Delusions, odd and common: Living in the prodrome, part 2 (originally 10 January 2011)

(We are republishing ‘legacy content’ from our PLOS Neuroanthropology weblog, which has been taken down, along with many of the other founding PLOS Blogs. Some of these, I am putting up because I teach with them. If you have any requests, don’t hesitate to email me at: greg.downey @ mq (dot) edu (dot) au. I suspect many of the links in this piece will be broken, but I will endeavour to try to slowly rebuild this content. I originally published this on 1 January, 2011. Comments have been pasted in at the end of the post from the original.) 

Author Rachel Aviv talked at length with a number of young people who had been identified as being ‘prodromal’ for schizophrenia, experiencing periodic delusions and at risk of converting to full-blown schizophrenia, following some of the at-risk individuals for a year.  In December’s Harper’s, Aviv offered a sensitive, insightful account of their day-to-day struggles to maintain insight, recognizing which of their experiences are not real: Which way madness lies: Can psychosis be prevented? (Freely accessible pdf available here.)

Psychiatric Research by Ted Watson

Aviv’s piece was really moving and inspired this post and an earlier one. The first part (Slipping into psychosis: living in the prodrome (part 1)) provides some sense of Aviv’s interviews, especially the story of ‘Anna,’ a woman who feared that she, like her mother before her, might be losing her grasp on reality.  In addition, the earlier post covered the controversy surrounding the attempt to formalize a diagnosis in the DSM-V of ‘prodrome’ and the ethical problems created by trying to identify who is at risk of ‘going mad.’

This post is my more speculative offering, contemplating the relation of the content of delusions to the cultural context in which they occur. How do the specific details of delusions arise and how might the particularity of any one person’s delusions affect the way that a delusional individual is treated by others?  Are you mad if everyone around you talks as if they, too, were experiencing the same delusions?

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