Want to understand the delusions? Listen to those who have them

For the first During his decades of Sohi Park career in the study of schizophrenia, he seldom stopped to think about the lives of his subjects. Now a professor of psychology at Vanderbilt University, Park introduced himself by studying the memory we are working on — a quick, scratch-like memory that helps us keep track of what we are doing. Using simple tasks to deconstruct the functioning of the schizophrenic brain, Pak hoped to address the root causes of the symptoms of the state of reality: delusions, false beliefs that can withstand conflicting evidence, and hallucinations, often in the following forms. imaginary sounds.

“We always do symptom interviews, and we ask questions about the symptoms – they’re very standardized and we have to do that,” he says. “We never talk about just life, or their philosophy of life, or their condition in general.”

Psychological research on schizophrenia usually looks like this: A person diagnosed with schizophrenia or another illness that causes similar psychosis is tested after the test. Typically, one of these is the PANSS or “Positive and Negative Syndrome Scale”. Conducting this test basically asks the researcher about the current experience of psychosis in their subject – and the subject PANSS. Persecution is the same as delusion (“Someone is trying to kill me”), which is similar to reference references (“Everyone is talking about me”).

Over the past few years, Park has taken a different approach: he asks open-ended questions to his research subjects. He heard about things outside the PANSS, such as extraterrestrial experiences; to imagine; and the state of the deep, all-day flow is conditioned by painting. His research now focuses on how people with schizophrenia feel about their bodies.

In psychiatry, Pak’s emphasis on personal experience is unusual. Academic psychologists have long preferred numerical and neurological techniques, such as symptom checklists and brain scans, to personal statements that are difficult to quantify. However, although they pose analytical challenges, these stories can still be studied. The articles in the most popular magazines last month are one Lancet Psychiatry and so on World psychiatry– analyzed first-person reports of delusions and psychosis. To some, such research, which deals with words and ideas rather than numbers and mathematical models, may seem unscientific. However, Pak, who did not participate in any of these studies, belongs to a small group of philosophers, psychologists, and neurologists who believe that first-person calculations help to better understand what psychosis is and how it works. “The urgency that biological and physical scientists want to accept,” he says, “is that we are left behind. Who is going through this? Who are the people who are going through this?”

This negligence begins at the time of diagnosis. In the Diagnostic and Statistical Manual (DSM), the so-called bibliography of psychiatric diagnosis is defined as indicator maps: To have a certain mental illness, you must have X of these Y signs for Z months. The original purpose of this system was to facilitate research by providing some objective basis for determining who did not have a mental illness. However, these checklists leave little room for the complexities of real life. “In my day-to-day meetings with patients, there was very little resonance between the experience I heard – the complexity, the nuances, the details and the context, the context of life that this person is describing. Rosa Ritunnano, PhD in Interdisciplinary Mental Health Research, University of Birmingham and co-author of the study. Lancet Psychiatry.

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