Tuesday, October 04, 2005

Delusional Disorder

As a psychiatrist, it is always interesting to find examples of Delusional Disorder--especially an example that has such a detailed and complicated central delusion, like here:

Host: "The U.S. naively asks: 'Why do they hate us in the Middle East?'"

Muhammad Khalaf: "There is nothing naive about it. This is the kind of thing they say as a pretext. The truth is that they understand, we understand, the American people understands, and the whole world understands that there is a comprehensive plan, and that 9/11 is just one of many small details of this plan, which is no longer concealed from anybody.

"It began with Bush Senior, who talked about a new world order. Plans were made and became public. The National Defense University developed a plan in January 1999, according to which, with the fall of the U.S.S.R., no other superpower should be allowed to exist - not the U.S.S.R. again, and not even the countries included in the U.S.S.R., not China, or any other country. They began thinking about filling the vacuum formed in Asia with the countries that had left the U.S.S.R., and the plan for Afghanistan had been published a year before.

"There was another secret plan that became public - I'm not inventing this, it's taken from their own sources. I'm not inventing anything. All this appears on the Internet. It all appears on websites which discuss some serious matters regarding 9/11.

"When we began talking about this... We, in the Arab world, are always accused of interpreting matters on the basis of conspiracy theories. Conspiracies are always possible, but nobody really expected that the U.S., the American White House, a law-abiding country, the country, which is a model of freedom and democracy for the entire world, would release a series of lies, which have not ceased until now - from 9/11, through the Anthrax [attacks], and to the purported WMDs in Iraq."

Read on and you will discover that the nefarious Dick Cheney was involved in the plotting; and that "The world's first terrorist operation was an explosion that took place on September 16, 1920, in Wall Street, New York."

You simply have to read the entire interview to appreciate the detailed paranoia and projection involved.

Many people probably wonder where such ideas come from. This particular one is classified as "non-bizarre" simply because the delusion, while ridiculous, is not entirely impossible. If the good Egyptian General had included the intervention of aliens from somewhere in the vicinity of Betelgeuse in his conspiracy, it would cross-over to the bizarre and frankly psychotic realm.

There are a number of psychological and social theories that explain the development of delusional thinking of this sort.

Sigmund Freud theorized that delusions serve a defensive function and protect the patient from intrapsychically unacceptable [homosexual] impulses through the use of reaction formation, projection, and denial. It is now appreciated that there are many "unacceptable" impulses, thoughts and feelings -- all of which may be defended against using paranoia and delusion.

Delusions can also occur when there are cognitive defects in the deluded person. Flawed logic (which of course is not logic at all) can lead to the development of delusions. Individuals and groups all too often can accept very strange ideas with too little evidence to support their conclusions. This is often the case when people really really want to believe something is true because it will confirm other pre-existing beliefs or thoughts.

Delusions also can result from abnormal perceptual experiences from an incapacitated brain or nervous system. Normal environmental cues are misinterpreted because the brain is not functioning on all cylinders.

Finally, social situations can contribute significantly to the development of delusional disorder in many individuals and in entire groups; particularly if members of a group see other groups as threatening.

Groups or nations in this situation display considerable paranoia, distrust and suspicion. They are often socially isolated and information (factual information) deprived; jealousy and envy toward the feared others is frequently present among members of the group. And, by projecting their own group's defects onto others, they protect the group from low self-esteem and a sense of inferiority.

I think it would be reasonable to say that the Middle East--particularly the Islamic portions suffer from a delusional disorder that serves the purpose of interpreting the world in a way that will minimize the need for introspection, reality-testing or internal change.

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