me,’ or ‘they planted ideas in my coffee.’ When someone has a bizarre delusion or an unusual hallucination, it is easy to make a diagnosis but when it is not so clear, it becomes problematic.
Traditionally, psychiatrists thought that schizophrenia was a brain disease and did brain scans showing that people with schizophrenia have slightly less grey matter and that their hippocampus is 5% smaller. It is not something gross like in Alzheimer’s disease but people tend to think that these changes are partly developmental and that the disorder runs in families to some extent like heart disease or diabetes. One does not inherit it directly but one can inherit a predisposition toward schizophrenia.
When the world worried that Iraq was stockpiling mass weapons of destruction, it seemed a fixed, unshakeable belief which was held with great conviction; yet it turned out to be a false belief. But, despite this, it was NOT a delusion. Why? Because it was shared by a great number of people. What would happen if someone told me today that there are weapons of mass destruction in Iraq; would it be a delusion? It might well be because I would have great difficulty finding anyone else who believed me. So, to some extent, a delusion is diagnosed when one cannot persuade other people to believe one’s belief.
I remember another example; Mohamed Al Fayed had the belief that was widely reported in the press that princess Diana and his son Dodi were murdered as a result of a conspiracy masterminded by the Duke of Edinburgh. Is this belief within normality – or not? There does not seem evidence for it yet he has maintained it with unshakeable determination for a long time although, as far as we can tell, it is false. It is however, understandable.. His son was on the verge, so he thought that an important relationship with royalty imight have been the cause.
So I would like to conclude that the general population is ‘sane’ and that there are only a few people with schizophrenia who are in hospital or, who should be there; then psychiatrists began to think that maybe some people who are a bit paranoid should be part of the spectrum; and now we think that a considerable proportion of the population probably have minor psychotic ideas the way we place people being somewhere on the distribution of diabetes or obesity.
Therefore, maybe we should not think that people with schizophrenia are something like an alien race and very different from the rest of us. In face, if we are given the right environmental circumstances, most of us have the capacity to develop psychotic ideas and have hallucinations as well as delusions.