Of Gods, Farishtas and my brief study of Psychiatry !!

delusion (1)As any other child growing up in the late seventies and eighties I had a lot of ‘free time’ to ponder about questions like who made the universe, how big is it, what lies beyond  and so on. Incidentally, God was also a past time topic of thoughts. Our interaction with God was limited to just a few yearly havans, small fascinating stories and the pujas preceding festivals. The stories were eagerly awaited though the excitement of the festivals left little time to delve into the actual deeper meaning of the pujas. However I do remember having a small family discussion whether Ram and Lakshman were humans or Gods ? What we finally agreed upon was they were humans who by their good deeds achieved Godliness ! So is it possible for everyone to become God ? “Its difficult, but it’s certainly possible.” So that was settled, a destination set – only the course had to be found and tread upon.

Somewhere on the way, in school or with friends, I came across the concepts of ‘son of god ‘ and of the chosen one getting direct messages from God himself. Initially it seemed nothing’s at odd – everyone is a son (or daugther) of God obviously, and God or our conscious does speak to us often enough to convey what’s apparently right or wrong ! So no problem! But then I discovered people are pretty serious about this special ability possessed by some, in the past, of a private tet-e-tete with God himself. It even seemed they could summon His highness at a time and place of their choosing and get him to give sermons on topics of their asking !! (sounds more like ‘Google’ today).

But at that time a more obvious question came to my mind – why not me ? I mean, why am  I not a ‘Son of God’ ?  And why can’t I talk to him or rather why doesn’t He talk to me ? I tried what I could, remaining in my senses, I tried sitting silently under a tree, skipping meals, keeping awake all night but nothing …absolutely nothing, no voice from the ‘Guy above’ ! Now, come-on, what could be different ? How can God be partial ? Why can’t He directly convey the message to me, I mean, if it has to be conveyed ? That’s not fair !

Well, with time other interesting things came to the fore like adolescence, cable tv and board exams  and these questions were lost somewhere in the background. These beliefs and superhuman godly men stayed somewhere in the back alleys of my mind till I again stumbled on them during my psychiatry postings in medical school.

Psychiatry was always regarded as fun posting during the undergraduate medical training. The professors were all very cool, there were no assignments and apparently the subject was also interesting. In fact I really liked the subject. Just knowing the basic characteristics of a personality gave me a whole new understanding of the people around me, not just the patients. I was able to assign reasons to acts and responses of people knowing their personalities and similarly observing their actions led me to a better estimation and understanding of their personalities.

The psychiatric ward which forms an integral part of many horror/psychic movies was although a depressing , best avoided type of place. It was under masonry repairs for most part of my posting but even then the picture of untidy beds with ‘physically’ confined psychiatric patients was enough to discourage many. Although many of the admitted patients were mostly heavily sedated, one could not help but be fixated to those who were the most disconnected from our ‘normalized’ reality. I  empathized with their suffering brought upon them by their altered senses.

This was one place where the term “chemical locha” aptly fits. In an anatomically and physiologically perfect individual some neurons in the brain start firing erroneously and change the entire ‘perceived reality’ for the individual and make it almost impossible to cope with the real world. Although the patients range from near normal to ones requiring heavy medications – two symptoms really intrigued me because of the subtle alterations in perceptions they characterize – delusions and hallucinations.

Delusion is defined as a ‘mistaken belief ‘ held with a ‘strong conviction ‘ even when presented with a contrary, superior rational evidence. For example, a person with a ‘belief’ that the earth is flat’ is likely to change it when a rational superior evidence is presented to him but a person with a delusion does not change his belief but may suggest mechanisms to prevent people falling of the edge. Delusions have ‘themes’, the usual ones being that of persecution, or grandeur or guilt(sin) and so on. So, a person with delusion of persecution would have an inconsolable belief that people around are intent on harming him or some harm is surely going to happen to him. Similarly, a person with delusion of grandeur would have a grossly exaggerated self belief about his power,worth,knowledge or even some special relationship to the divine or a famous person. While the delusion of sin or guilt is a belief that some horrible crime deserving severe punishment has been committed  or he may hold himself responsible for some unconnected tragedy or disaster. The themes may be quite varied and overlapping, often with religious overtures. No surprise then that there is actually something known as a God Complex and a Messiah Complex !

The exact causes of delusions still alludes us but besides the genetic predisposition, distortions in ‘understanding life’ and ‘coping with it’ also play their part.

The other symptom which I found really stirring was hallucinations. Hallucinations occurs when one perceives a sensation when none actually exists ! For example a person may hear a voice when there is none. The hallucinations may be auditory, visual, of smell, taste or touch !! Scary ??  Commonest are auditory hallucinations – which usually involve hearing one or more talking voices. The voices may talk about the patients own thoughts or actions or may be arguing about something. The voices get pretty nasty and its not the same as getting a song stuck in one’s head.

Both these symptoms -delusions and hallucinations can occur in a wide variety of psychiatric disorders, varying from schizophrenia to individuals with normal sensorium. Now while some individuals may be aware of the abnormal or unrealistic nature of these symptoms, some are unable to differentiate these aberrations of perceptions from the actual reality. The symptoms may arise even after head injury, traumatic experiences, social isolation, cognitive impairment, personality disorders, substance abuse and strikingly even have cultural influences !! Cultural influences include parents, teachers,peers, friends, religion, books, education, internet and now social media too. Thus the theme of the delusions are influenced by the prevailing conditions to which one is exposed, or to the normal ‘beliefs’ around him. It is thus no surprise that people in west are more likely to experience a delusion of guilt/sin, whereas those in middle-east are more likely to experience persecutory delusions ( in  line with the predominant religious narrative). Well, the question arises whether such people would have been delusional without the existing religious beliefs, can’t say for sure, probably yes but the repetitive reinforcement  certainly provides a template. As we all know that many religious beliefs have the same components of incorrigibility and impossibility yet are not considered ‘delusional’. This paradox is perhaps best addressed by this quip-

“Belief in one’s own hallucinations is delusion ,

belief in someone else’s delusions is Religion !!”

Looking back, my brief study of  psychiatry did reveal to me the subtle variations of the  ‘ways of the mind’, the perceived ‘normal’ reality and the deceptive nature of our sensations. It pointed out the importance we all should place on an experience rather than a belief. It taught me that the only difference between a belief and delusional state is the ability to change, when confronted  with better reasoning and understanding, and therefore to be unafraid to challenge existing theories.

It also provided me an opportunity to ponder over the several questions which had lingered on the back of mind since childhood. In the end, I really really thanked ‘God’ that I was not the chosen one to receive direct messages from up above and that I had no overwhelming desire to proclaim myself the special ‘Son of God’ ! One realizes how precariously the equilibrium is maintained and how little needs to go awry to disturb the balance.

—Saurabh Agrawal