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I saw Dr O today and we talked about paranoia, which, she said, through no fault of my own but because of paranoid schizophrenia, colors my outlook on life, my approach to the world. She says I am prone to "see" and "hear" conspiracies and secret messages where none exist simply because my brain is disposed that way. Naturally I am certain I'm right about what I feel is going on, because that is human nature: to assume our perceptions correctly interpret the world. But, she said, in my case, I have to be more circumspect and not automatically assume that everything I perceive tells me the truth. So she made up a card for me to carry in my wallet with three steps on it for me to read whenever I feel that someone hates me or has it in for me or that They are "doing something to me" or "conspiring against" me. Step number one says: Notice when afraid or upset that someone else feels negatively towards you. It will feel certain. Step number two: Allow for the possibility that you might be wrong. Step number three: Check it out! Checking it out is not necessarily easy, even though it is a three word step. It means asking someone if it is going on, if they are thinking this way or doing this thing etc which cannot always be done comfortably or appropriately. So sometimes you have to ask someone else, like Joe or Dr O or Lynnie etc what they think is going on, or is happening...Or discreetly ask someone on the periphery, I dunno. Somehow you have to find out the truth, the facts, whether or not what you fear is actually happening.
Now these three steps, essentially a way to reality test for paranoia, seem simple, even simple-minded, but for me they are very difficult, most especially the first. How do I know when to notice? How do I even think to challenge my immediate "KNOWLEDGE" -- which is how it feels, not a suspicion that people are out to get me but full-blown certainty. Aha, there it is, that word, "certainty". She said, "It will feel certain...that someone feels negatively towards you..." So I could take that feeling of certainty as a benchmark for when to use the three steps. Whenever I feel convinced that people hate me or are doing things to me etc, whenever that feeling of absolute certainty that something negative is happening hits me, that is when I must NOTICE it, triggering the three steps of the reality test. I wonder if that would work. I know that Lynnie told me to assume absolutely without question that whenever I thought someone was SECRETLY doing something, communicating something to me secretly etc that it was paranoid. This helped me to question certain delusions, when I managed to catch myself speak or think the word "secretly." When I didn't actually use the word "secretly" it was harder, as I was literal enough to have the "delusion buster" triggered only by one word at first. But later, it became clearer to me that anything communicated sub rosa, so to speak, anything I thought was communicated in a manner that was not clear and aboveboard for the most part ie not verbally or written down, should trigger her paranoia reality test.
Now it doesn't work if I don't notice the "secretly" does it? And much of what I said about the cabal of DOs yesterday fits under that rubric (though I maintain that Dr F's RN really did do something to get Dr F to hate me...There was something weird going on there...). But I didn't notice it, so certain was I that Dr C hated me and was against me, along with his RN. So CERTAINTY and SECRECY are two words/concepts that have to start triggering reality testing or I'm going to continue to run into situations that I build up into huge paranoid constructions, rather than situations that I appraoch with paranoia but quickly defuse. And how will I defuse them? By: Noticing my fear and certainty that They are against me; allowing for the possibility that I might be wrong; and Checking it out (by asking them or getting help from Joe or Dr O or someone else in finding out if it is true). In point of fact, though, I've found that with any reality test, merely noticing and challenging the thinking, the delusion, asking yourself if you might be wrong, can be enough to get you to think a different way, to stop pushing the panic button and accept that you're merely paranoid. Actually checking it out ends up being less necessary than Dr O thinks, because once you suspect you are paranoid, well, that answers a lot of questions and allows for a lot more clear thinking.
So, how'm I doing? I still feel afraid that Dr C and the DOs are in something against me and I still feel upset by the smile that I read as a smirk when he talked about meds taking away my appetite (I didn't write about this yesterday but it was one of the things that bothered me) but I can at least tell myself I'm probably wrong about it, that it is a paranoid way of thinking, that there is in fact NO REASON for a cabal of DOs to be thinking or talking about me, just as one of you said, they have more important-to-them things on their minds! And sometimes a smile is just a smile...How can I tell it was a smirk? Do I know the guy? I've seen him twice, for god's sake! Can I read his mind? I barely look at people! And now I'm looking at him so closely I say I can tell a smirk from a smile on someone I don't even know??? C'mon! (I feel certain that I can, but I could be wrong...) So I've got to assume that it's mostly paranoia, despite the feelings that make me afraid and upset (still) and on that basis have to talk to myself more about how other people worry about their own lives much more than mine, they have their own paranoias and fears and upsets, and don't spend their time trying to torment me...WHY would they? Who am I that they would care that much to spend hours tormenting me? AM I that important? If not, why would they bother? All good questions, and I can't answer them, except mostly to say either I dunno or No. Which means, Okay, I guess it is paranoia. So now I have to act as if it is, and ignore how I feel, hard as that is, hard as that is.Posted by pamwagg at November 21, 2006 07:12 PM