What we believe

The mind is capable of accepting anything. Our conception of reality is far more plastic than most of us realize. And yet my sense walking through life is that, though imperfect, my mind is honing in on the real. It is constantly making fine adjustments, like a high powered lens on a microscope, moving incrementally in and out, until the film on the slide comes sharp. And the way I know I am getting closer, perhaps the only way of knowing, is through communication with others and comparison with how they describe their own realities. But is the collective finally a fair arbiter of the true? A whole town drank the Kool Aid. A whole nation embraced Hitler. But without a doubt, one at a time, we are all capable of utter madness.

After a life of psychological stability, one of my patients has succumbed to hallucinations and delusions. She is an elderly woman who lives alone at the end of a line of modest row houses. She has windows on three sides of her home and she is convinced that others are looking in. They are spying on her. They are bugging her home. And they can watch her through the TV. It's a new feeling but she believes it with steadfast conviction. The elephants and Roman soldiers that now occasionally appear in the kitchen, she knows that these are not real. But the people off in the distance with the binoculars and the surveillance equipment, with deep pockets and nothing but time, they are a certainty.

"I swear to God." she says to me. "They are there."
"What do they want with you?"
"I think it's the house. They want the house."
"Why should they want your house?"
"I've lived here for so many years and I've never had this problem. But this house is ripe for it."
"What?"
"Something big is going to happen. I don't know what. But something big."

A towel neatly covers the TV. She wants me to find something to spray over the windows. I look outside and wonder if the high-intensity street lights are bothering her. They certainly aren't responsible for her psychotic break but maybe they are contributing.

What strikes me most is her willingness to let go of one set of bizarre indicators but not another. Roman soldier: ridiculous. Shadowy cell watching her through the TV: unshakable. When I gently challenge her assumptions, she takes a deep breath, looks down, and sighs: "how can I explain this to you?" I wonder at my own very solid-seeming set of life-premises. How reliable are they?

My experience with addiction has taught me an enormous amount of humility when it comes to reality testing. I repeatedly put my mind and my life in serious jeopardy and accepted that such behavior was reasonable. Rather than confronting and perhaps overcoming the things that challenged me, I welcomed a highly toxic escape. The Big Book of AA likens the decision to continue drinking despite often devastating consequences to a man who revels in the thrill of jaywalking busy streets despite repeatedly being hit. The woman I speak of above is responding to a delusion. I was contending with incredible denial, and I continue to do so. The addictive or alcoholic way of responding to problems does not disappear with abstinence. Psychiatrists, I am sure will object with my comparison of delusion and denial. Delusion is certainly more intrusive while denial allows us to continue doing something that on some level we deeply desire. But both result in breakdowns in our ability to recognize what is true. So what is true?

At the outset, I write that the collective may not be the best arbiter of the true. I am sure that a lot depends upon which collective. However, I am of the mind that those practices that bring us closer to a state of serenity are bound to be true, at least on some level. One may argue that the thought of the universe in all of its vastness and silence is highly disquieting. Indeed it is. Yet the peace that we begin to approach when we empty our minds of thought and just accept is...well, it's something. And it appears to be fairly universal, though rarely practiced. Perhaps it is an act of faith, but I have far more confidence that when I am in a place of calm and acceptance, I will see things as they truly are. I believe this fiercely and yet, amazingly, I still resist the practice that will take me there: meditation, prayer, and cultivating balance in my life. I revolt against it. I tend toward obsession, worry, distraction. It's a struggle. The woman suffering with her delusions is a good reminder for me. Do I really want to remain in a false reality? Isn't it time to embrace the real?