An observation that may help caregivers not feel quite as hurt by seemingly personal affronts of such delusions.
When you have SZ, you sometimes are searching for a reason for your pain and suffering. Certainly it must be some big trauma and it must have been repressed, because otherwise you would have known it all along. Physical and sexual trauma seem a likely suspect, as they are known to happen at the hands of family members and others. A random stranger isn’t as psychically satisfying as someone you know as you can’t confront them, a close still living family seems ideal and voicing such an affront seems guaranteed to get both attention and feel internally satisfying.
I’m not saying that these are conscious choices. My first therapist was a Jungian, and they place emphasis on unconscious forces within the psyche. Even though we know more about the physical and biochemical processes of SZ, I think some of Jungian theory is a valid model regardless of what physical processes manifest them.
I had a different therapist who had a succinct way of explaining this process. She said a hallucination was just the brain’s response to stimulus. The brain doesn’t know whether the stimulus was real or not, it’s job is to try to figure out what it is. A delusion is the process of putting thoughts, memories and new stimuluses together in an overall context. Again the brain isn’t sure how this information all got there, although it seems to try to weight some possibilities more likely than others. So it runs through various scenarios and makes its best guess as to what happened and makes up a plausible story to fit. It’s an executive function that is believed to be impaired in SZ brains. You experience similar effects when you dream. Dream imagery is often bizarre, part of that is the random associations that happen due to junk content, part of it is the tenuous story that your brain put together in response to random content, and it’s reinforced by novel patterns being more memorable than others. We forget much of what we dream, but what we retain tends to be the more interesting and often paradoxical content whose logic doesn’t make sense after you wake up. I know I often wake from dreams when I hit a logical paradox or inconsistency and it bothers me and I wake up.
Putting this all together, when you have SZ the intuitive unconscious internal story-making processes that try to explain stuff are working overtime, even when you are awake. And because they work overtime they make more mistakes. And the executive function that decides which stories have good explanations that fit the context doesn’t work so well, and tends to stick with stories that are novel and feel like that they should be true or are somehow internally satisfying. Errors and inconsistencies get overlooked and you come to believe them even if they aren’t true, because they feel right. So stories of sexual and physical abuse are common stories because of the reasons listed above. These common patterns of explanations are sometimes called the collective unconscious by Jungians.
When I had such thoughts and feelings in my therapy, I had the judgement not to voice them to family members, because I knew it would be hurtful, and my recollections might not reliable. In the end I came to the conclusion that the actual content of any possible traumas real or imagined didn’t matter, since I couldn’t be sure of them anyway. It was more important to get past the distress they caused me, regardless of how much truth there was or wasn’t to them. But I had more insight than most people with SZ and had some good therapists, so I was able to do this in a safer manner for all parties.
Unfortunately many of you aren’t so lucky, and are bearing the brunt of these archetypical stories. I’m not saying these abuses don’t happen, but a more typical response would be for the victim to develop DID (disassociative identity disorder) and not SZ. And that’s a far more confusing syndrome to understand than SZ and in the United States more controversial. I’ve been doing research on it and it’s quite confusing. I see estimates of frequency that range from 7 percent down to .1 percent, so I don’t quite know what to think about it.
