Defining ‘psychotic symptom’

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What exactly do people mean when they say “psychotic symptom”? Let’s explore why it might not be such a good term to use after all…

In medical parlance, hearing, seeing, feeling and smelling things that aren’t really there (hallucinations) or believing in things that aren’t real (delusions) are two of the most common psychotic symptoms that a psychiatrist will look for when assessing somebody for a diagnosis of psychosis. However, by diagnosing something as a “delusion,” this implies that there are two clearly defined sets of beliefs you can have: one that is healthy, and another that is disturbed. But who decides where this line is drawn?

To illustrate our point, think about the following examples:

• Should a person who believes they have been abducted by a UFO be labelled “psychotic?” What about a person who believes that The Sharks are ever going to win a premiership? Now THAT is an odd idea to have!

• What about people who believe they have memories of a past life? Are they psychotic? And if you answered “yes” to that question, what are you saying about the majority of the population of India, where reincarnation is an everyday belief shared by almost the entire population?

• Richard Dawkins wrote a book called “The God Delusion” in which he claims that having a belief in God is some kind of mental aberration. Yet psychologists know very well that the human mind is geared towards finding “agency” behind all phenomena. If that’s the way our brains work, then you could also argue that believing in God is the “normal” mindset, and that atheism is abnormal (after all, atheists are in the minority everywhere on the planet). How do we tell who has the “delusion” in this situation?

• In some political regimes, people with “incorrect” political views have been labelled mentally ill so the government could have a convenient excuse to lock them up. After all, one of the quickest ways you can discredit somebody who opposed you is to attack their credibility, and accusations of mental illness, sadly, tend to work really well for this purpose.

• And what about poor Galileo Galilei? Back in the 17th Century Galileo was forced by the Church to recant his idea that the Earth went around the Sun. Well, I think almost everybody believes his findings now, but a few hundred years ago it was easy to paint him as being mad, bad, or both.

On the other hand, many of us will experience (or know people who experience) mental states that are not just unusual or “interesting”, but are extremely unpleasant or outright threatening to their wellbeing. Most of our readers would know someone who has been tormented by voices, or who sees terrible things. Whatever the nature or the cause of these states, the important things is to learn how to deal with them as best as we can right now. We need to do this both for our own sake, and for the sake of the people we support.

To sum up: when we use the term “psychotic symptom,” we are describing a problem that the person we are supporting DEFINES as a problem.

Pluses and minuses

Positive symptoms are things that are ADDED to a person due to a mental health issue (voices, delusions, hallucinations)

Negative symptoms are things that are TAKEN AWAY from a person due to mental health issues (reduced levels of self-care, losing most of your motivation, an inability to show emotion)

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