Saturday, August 24, 2013

Conservative Delusions: Treatment Just Around The Corner?


"I cannot but conclude the bulk of your natives to be the most pernicious race of little odious vermin that nature ever suffered to crawl upon the surface of the earth."

Jonathan Swift, Gulliver's Travels, Voyage to Brobdingnag, Ch. 6.
"I said the thing which was not. (For they have no word in their language to express lying or falsehood.)"

Gulliver's Travels, Voyage to Houyhnhnms, Ch. 3.


The Wikipedia entry, "Delusions," informs us:

"A delusion is a belief held with strong conviction despite superior evidence to the contrary.  As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, or other effects of perception.

"Delusions typically occur in the context of neurological or mental illness, although they are not tied to any particular disease and have been found to occur in the context of many pathological states (both physical and mental). However, they are of particular diagnostic importance in psychotic disorders including schizophrenia, paraphrenia, manic episodes of bipolar disorder, and psychotic depression.
The causes of delusions?  Wikipedia continues:

"One is the genetic or biological theory, which states that close relatives of people with delusional disorder are at increased risk of delusional traits. Another theory is the dysfunctional cognitive processing, which states that delusions may arise from distorted ways people have of explaining life to themselves. A third theory is called motivated or defensive delusions. This one states that some of those persons who are predisposed might suffer the onset of delusional disorder in those moments when coping with life and maintaining high self-esteem becomes a significant challenge. In this case, the person views others as the cause of their personal difficulties in order to preserve a positive self-view.

"This condition is more common among people who have poor hearing or sight. Also, ongoing stressors have been associated with a higher possibility of developing delusions. Examples of such stressors are immigration or low socio-economic status.

"Researcher, Orrin Devinsky, MD, from the NYU Langone Medical Center, performed a study that revealed a consistent pattern of injury to the frontal lobe and right hemisphere of the human brain in patients with certain delusions and brain disorders. Devinsky explains that the cognitive deficits caused by those injuries to the right hemisphere, results in the over compensation by the left hemisphere of the brain for the injury, which causes delusions.

"A study carried out by a team from The Warwick Medical School at the University of Warwick, Coventry, England, led by Andrea Schreier, Ph. D., indicated that children who suffered bullying are more likely to develop psychotic symptoms in early adolescence. The background facts demonstrated that hallucinations and delusions are common in childhood as well as in adulthood and that children who experience such symptoms are more prone to develop psychosis later in life. Furthermore, the study demonstrated that the risk of psychotic symptoms, including delusions, was multiplied by two for children who suffered bullying at age eight or ten. The authors remark that bullying can cause chronic stress that may have an effect on a genetic predisposition to schizophrenia and result in setting off the symptoms."


And under their entry, "Delusional Disorder," Wikipedia's definition more closely fits the realm of Conservative delusional thought:

"Delusional disorder is an uncommon psychiatric condition in which patients present with non-bizarre delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect.  Delusions are a type of psychotic symptom. Non-bizarre delusions are fixed false beliefs that involve situations that could potentially occur in real life; examples include being followed, or that microwaved food, TV antennae, cellphones, and lap computers cause radiation poisone\ing (as is believed by the Fa Cha Chi Gong spiritual belief.  Apart from their delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behaviour does not generally seem odd or bizarre.  However, the preoccupation with delusional ideas can be disruptive to their overall lives.  For the diagnosis to be made, auditory and visual hallucinations cannot be prominent, though olfactory or tactile hallucinations related to the content of the delusion may be present.

"To be diagnosed with delusional disorder, the delusion or delusions cannot be due to the effects of a drug, medication, or general medical condition, and delusional disorder cannot be diagnosed in an individual previously diagnosed with schizophrenia. A person with delusional disorder may be high functioning in daily life, and this disorder bears no relation to one's IQ.  According to German psychiatrist Emil Kraepelin, patients with delusional disorder remain coherent, sensible and reasonable.  The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines six subtypes of the disorder characterized as erotomanic (believes that someone is in love with him or her), grandiose (believes that he/she is the greatest, strongest, fastest, richest, and/or most intelligent person ever), jealous (believes that the love partner is cheating on him/her), persecutory (believes that someone is following him/her to do some harm in some way), somatic (believes that he/she has a disease or medical condition), and mixed, i.e., having features of more than one subtype.  Delusions also occur as symptoms of many other mental disorders, especially the other psychotic disorders.

"The DSM-IV, and psychologists, generally agree that personal beliefs should be evaluated with great respect to complexity of cultural and religious differences since some cultures have widely accepted beliefs that may be considered delusional in other cultures."


Which brings us to our daily reprint, an essay "Delusional People See the World Through Their Mind's Eye," by Tanya Lewis, Staff Writer at Livescience.com:

"A mechanism for how the brain creates and maintains delusions is revealed in a new study.

"Human beliefs are shaped by perception, but the new research suggests delusions — unfounded but tightly held beliefs — can turn the tables and actually shape perception. People who are prone to forming delusions may not correctly distinguish among different sensory inputs, and may rely on these delusions to help make sense of the world, the study finds. Typical delusions include paranoid ideas or inflated ideas about oneself.

"'Beliefs form in order to minimize our surprise about the world,' said neuroscientist Phil Corlett of Yale University in New Haven, Conn., who was not involved in the study. 'Our expectations override what we actually see,' Corlett added. [The 10 Biggest Mysteries of the Mind]

"The prevailing thinking holds that people develop delusions to predict how events in their lives will occur — just as Pavlov's dog learned to predict that the sound of a bell ringing meant dinnertime was imminent. Humans update their beliefs when what they predict doesn't match what they actually experience, Corlett said.

"But delusions often appear to override the evidence of the senses. To test this idea, German and Swedish researchers conducted behavioral and neuroimaging experiments on healthy people who harbor delusions.

"In one experiment, volunteers were given a questionnaire designed to measure delusional beliefs. Questions included: Do you ever feel as if people are reading your mind?; Do you ever feel as if there is a conspiracy against you?; Do you ever feel as if you are, or destined to be someone very important?; and Are you often worried that your partner may be unfaithful?


"The participants then performed a task that tested their visual perception: They were shown a sphere-shaped set of dots rotating in an ambiguous direction, and asked to report which direction it was rotating at various intervals.

"People who harbored a greater number of delusional beliefs (those who scored higher on the questionnaire) saw the dots appear to change direction more often than the average person. The result confirms findings from previous studies that delusional individuals have less stable perceptions of the world.

"In a second experiment, the volunteers were given glasses, which they were told would bias their view so that the rotating dots would appear to go in one direction more often than the other direction — a delusion, because these were actually ordinary glasses. The volunteers performed a similar dot-watching task, with a learning phase and a test phase. During the learning phase, the dots clearly rotated in one direction, but during the test phase, the direction was ambiguous.

"While wearing the glasses, the volunteers reported seeing the dots rotate in the biased direction, even during the test phase. They clung to the delusion that the glasses altered their vision, even though the visual evidence contradicted this idea, suggesting they used their delusional beliefs to interpret what they were seeing.

"A third experiment was similar to the second, but brain scans were taken using functional magnetic resonance imaging. The scans showed that when people were deluded about the direction of the dots' rotation, their brains were encoding the delusion as if they had really seen the dots move that way. In other words, people weren't just ignoring what they saw; they were really seeing something else.

"Furthermore, the brain scans revealed connections between a brain area involved in beliefs, the orbitofrontal cortex, and an area involved in visual processing, the visual cortex. (Both became active during the delusional observations.)

"Corlett finds the results exciting. The study 'gives us a nice explanation for the relation between belief and perception and how it might go awry,' he said.

"But he cautioned that drawing inferences about people who are clinically delusional, such as those with schizophrenia, may be premature. Time will tell whether the same brain mechanisms are at play for these patients, he said."

*****


The exciting news for the Sheeplets, the True Believers who have been hoodwinked by the Conservative propagandists into believing "that which is not true," is that treatment is at hand!

Again, from Wikipedia:

"Treatment

"A challenge in the treatment of delusional disorders is that most patients have limited insight, and do not acknowledge that there is a problem.  Most patients are treated as out-patients, although hospitalization may be required in some cases if there is a risk of harm to self or others.  Individual psychotherapy is recommended rather than group psychotherapy, as patients are often quite suspicious and sensitive.  Antipsychotics are not well tested in delusional disorder, but they do not seem to work very well, and often have no effect on the core delusional belief.  Pimozide may be more effective than other agents.  Antipsychotics may be more useful in managing agitation that can accompany delusional disorder.

"Psychotherapy for patients with delusional disorder can include cognitive therapy which is conducted with the use of empathy. During the process, the therapist can ask hypothetical questions in a form of therapeutic Socratic dialogue.  This therapy has been mostly studied in patients with the persecutory type. The combination of pharmacotherapy with cognitive therapy integrates treating the possible underlying biological problems and decreasing the symptoms with psychotherapy as well. Psychotherapy has been said to be the most useful form of treatment because of the trust formed in a patient and therapist relationship.  The therapist is there for support and must not show any signs implying that the patient is mentally ill.

"Supportive therapy has also been shown to be helpful. Its goal is to facilitate treatment adherence and provide education about the illness and its treatment.

"Furthermore, providing social skills training has helped many persons. It can promote interpersonal competence as well as confidence and comfort when interacting with those individuals perceived as a threat.

"Insight-oriented therapy is rarely indicated or contraindicated; yet there are reports of successful treatment.   Its goals are to develop therapeutic alliance, containment of projected feelings of hatred, impotence, and badness; measured interpretation as well as the development of a sense of creative
doubt in the internal 
perception of the world. The latter requires empathy with the patient's defensive position."


So we finally have the methodology to separate our Conservative Sheeplets from their leaders, propagandists, and fellow travelers!  When Conservatism is criminalized, this testing will tell us who is delusional and who is not. If a Conservative suspect is truly delusional - or like Rush Limbaugh, Ann Coulter and their ilk, if they haven't really swallowed the Kool Aid, and if they are just using the Conservatives for money or power, then the courts will await them along with the other Conservative criminals awaiting trial.The difference is important. Those who have been "faking it" will be subject to prosecution and punishment (see our Page, "Punishments," on the tab on the top of our site), or if they are the ones who are clinically delusional and need treatment, they will receive it.



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Leonard:  I'm just saying, you catch more flies with honey than vinegar.
Sheldon:  You catch even more with manure, what's your point?

The Big Bang Theory

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