Natalie also remembered other beliefs, including that she was dead (known as Cotard delusions), which she did not share with doctors at the time. She noted that she entertained this idea because there were no other explanations to explain her strange experiences and an idea from a television show.
Natalie said she eventually dismissed this idea as unlikely, even though she still harbored other delusions. This suggests that belief evaluation may involve different thresholds for different delusions. It also emphasizes the personal nature of some delusions.
Despite all her delusions, Natalie described her active involvement in trying to explain and manage her experiences. She reported that she had considered several explanations and tested them by seeking more information. For example, she asked questions to the people she thought were her in-laws. This suggests a surprisingly similar approach to the way we typically form beliefs.
Natalie recalled the influence of television and films on her ideas. She also remembered how she worked out her delusions, once formed, based on information from her environment.
These features challenge theories that delusions simply arise from anomalous sensory data. Instead, they emphasize the role of the individual's search for meaning and social context, as well as the subsequent impact of delusions on perception and thinking.
Implications
As a case study, Natalie's experiences are not necessarily representative of all people who experience delusions or postpartum psychosis. However, Natalie's case exhibits informative features that theories of delusions should take into account.
In particular, Natalie's personalized insights highlight the critical role of the individual in actively seeking to understand and make meaning of their experiences. This is in contrast to merely passively accepting beliefs in response to anomalous sensory data or neuropsychological deficits. This suggests that psychological therapies may be useful in treating psychosis, in some cases in combination with other treatments.
More generally, Natalie's account reveals the similarities between delusions and ordinary beliefs and supports the view that delusions can be understood in terms of cognitive processes at the stages of normal belief formation that we have identified.
Although challenges remain in investigating delusions, further research can provide insight into the foundations of everyday belief and, in turn, ourselves.
Michael Connors, Joint Senior Lecturer in Psychiatry, UNSW Sydney, and Peter W Halligan, Professor of Neuropsychology, Cardiff University. This article is republished from The Conversation under a Creative Commons license. Read the original article.
