National Alliance on Mental Illness
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Updated Edition of Classic Work Now Available
E. Fuller Torrey, MD, has fully revised and completely updated his classic book, Surviving Schizophrenia: A Manual for Families, Patients, and Providers. This indispensable guide, first published in 1983, examines the nature, causes, symptoms, and history of schizophrenia.
The fifth edition of this definitive work includes the latest research findings on schizophrenia as well as the newest treatments available. New sections added in this edition include, “The Recovery Model,” “Herbal Treatments,” and “The Influence of the Pharmaceutical Industry on Prescribing Patterns”.
NAMI is pleased to provide our readers with the following excerpt from the latest edition of Dr. Torrey’s book:
Delusions and hallucinations are probably the best-known symptoms of schizophrenia. They are dramatic and are therefore the behaviors usually focused on when schizophrenia is being represented in popular literature or movies. . . .
And certainly delusions and hallucinations are very important and common symptoms of this disease. However, it should be remembered that they are not essential to it; indeed no single symptom is essential for the diagnosis of schizophrenia. There are many people with schizophrenia who have a combination of other symptoms, such as a thought disorder, disturbances of affect, and disturbances of behavior, who have never had delusions or hallucinations. It should also be remembered that delusions and hallucinations are found in brain diseases other than schizophrenia, so their presence does not automatically mean that schizophrenia is present. . . .
Delusions are simply false ideas believed by the patient but not by other people in his/her culture and which cannot be corrected by reason. They are usually based on some kind of sensory experience that the person misinterprets. This may be as simple as brief static on the radio or a flicker of the television screen that the person interprets as a signal. Family members often wonder where the delusional ideas in the affected person came from.
One simple form of a delusion is the conviction that random events going on around the person all relate in a direct way to him or her. If you are walking down the street and a man on the opposite sidewalk coughs, you don’t think anything of it and may not even consciously hear the cough. The person with schizophrenia, however, not only hears the cough but may immediately decide it must be a signal of some kind, perhaps directed to someone else down the street to warn him that the person is coming. The schizophrenia sufferer knows this is true with a certainty that few people experience. If you are walking with such a person and try to reason him/her past these delusions, your efforts will probably be futile. Even if you cross the street, and in the presence of the same person question the man about his cough, the individual will probably just decide that you are part of the plot. Reasoning with people about their delusions is like trying to bail out the ocean with a bucket. . . .
In many cases the delusions become more complex and integrated. Rather than simply being watched, the person becomes convinced that he/she is being controlled by other persons, manipulated, or even hypnotized. Such persons are constantly on the alert for confirmatory evidence to support their beliefs; needless to say, they always find it from among the myriad visual and auditory stimuli perceived by all of us each day. A good example of this was a kind, elderly Irish lady who was a patient on my ward. She believed that she had been wired by some mysterious foreign agents in her sleep and that through the wires her thoughts and actions could be controlled. In particular she pointed to the ceiling as the place from which the control took place. One morning I was dismayed to come onto the ward and discover workmen installing a new fire alarm system; wires were hanging down in all colors and in all directions. The lady looked at me, pointed to the ceiling, and just smiled; her delusions had been confirmed forever!
Delusions of being wired or radio-controlled are relatively common. Often it is the FBI or the CIA that is the suspected perpetrator of the scheme. In recent years, an increasing numbers of delusions have involved the Internet. One patient was convinced that a radio had been sewn into his skull when he had had a minor scalp wound sutured and had tried to bring legal suit against the FBI innumerable times. Another man, at one time a highly successful superintendent of schools, became convinced that a radio had been implanted in his nose. He went to dozens of major medical centers, even to
Friends of the unfortunate people often try to reason them out of their delusions. Rarely is this successful. Questions about why the FBI would want to control them are deftly brushed aside as irrelevant; the important point is that they do, and the person is experiencing sensations (such as strange noises) that confirm the fact. Reasoning a person with schizophrenia out of a delusion is hampered by the distorted stimuli he/she is perceiving and also by the fact that the thinking processes may not be logical or connected. . . .
Paranoid delusions may on occasion be dangerous. “During the paranoid period I thought I was being persecuted for my beliefs, that my enemies were actively trying to interfere with my activities, were trying to harm me, and at times even to kill me.” The paranoid person may try to strike first when the threat is perceived as too close. . . .
Delusions may be of many types other than paranoid; grandiose delusions are quite common: “I felt that I had power to determine the weather, which responded to my inner moods, and even to control the movement of the sun in relation to other astronomical bodies.” This often leads to a belief by the person that he/she is Jesus Christ, the Virgin Mary, the President, or some other exalted or important person. . . .
A relatively common delusion is that a person can control other people’s minds. One young woman I saw had spent five years at home because each time she went into the street she believed that her mind compelled other people to turn and look at her. She described the effect of her mind as “like a magnet—they have no choice but to turn and look.” . . .
Another variant is the delusional belief that one’s thoughts are radiating out of one’s head and being broadcast over radio or television; this is called thought broadcasting and is considered to be an almost certain indication of schizophrenia. One woman described it as follows: “I believed I had a ticker tape going in one ear and coming out the other, with all my thoughts written on it.”