DELUSIONS: WHAT WE KNOW, WHAT WE DON’T

Don Molde

Psychiatrists have lots of experience with delusions. Delusions (and hallucinations) are one of the hallmarks of schizophrenia. Delusions are often directly related to how/why a person suffering from that disorder comes to the attention of psychiatrists.

One definition of a delusion is an idiosyncratic fixed and unalterable false belief.

In psychiatric circles, delusions come in all shapes and sizes though typically they have bizarre components, often involving suspiciousness and control themes where the person is being influenced by some outside force such as the government or one of its agencies.

One thing psychiatrists and other mental health professionals learn quickly is that facts and truths are not effective treatments for delusions. Families are often advised to refrain from debating the merits of a delusion or trying to ‘talk’ the afflicted family member out of his/her odd way of thinking since that may only serve to strengthen the delusion.

To provide effective treatment to a person afflicted with schizophrenia with its delusional component, certain drugs are almost invariably required. Drugs can reduce and even eliminate delusional thinking, after which psychotherapy and other social treatments may add additional benefit for the person’s treatment plan.

What psychiatrists know little to nothing about is what to do about significant national delusions based not upon a mental disorder but some other basis or distorted rationale.

We’ve had national delusions for a long time, mostly of relatively low intensity, such as:

John Birch Society/Senator McCarthy communist government infiltration.¹
The Kennedy assassination.²
Roswell, New Mexico aliens.³
Fake moon landing.⁴
9/11 never happened.⁵

Now, we have what are termed Conspiracy Theories, some of which look very much like delusions seen in mental illness. For our purposes, these terms will be synonymous.

Let’s list The Big Three:

The Big Lie, the notion that our last presidential election was ‘rigged’ in favor of Joe Biden, that President Trump was the true winner, that massive fraud was perpetrated on the country despite mountains of evidence to the contrary.
QAnon, with truly bizarre notions that Democrats kill and drink the blood of babies, that former President Trump will be reinstated, that God designated President Trump to eliminate all child trafficking perpetrated by Democrats
Anti-Vaccine notions, that microchips are contained in the vaccine for purposes of controlling recipients, that vaccines will change our DNA, that Bill Gates is trying to control the world through vaccines.

We know that schizophrenia has a rate of occurrence in the general population of about 1%. At any given time, we have about 3 million persons with that diagnosis living among us. Clearly, we can’t account for all who believe one or more of the The Big Three based on mental illness.

We also know that delusions arising from some origin other than mental illness are just as resistant to correction by facts and truth as delusions arising from mental illness, at least for now. There is plenty of evidence to support that observation.

What might be the origin of our current ‘political’ delusions if not from mental illness?

The Big Lie is reminiscent of lessons learned from Germany in the 1930s. Authority figures used the technique of repetitious pronouncements of large-scale misinformation. The historical record seems clear that such conduct by authority figures can and did produce false and dangerous beliefs in the public.
We have had politically influential figures in this country repeating large scale lies about one or more of The Big Three for several years. It is highly likely that repetition has been successful in creating false beliefs among some of the public.

Other factors generating delusional beliefs among the public are more difficult to define.
Political divisiveness, general distrust of government and politicians, strongly held polarizing values. social media amplification of odd ideas sent round the world with the click of the mouse for no cost, continuous talk radio and cable news programs with significant slants, charismatic leaders loose with the facts and more, all may have contributed in some fashion.

The Big Question is what do we do to combat dangerous delusions that resist facts and truths; strange beliefs that may threaten our very form of government?

For one thing, we know these large-scale national delusions are not the result of a genetically determined mental illness like schizophrenia. Free of a genetic anchor, belief systems may be more flexible, over time, with certain interventions. Regression or reversal of delusional beliefs originating from non-genetic causes would seem, by intuition, to be more likely to have flexibility for modification at some point in their lifespan.

It is likely that believers of The Big Three are not homogeneous but have variable levels of attachment and commitment to those beliefs. Perhaps the repeated presentation of facts and truth, over time, will peel off those on the margin who tire of failed predictions, e.g., President Trump was to be reinstated in August, then September, etc.

The legal system may offer some corrective leverage, particularly with respect to prominent influential persons making false claims who wind up being sued for defamation, lose their law license, acquire a felony conviction for interfering with the election process.

Some of those arrested for their conduct on January 6th are said to have had epiphany-like awakenings while grinding their way through the legal process with no chance of a presidential pardon or having President Trump pay their legal bills.

Perhaps more persons of influence like Liz Cheney will gradually come forward, demonstrate courage and leadership, and stand up for facts and truth. Repetition of truth and facts by such leaders may have a reverse effect on The Big Three over time.

Over the long term, though, the nation needs citizens with better quality critical thinking skills. Knowing how to fact check, to do research, to reserve judgment until more information is acquired, to administer the ‘smell test’ if all else fails are some of those needed skills.

Where critical thinking skills should be acquired is an open question. Do parents have that responsibility? Is it up to schools to teach that? Does the news media have a contribution to make by playing it straight with the news, avoiding slants and innuendo?

We now know this country is facing serious consequences if troublesome and dangerous national delusions continue without abatement. Our form of government may be threatened in the not-to-distant future.

We also know we have no current effective means of reversing or neutralizing large-scale false beliefs. We are in the early phases of finding our way. Our efforts must continue on all fronts to counter and combat such misinformation.

Sometimes individuals with significant mental illness, and even unrelated personality disorders, can undergo ‘burn out’. Over time, symptoms may persist but lose significant intensity and focus. Whether that will occur with The Big Three is yet to be determined.

Meanwhile, please place your best suggestions in the nearest suggestion box.

Carol Schaye, Editor; For your reference

Don Molde is a 50-year Reno resident, retired psychiatrist, co-founder of Nevada Wildlife Alliance, former board member of Defenders of Wildlife, and former board member of the Nevada Humane Society. He has been active in wildlife advocacy for 45 years.

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