Tag: mental health

"Nobody is safe from psychosis"

Have you ever believed that you are already dead or the star of a Reality-TV series? Psychiatrist Joel Gold has seen his fair share of delusions and believes that our culture has more impact on it, than we might think. A conversation about Donald Trump copycats and our vulnerability to insanity.
In your book Suspicious Minds, you describe how culture shapes madness. How does it?
Throughout the history of mankind, our culture has influenced the content of our delusions. There are many forms of delusions such as paranoid or religious delusions. The forms stay largely the same but the content of the delusions changes over time. In post-revolutionary France, many people that suffered from the grandiose delusions that they were Napoleon. Today a person with a grandiose delusion might believe he is a TV celebrity. Thirty years ago, some paranoid people might have believed that they were being targeted by the CIA or KGB, today it might be ISIS or the NSA.

Photo by Elizabeth Graham
Dr. Joel Gold is the author of a new book, “Suspicious Minds, How Culture Shapes Madness.” He’s giving a talk about the book at Greenlight Bookstore on the 24th.

Madness is always updated?
Yes, but the more controversial question is: can the environment actually induce madness when it would not have otherwise manifested itself in a different environment? Are there circumstances or environments that are likely to cause psychosis? These are fundamental questions.
Distressing situations are obviously fostering mental illness but can they induce it then?
There is actually evidence that shows that the opposite can be true, that in very stressful or painful situations like war, some people with mental illnesses actually do better. They pull themselves together. There are a lot of theories about this but I think that if somebody’s external and internal world match, things make more sense to them. In situations like these, your suspicion or your fears are legitimate, not irrational. But of course in many people war can induce anxiety or depression. In our book, my brother and I argue that environments like the surveillance state and our culture in which seemingly anybody can become a star without any special talents, might be prone to induce delusions. I think the Truman Show delusion could be such a manifestation.
You coined the term the Truman Show delusion which is the belief that one is the star in a reality-TV series and that the world surrounding you is completely fake – just like in the famous movie The Truman Show.
It might be an old delusion in a new guise but the content is new. That specific belief did not exist 200 years ago. But I don’t think that the movie caused the delusion. Some people with this delusion had it before they had ever seen the movie – if they had seen it at all. But many people who have this experience feel it confirmed when they see the movie. It perfectly encapsulates their feelings. The movie is a scaffolding around which the delusion is built.

“Delusions are social in nature”

Delusional people often share the same stories or beliefs. What is it about a certain narrative that makes it so credible for delusional people?
My brother and I believe that delusions are social in nature; our minds are wired to negotiate the social world. There is a part of our brain that we have labelled for descriptive purposes the suspicion system. The suspicion system is meant to monitor the environment for social threats. When the suspicious system is disconnected from the reflective system of our brain, the part that analyses a situation and counterbalances the suspicion system, then delusions can form. Another factor is social interaction. We are not suspicious of furniture but of other people and today there is a huge variety of ways in which we are connected to others. At the core of most delusions is the belief in the malignity of other people. Police, co-workers and family can be the perfect cast for such scenarios. That’s why certain themes recur in delusions.
Is the form of delusion a decisive factor in choosing the adequate narrative?
I think so but as I pointed out, most of them are linked to our social surroundings. That is the common denominator. Take the Napoleon delusion: It is not necessarily a paranoid delusion but more a delusion of grandeur. But it is also social in a way: if you think you are superior, you are less likely to be in danger. You put yourself in a position of power to escape social threats. Today we are surrounded by some people who are famous for no particular reason. That can give the impression that power and fame are easy to acquire.

I hope there won’t be too many cases of Donald Trump copycats.

It would not be surprising if more people with grandiose delusions report that they are Donald Trump. In fact, a colleague of mine told me that he has had some patients of late that believed just that or that he is spying on them. He is the most famous person in the world right now and he is ubiquitous.

“Madness is an experience we are all capable of having”

Delusions are a different perception of reality. Usually that reality is an isolated and unique perception but if a delusional reality spreads and enough people believe it, it can quickly become an alternative reality all together.
That is a valid point. We have criteria to diagnose certain mental illnesses. The problem however is that if a large enough number of people believe something, it is not necessarily recognized as a delusion. Conspiracy theories are good examples. Some of these theories are completely fact-free but we don’t categorize them as delusions but as conspiracy theories because many people hold the same beliefs. The line between the two is very thin.
Myths are another thing that could qualify as delusions but are considered important narratives for our existence.
It’s often said that if you can prove something, it is not a delusional idea. But you can “prove” a lot to back your claims. People can be led to believe a lot, so myths and conspiracy theories are extremely hard to debunk.
Myths not only influence the delusional mind. There are also a lot of myths when it comes to how to cure madness. People used to believe that the “stone of madness” caused insanity or that “black bile” – a humor of medieval physiology believed to be secreted by the kidneys or spleen – caused melancholy and depression.
This is not just true for mental illnesses. There were a lot of medical myths at the time because people didn’t know about viruses or bacteria and so came up with other explanations. Instead doctors used things like leeches to cure patients. Today that would be considered malpractice. When knowledge is absent, people come up with ideas that might seem strange later on. But if many people believed it, it was considered science. Consider the example of vaccinations: A British researcher published an article in the renowned medical journal The Lancet that stated that vaccines could cause or at least increase the risk of autism. People still hold on to that idea well after it has been debunked. Now there is a highly charged controversy surrounding vaccines and his theory is still gaining traction.
Society has a very strange view on mental illnesses, it seems to me. On the one hand, people don’t want to interact with mentally ill people but on the other hand, we cherish the myth of the manic genius or the tormented writer. It could be concluded that we only accept mental illness if it enables you to produce something good from it, if it propels you to another level of creativity.
That’s true. Madness is something we are very afraid of because it is an experience that we are all capable of having. Nobody is safe from psychosis. On some level, possibly unconsciously, we realize that. The right conditions can drive almost every sane brain into madness. If we see a person with mental illness on the street, we find it uncomfortable because we know on some level that it could happen to us. On the other hand, we almost envy some people with mental illness because we believe that their illness has enabled them to do something we are not capable of. Think about somebody like the brilliant mathematician John Nash who suffered from schizophrenia. We tend to think that because of his alternative view of reality, this geniuses realized things that are beyond our imagination. And sometimes that is true, but there is a price you have to pay for that. People with bipolar disorder can show great creativity and productivity during their manic phases but that is by no means guaranteed. In most cases, you pay the price without getting the benefit.
Over the years, you have seen and heard about so many delusions. Is there one in particular that still fascinates you?
Two actually: The Truman Show delusion of course because it was such an important influence on my work. But I also find the Cotard delusion fascinating. It is the nihilistic belief that one is dead but still walking the earth. It is amazing to me because it is such a wild contradiction. Somebody is telling you that he is dead. “But Sir, you are talking to me. How can you be dead?” The belief sticks regardless. New delusional contents might be added to the list but the old forms remain. Still, the list grows.

"We accept a reality that is slowly killing us"

Moby’s newest album proclaims that “These Systems Are Failing”. We spoke with the musician about why it’s worth putting up a fight.

You have named your latest album „These systems are failing”. It sounds very dystopian but actually the lyrics make it seem as if you are almost relieved that everything is crumbling. Is that true?
It’s tricky because the systems that we have created are working, but they are not contributing to our long-term benefit and well-being. It’s not obvious to everybody but once you realize how the systems – economic, political or social – are failing, it’s an ostensibly depressing thought. But our man-made, broken systems need to fail in order for something new to rise. So yes, there is optimism in the current catastrophe. It’s similar to going to the doctor maybe…
In what way?
Say you eat a lot of junk food and your health deteriorates and you have to see a doctor: he will tell you to change your diet to avoid chronic or deadly diseases. It’s a wake-up call and we often need one of those to see what’s going on around us.

”We are sponsoring our own demise.”

There is almost something like a myth of “the broken system” that everybody is well aware of but only few know what it translates to in reality or how to do something about it. You pointed out that as a musician, you can not fix the problems but only hint at them. Does that not evoke a feeling of helplessness?
Not really, because I can do something about it. We all can. There are so many ways to look at a problem. You can look at it from an anthropological or political aspect and it changes accordingly. There are three very easy things we can do to avoid humanity heading for calamity: stop subsidizing industries that destroy us. Animal agriculture, the tobacco industry, the arms industry – they all receive trillions of tax dollars. We are sponsoring our own demise. The other two things we should do is stop using oil and stop eating animals. If we would do these two things, climate change would be reduced by 75% and human health would skyrocket. People think that systems exist in a way that they can not be changed. Have you looked at old globes?
There is one in my living room, I am looking at it as we speak.
I collect old globes and one of the things I like about them is that they represent geopolitical shifts. A globe from 1920 will show a very different order. The status quo is in a way only temporary. It only takes democratic will to change it. I know this might all sound very naïve, but I prefer naïve optimism to depressed resignation. Throughout history people have made really good changes, it’s just hard if we believe the myth that everything is fine.

”We have become confused about what our needs actually are”

Because a reality has been created that distracts us from seeing an alternative, less shiny reality?
Absolutely. Do you know the boiling frog theory?
I hope it’s just a theory and not something somebody tried but the idea is that if you take a frog and throw it in a pot of boiling water, it will do everything to escape the boiling water. But if you put the same frog in a pot of water at room temperature and slowly raise the temperature, the frog will not try to escape and eventually die. We become so accustomed to the false beliefs and myths that everything is fine that we accept a reality that is slowly killing us. The underpinning issue here is the human condition. Every political or economic system exists to meet our supposed needs. But we have become extremely confused as to what our needs actually are. We have alienated us from ourselves.
There is a difference between power and cultural hegemony. If you exert power over somebody, that person will notice. Cultural hegemony however means that a ruling elite can establish their rules as cultural norms and thereby conceal their exercise of power or oppression. It sounds like that is what these systems you refer to are about.
Yes, no doubt. But that tactic means that there is also the possibility to use it for a good cause. Think about racism in the US: Here, like in so many other countries, racism was and still is a huge problem. But the ruling class can introduce legislation that can then shape social norms and beliefs. You can provoke a lot of change in society with some comparatively minor decisions in politics. The thing is that we want the system to change and we want people’s hearts and minds to change. Very often, the latter is the more difficult one but there is a connection between the two. Changing legislation on marriage equality in the US lead many people to reconsider their views. In a perfect world, we could just lean back and wait for people to realize that they are digging their own graves but we are in a dire situation that needs concrete action now. (pauses) I guess this is a bit different than most new album music interviews.

”Music needs substance, not just sounds”

Usually the Anthropocene does not come up that much, no. So on the more musical side…
Oh no, I’m perfectly happy not talking about music. I mean one of the reasons why I gave the record this name is because I really wanted an opportunity to talk about this stuff because it is so important to me. It begs the question: If you are a 50-year old musician and you make your 15th record and you don’t plan to go on tour: why make an album?
I’m listening.
There is the selfish aspect which is that I love recording new material. But there is also the activist aspect. A new album is an opportunity for me to give interviews and write articles.
Why not just write a book on these issues? Why record an album?
At the core of everything is the individual and we are an emotional species. As an activist, I want to reach people emotionally and I think music and visuals are far more effective in that respect than plain text. A few years ago, I put out a very dry academic book called “Gristle” that analyses the consequences of animal agriculture and it sold around 5.000 copies. There is place for academia and textual analysis but that place is not the mainstream. I believe music needs substance and not just sounds.

”Producing hit-singles just seems dull to me”

You recently said that a lot of your fellow middle-aged musicians are making too many compromises to be commercially successful but that you don’t see the point in that.
Again, I wish we would live in a universe where we have the luxury of being selfish. If we had a life expectancy of 500 years and infinite natural resources and everything would be fine, we would be in a position to make art that has no deeper meaning. But everything is not fine. I don’t mean to say that we only need strident didactic art and culture but at the very least it seems almost unethical to me to be like Nero as Rome is burning and we are all just fiddling. To me, the only thing giving my life meaning is trying to figure out this world and make this huge place a little bit better. Nothing excites me more than that. Producing hit-singles and making millions of money just seems very dull to me. You end up feeling like a self-involved pop star that has lost touch with reality – I’ve been there.
That is the big myth of show business: that fame and money will lead to happiness. You recently told the story of how during the height of your success in the early 2000s, you were staying in the most luxurious suite in Barcelona next to the likes of Madonna and all you could think about was killing yourself because you felt miserable. The next day you won an MTV EMA and it was back to business.
It was horrible. This again ties in with what I said earlier: at the core of everything is always the individual. But we individuals often overlook the facts. We don’t look at things based on evidence. We keep doing things without an empirical understanding of what we are doing. I thought to myself: I am a successful musician now, I draw huge crowds and make a lot of money – I should be happy. But I never looked at the evidence that all of this could not make me happy. I desperately tried to avoid looking at the truth. We all do.

”It’s better to fight and fail miserably than not doing anything at all”

The systems are failing because we are failing?
I don’t want to be too hard on us. We have a hereditary component, we evolved in very adverse situations. Think back to who we were thousands of years ago: we were just trying to survive, not starving or getting eaten by a predator. Therefore we still think that if we have enough calories and a place to sleep, everything is ok. Our brain just wants that. We are not conditioned to want a better system as long as the current one works for us. But we need to change our mindset. We still respond to the world like we’re crocodiles. It’s a bit like Don Quichote, I go out fighting in a way that might be completely pointless but I feel it’s better to fight and fail miserably than not doing anything at all.
Moby & The Void Pacific Choir – These Systems are Failing is out on Mute Records.