I remember finding this concept difficult in medical school training. We were supposed to look for delusions in patients as a sign of their mental health. Delusions were defined for us medical students, and for all of us, as “an unshakeable belief in something untrue”. I remember rolling my eyes as that was presented. I could think of quite a few fellow students and relatives who had unshakeable beliefs in things I thought were not true. Were they crazy, or me?
But then I had to spend some time with the folks living under the Alaska Way in Seattle that would be brought into the Harborview Emergency Room. The older Native American with the rotted foot, diabetic, who believed the drugs offered to control his blood sugars were poison. Or the young schizophrenic who just knew the truth was to be found in the Seattle Times horoscope, not in the medications we offered. I had lived a sheltered life and had not learned that delusions could be fatal.
But now I live in a time when the marketing, the promotion, and the power of selling delusions makes some billionaires and the rest of us crazy. Whose truth will you embrace? Do you know for a fact that our former president flushed documents down the White House toilet, or do you instead know for a fact that the FBI instilled informants in the January 6th Capitol riot? Or are you both delusional and I need to find a safe retreat? We need to sort this out.
Many people with delusions do just fine in regular society. I remember a conversation at a Democratic county picnic. A man came up to me in a reasonable manner, engaging, but pretty soon he was talking about fluoride in the water and how it was poisoning people to believe in communism, and just what was I going to do about it as a State Senator. He was fine, I was okay for the moment, but I found myself concerned for his mental health. Are we all crazy?
I don’t think so. We mostly are pretty rational human beings. But what we all can agree on as the truth may be like a distant mirage in the desert. A distant hope, an illusion, a figment our imaginations provide. And the only truth will be in our pursuit.
There’s no good medicine for delusions. It’s not like there’s a simple brain chemistry explanation. The best treatment is to promote function. So, if you believe these medicines for your diabetes are poison, and your foot is stinking, rotten and dead, how can we help you? I have seen a lot of diabetic amputees.
Delusions are part of our everyday existence. How they affect us is the test. But will we learn and change?
Here’s the catch. And it’s Catch 23, because it’s powerful. Unhealthy people with delusions cannot be dissuaded. The schizophrenic who finds comfort in the horoscope, the diabetic who sees poison in pills will persist in their beliefs until they die from their disease, even as they lose limbs or jump from the bridge.
We are at this place in our civil discourse. Your truth is not mine. My truth is not yours. Does such a lack of shared truths mean opposing the delusions of others is our destiny? Is there a hope for representative democracy? Or is the middle ground the dismal position where we dismiss the unshared truths of others? I write this as an Idaho Democrat. You might be reading this as an Idaho Republican. Can we share some truths?
Our founders based the radical concept for this country on their belief in the rational, educated mind, that such communal wisdom would promote the common good.
I do not dismiss your delusions. I believe there is a truth we can share. Help me disabuse myself of mine.