Schizophrenia is a complex illness.
This should not be surprising; the brain is by far and away
the most complex organ in our body, and our understandings of how it functions
– and dys-functions – are rarely complete.
Typically, the symptoms that are diagnosed as pathological
for schizophrenia are delusions and hallucinations. A delusion is an entrenched
belief in something that is commonly understood not to be the case. A
hallucination is a sensory experience that occurs in the absence of an external
Are you with me so far?
Today I would like to talk about one of the most common
delusions: the delusion of reference.
A delusion of reference is the belief that un-related
occurrences in the external world have a special significance for the person
who is being diagnosed. So, for example, a delusion of reference might occur
when someone watches a movie and believes there is a message in the movie that
is meant specifically for them, and that makes some kind of “sense”. Delusions
of reference may also occur in other media. For example, a person may believe
there are messages for them in music. One of the more prominent examples of
this is the Laurel Canyon cult leader Charles Manson, who believed he was
receiving injunctions to act in certain ways from certain Beatles songs.
(Apologies to all the Beatles fans out there).
A delusion of reference can also occur in other places. A
person may believe that elements of the natural world have special meaning for
them. For example, a person may believe that leaves on a tree are moving in
time with music they hear internally.
I like to use the following example to explain what a
delusion of reference feels like.
Imagine a bowl of red MnM’s. A big bowl full of red MnM’s.
Now imagine that there are some orange MnM’s scattered
throughout the bowl. I would say that your attention would naturally be drawn
to the orange MnM’s. They would “stick out”.
And now imagine this. The orange MnM’s are laid out in such
a way as to spell your name.
This may give you some idea of what the delusion of
reference feels like – a message just for you in a medium that does not
normally carry messages.
In many cases of delusions of reference, the person being
diagnosed will not have insight into their delusions. They will be firmly
convinced of the reality of their delusion. In this case, convincing the person
to be admitted to a ward or clinic or to take medication can be very difficult.
It should also be kept in mind that delusions of reference can emerge in
different media, in different sources, and can carry all manner of different
messages. Indeed, as with other symptoms of psychotic disorder, the content of
the disorder can be as complex as the human imagination itself.
Perhaps, with time, we will come to understand the
neuro-chemistry that underlies delusions like this and help the recovery of
those for whom these delusions are debilitating.
Dr. Richard Schweizer, Policy Officer at One Door Mental Health firstname.lastname@example.org.
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Dr Richard Schweizer