What does it mean to be called “crazy” in a crazy world?
If you are familiar with Madness Radio, that’s a question that you’ve heard before! But it is also a question that seems increasingly important in a society where ever larger groups are organized by what seems to be paranoid or overtly delusional perspectives. Incredibly, beliefs like the notion that powerful elites are arranging to replace white people and/or to promote pedophilia, are now held by perhaps a third of US citizens and are shaping our politics.
In psychiatry, believing in “conspiracy theories” is distinguished from “delusion” since belief in conspiracy theories makes one part of a group, and so in a perverse way can increase social connection, while delusional beliefs are unique to an individual and serve to separate the individual from others.
But this distinction is fuzzy, and may be more one of scale rather than a clear categorical difference. Those who endorse a conspiracy theory for example may experience improved relations with their fellow believers, but these beliefs at the same time cause problems in their relations with non-believers. And while those with unique “delusions” do not have the possible benefit of improved relations with other believers, they may be seeking a kind of internal consistency, an improved relationship with other parts of themselves which now all agree on one “truth” however strange it may seem to outsiders.
Mainstream mental health approaches have framed “delusion” as inevitably the result of something wrong with the brain, but the rise of what seem to be outlandishly untrue beliefs in society generally supports the alternative notion that such beliefs can result from certain social and psychological dynamics, as individual minds and groups attempt to organize themselves in the face of threats and uncertainties.
Unfortunately, while these kinds of belief may be a response to perceived threat and uncertainty, they tend to create and spread more threat and uncertainty! And while only individual “delusions” can lead to people being forcibly “treated” in attempts to change beliefs that are judged to be dangerous, it seems that the group-endorsed conspiracy theories are the greater danger, as they can motivate large groups of people to move in ill-informed directions that may endanger us all.
In addition to the ethical problems with use of force in attempting to change beliefs, there is also the problem where such efforts often backfire when people “dig in” to protect their autonomy and hold onto their belief even tighter. So what else is possible?
Cognitive behavioral therapy (CBT) has developed ways of working in a friendly and collaborative way with people experiencing apparently delusional beliefs and paranoia. This approach can help people learn to feel safe enough to re-engage socially and to resume life goals, and often to eventually drop the paranoia and the beliefs that had been impairing progress.
One way to learn more about this approach is in a live online seminar, Paranoia and Troublesome Beliefs: A CBT Approach that I’m offering on 6/10/22. The early bird discounted price is $89.99 until 5/20/22, then $109.99. CE credit is available.
We are all facing very uncertain times. And a key difficulty is that some of what we feel certain to be true may not be, and sometimes powerful groups do conspire to do dastardly things while keeping the rest of us in the dark! One positive thing about CBT for psychosis is that professionals do not have to take a position of certainty: rather, the emphasis is on collaboratively facing uncertainty and sorting out what is likely to be a positive direction. I do hope some of you join this seminar and/or forward the information about it to your colleagues.
OK, this is changing the subject a little, but since I’m posting, I wanted to mention that I recently organized a webinar with two remarkable women, Gogo Ekhaya Esima and Emma Goude, who shared how they found their own approaches to working through strange experiences and uncertainties, ultimately finding a lot of value in the journey. The recording of this webinar is below!