Psychosis – The Brain’s Inner Conflict

Sensation is a function of the five senses: taste, smell, touch, vision and sound. Sensory organs convert stimulation into experiences that can be described as meaningful by means of neural receptors that send sensory information to the brain. Thus, the brain interprets sensory information as experience as meaningful. The human brain experiences the absorption of energy as meaningful in terms of the senses involving taste, smell, touch, sight and hearing.

Perception is different. It is the process by which the brain organizes and interprets sensory information, shaped by learning, expectation and attention. Perception also affects how we understand sensory information and give it meaning by using memory and emotion. Although sensation and perception work together to create meaningful human experience, they are separate processes, implicating separate functions.

Perception results in consciousness of the material world. Although sensory perception allows us to maintain information about the world gathered by the five senses, intellectual perception allows one to comprehend information. This differs from ordinary perception. Intellectual perception allows one to extrapolate from sensory experience and reason about it analytically and abstractly.

Thinking about sensory experience involves Piaget’s conceptualized abilities of assimilation and accommodation. Assimilation involves fitting objects or concepts into categories. For example, we might place an “apple” and an “orange” into the category of “fruit”. An example of accommodation involves the creation of a new category that cannot be assimilated into the category of “fruit” by creating a category for “vegetables” when one is first introduced to a vegetable, such as “cabbage”. The concepts of assimilation and accommodation are the basic tools by which knowledge is created and comprehended.

It is obvious that the processes of thought and knowledge about the world are much more complex than is signified by these examples. Sensory stimulation, sensory experience, sensory perception and categorization of concepts, intellectual perception, and meta-cognition or thinking about thinking are amalgamated except perhaps by philosophy’s attempts to disseminate such knowledge in a rational way. It is obvious in an intuitive way that thought processes rely on various ways of thinking, feeling and sensing.

A baby is born with sensory perception. She responds with emotion to pain and pleasure. Emotion represents a form of perception. Some of our emotions are virtually instinctive and innate. Other emotions depend on memory and learning that combine with sensory and intellectual perception to create the various ways we feel about and experience the world. In short, we construct our understanding of the world.

People, generally, do not create consistent worldviews, and it is blatantly clear that cognitive errors are rampant in the minds of virtually all individuals. Even speaking of consciousness, a state that all people know by experience, may baffle most people. Cognitive error can be comprehended as afflicting all individuals who do not have belief systems that are interconnected logically and consistently. It may not be possible to achieve a belief system that is logically consistent in terms of a worldview.

Cognitive dissonance — the mental stress experienced by someone who holds more than one contradictory, conflicting idea in their minds — stems from cognitive error that is skewed by emotion to create views that an individual, when made aware of this dissonance and corresponding error, attempts to modify by changing his views or reinterpreting his experience.

For example, the “just-world hypothesis” is a cognitive bias that is comprised of the view that an individual’s actions always result in ethically fair consequences, such that good deeds are rewarded and bad actions are punished. When information contrary to this assumption is revealed to an individual, the individual may change his views to make them compatible with his assumption of the just-world hypothesis, such that he may maintain that the individual who is punished for good deeds in fact deserved his punishment.

It should be noted that paranoid psychotic individuals have views that represent amalgamations of experience involving sensation, perception, emotion and thought or thought about thought. Psychotic individuals have the misfortune of enduring pseudo-sensory experience in the form of hallucinations. This experience is as visceral and real to them as is the experience of the five senses that most people endure. Hallucinated experience cannot simply be dismissed as “white noise” because it is said to be unreal — it persists in the mind of the schizophrenic, and, especially in terms of auditory hallucinations, it has immediate meaning in that the schizophrenic “hears” verbal material in what should be the safe sanctuary of her own mind.

Nevertheless, we distinguish between the mentally ill and the non-mentally ill with either/or mentalities, such that it is assumed that a person is either mentally ill or not so, when in fact all people make cognitive errors. While cognitive dissonance is experienced by all people who misinterpret sensory and perceptual experience, the mentally ill are punished for such misinterpretation. If there exists any reason to challenge the attributions of the mentally ill that are entailed by stigma, this should be the most salient one. The ideation of the psychotic mentally ill is comprehensible, and, if it is viewed as such, the stigma regarding mental illness may be diminished. In fact, a lack of stigmatization of the mentally ill might paradoxically allow them to release over-valued ideas.

It is the paranoia of the psychotic mentally ill person that creates a vigilance by which that individual responds to hallucinations and delusions, and vigilance creates a sensitivity to reinforcement of delusional material. Paranoia fuels psychotic ideation because it implicates an intolerance for ambiguity that corresponds with fear. Clearly, if the psychotic individual does feel safe or safer, she may express less of a need to speculate, perhaps endlessly, about the world-view that is unwillingly owned by her.

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Ann Reitan, PsyD

Ann Reitan, PsyD, is a clinical psychologist and well published essayist of fiction and creative nonfiction. She holds a Bachelor of Arts in Psychology from University of Washington, Master of Arts in Psychology from Pepperdine University, and Doctorate of Clinical Psychology from Alliant International University. Her post-doctoral research at Washington University in St. Louis, MO, involved personality theory, idiodynamics and creativity in literature. She recently published Illuminating Schizophrenia: Insights into the Uncommon Mind.
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