Chapter 4 Is delusional disorder a disease?

The mathematician got sick and called his family doctor.According to the instructions, he inserted the thermometer into an organ on the surface of the body and waited for ten minutes.Mathematically speaking, ten minutes is ten minutes. "What's wrong with you?" the doctor asked.The mathematician's answer was: "I have a fever!" "What's the temperature?" "Exactly 37 degrees 3." The patient answered accurately. "Do you need me to run here? Please, you don't have a fever!" But the mathematician immediately gave his own analysis: "Fever is a temperature higher than normal body temperature, right? Normal body temperature is 37 degrees, yes Right? Isn’t 37 degrees 3 higher than 37 degrees? That’s why I called you because I had a fever.” The doctor sighed and said, “Let me tell you, a fever above 38 degrees…” Mathematician He said dissatisfiedly: "If it is higher than 37 degrees, you have a fever..." A discussion that made people sweat began like this.

Which of these two gentlemen is right?You may support your doctor.But you and I usually love to argue as much as the mathematician.We are either healthy or sick, with a fever or without a fever.Our bodies or minds either function normally or they don't; There is gray.A temperature of 37 degrees 3 is not a sign of illness, so you are not sick.We are gradually moving from "no fever" to "fever". Even if this incident seems trivial, it illustrates a problem.We usually think in a non-hierarchical way, holding a black and white view of right and wrong.The gradual process, such as the gradual transition from a healthy state to a sick state, is a very common phenomenon, not only in behavior, but also in our spiritual world.

Seen through the lens of biology, the gradation from normal to abnormal is easy to explain.Our bodies and minds are not digital - not one or zero, on or off - but made up of many analog signals superimposed (allow me to use a computer term).Everything has a transition period, that is, an intermediate transformation period.A recent study of paranoia illustrates this point well.For a behavioral biologist, it's interesting to look at the condition through a Darwinian approach.Paranoia is often seen as an abnormal mental state that can only occur in people with mental problems.They are extremely afraid of being blamed or criticized by others.Is this really a mental illness?Can it be defined in such a black and white manner?I don't think so, because we have far more delusional behavior than we think.Delusions appear everywhere in the human brain.That recent study I just mentioned is a good example of how everyday delusions of "being blamed" are.Studies indicate that one in three people exhibit some form of delusional disorder in their daily lives.Ouch, that sounds scary, is a third of us mentally ill?Or are we erroneous about human beings' ability to behave rationally and argue?As if it were true, in everyday life, sanity is rarely present.If we keep looking at ourselves, it becomes clear that in many cases we are held back by emotions and sensations that are constantly at the lower levels of human consciousness.Analyzing the richness of human emotion, we can draw the following conclusion: delusions are not so strange at all.

The experiments in that study were interesting, and at the same time suggested a whole new approach in behavioral research.I can without apology present those experiments as examples, because they are so novel that many behavioral researchers will surely follow this approach in the future.Heed my prediction: Within a decade, we're sure to see countless behavioral studies based on this model.What kind of model is it?It's a virtual screen.Those who participated in the experiment will get a super-advanced headgear—actually a kind of glasses, through which a virtual world will appear in front of people's eyes.In that world, for example, participants move freely within a few subway cars.They'll meet people—virtual avatars, actually—doing the most normal things, quietly reading the newspaper, ignoring the people who participated in the experiment, while others will get in the way, and many others Condition.As a result, one-third of the experimental participants said that they were more likely to be watched by others than usual, and felt threatened... In other words, delusional phenomena appeared in these people.And this phenomenon happens in the daily life environment, although that environment is virtual.The people who participated in the experiment also had to do several psychological tests before, so as to detect their fear level and their perception of themselves in daily life.The analysis of the test results showed that the group of people who had delusional reactions in the subway had a sense of fear before or habitually underestimated themselves.

A good understanding of the biological basis of human emotion—e.g., how it is produced and forged by evolution—would have a purely theoretical basis for making predictions: the delusion of being blamed by others exists not only in some abnormal exceptions, but also in It exists among every normal person of us.The experiment verified this prediction through virtual avatars, which is indeed interesting.But what are the facts, and what should we know about feelings? First, fear is a basic emotion that arises in the amygdala of the brain.The amygdala works extremely fast, out of our awareness.

The amygdala responds with fear before we realize we're seeing something scary.That's why we easily feel fear of things that are usually not feared by rational thinking.Take the example of a water pipe in the grass.Humans rely on rational observation to classify this thing as a non-hazardous rubber product that can be used in the garden.But before this awareness arises, the amygdala may see it as a snake, resulting in a startle response.This is actually quite easy to explain: water pipes came later in human history.If our ancestors saw something that looked like a snake, they thought it was a snake.The advantage of the amygdala is that it responds quickly, and a small obstacle can be produced immediately in the brain nucleus, which is like oversensitivity, and this small obstacle may have a considerable impact on human fear, causing the fear that people sometimes have. Too much, sometimes too little.People who had a lot of delusions when they participated in the experiment before had a strong sense of fear, which means that their amygdala may be more sensitive than ordinary people.But this is not an exception.

Second, the amygdala does not function freely and is controlled by the modern human brain—especially the neocortex.This part of the brain is more rational and will occasionally brake to slow down.This control is beneficial.If the amygdala kept shouting murder, fire, the normal functioning of the human being would be thrown into disarray.But this supervision from the neocortex also sometimes goes off track or does not work well, such as braking too hard or too weakly.A small impediment in rational control may increase the probability of fear, which may also happen to those who participated in the experiment.Contrary to the amygdala, the neocortex can relativize the gaze or attitude of passengers in the subway, and dissolve the dangerous information contained in it.However, if the communication with the amygdala is not good, people may develop delusions.

The third point to mention is the hormone oxytocin.In original evolutionary terms, it started out as a fertility and breastfeeding hormone before it evolved into a social hormone that blunted humans' innate distrust of others.The increase in trust greatly motivates humans to seek out communication.However, the amount of hormones in the blood is not static, and will always be in a state of change due to the environment and blood circulation.Moreover, it varies from person to person, and not everyone produces the same amount of hormones.Some people have lower-than-average levels of oxytocin, have a relatively low sense of trust in others, and are quicker to detect certain hostility in other people's eyes or behavior.These people are more prone to delusions.

In short, the amygdala can be weak or strong, rational control can be more or less, and so can oxytocin in the blood.If these factors are "weakened" at the same time, the normal fluctuations in the human body make human delusional behavior possible.That prediction was tested in an experimental study using virtual subway cars and passengers.In between black and white, it seems, there are plenty of everyday grays. The doctor left the mathematician's lodgings, and that dispute was still unresolved. "37 degrees 3 is higher than 37 degrees!" The doctor got into the car angrily, still muttering: "But Mr. Mathematician, biology is very complicated, you can't just apply a few formulas!" But he still gave The patient was prescribed medicine, which is considered a placebo.As long as the thermometer drops by a few tenths of a degree, the drug is mathematically working, and everyone is happy.