Delusional

Or, Are They Crazy?, part 2

I recently had a long and unpleasant discussion with a “constitutionalist” who had a collection of unshakable-by-facts beliefs. And I realized; this is what they used to call paranoia. So I went off to DSM-5, the handbook of names and descriptions of mental illness, to find out more. I found it in a chapter titled “Schizophrenia Spectrum and Other Psychotic Disorders,” where it is called “delusional disorder, persecutory type.” If the delusions are exceptionally strange, for instance involving demonic possession or Jewish space lasers, it is called “delusional disorder, persecutory type, with bizarre content.”

Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Their content may include a variety of themes (e.g., persecutory, referential, somatic, religious, grandiose). Persecutory delusions (i.e., belief that one is going to be harmed, harassed, and so forth by an individual, organization, or other group) are most common. Referential delusions (i.e., belief that certain gestures, comments, environmental cues, and so forth are directed at oneself) are also common. (DSM-5, p. 87, extended discussion, pp. 90–93)

People with delusional disorder appear normal when they’re not actually wrapped up in their delusions:

A common characteristic of individuals with delusional disorder is the apparent normality of their behavior and appearance when their delusional ideas are not being discussed or acted on. (pp. 93)

They often do fine when their delusions don’t affect their lives:

The functional impairment is usually more circumscribed than that seen with other psychotic disorders, although in some cases, the impairment may be substantial and include poor occupational functioning and social isolation. When poor psychosocial functioning is present, delusional beliefs themselves often play a significant role. (p. 93)

People with delusions of persecution are the sergeants of fascist paramilitaries, from the Nazis who believed, unshakably, that Jews were persecuting them, to the Jim Crow white supremacists who believed that subjugated Blacks, natives, and other people of color were persecuting them, to the modern homophobes and transphobes who believe, again, that gays and trans people are persecuting them. Combine delusional psychosis with a lack of empathy, and you get violent terrorism.

Not every participant in a fascist paramilitary, not every white supremacist, antisemite, homophobe, or transphobe is delusional. The very conviction of delusion, the diagnostic sign that this is delusion rather than simple belief, is persuasive, especially in conjunction with the apparent normality of a deluded psychotic. Delusional psychotics are not only problems in themselves, which is bad enough, they persuade others to adopt their delusional beliefs. Which, of course, is why they are so useful to the leaders of fascist movements as the movement is establishing itself. Their delusions become problematic once the movement has taken power, making them disloyal to the leadership. Hence the Nazis rejected the Sturmabteilung (SA, Brownshirts), assassinating their leaders, in favor of the personally loyal and reliable Schutzstaffel (SS.)

There is, I think, a broader article, or even a book, to be written about the internal structures of authoritarian movements, and the various personalities that make the different levels of the movements. Such an analysis might be useful in opposing authoritarianism. For now, I think I can say that there is little one can do to sway the delusional, but at least their followers can be peeled away. In the now-famous Broockman and Kalla study where regular Fox News viewers were paid to watch CNN for a month, views changed, though fundamental beliefs did not, and the Fox viewers reverted to watching Fox when the study ended. Give these people a chance at truth, shut down the firehose of propaganda with a fairness doctrine, get them away from their delusional leaders, and give them something to hold on to, and I think they can be swayed.

Part of what is going wrong now in the USA is that we do not have visible leaders and solid alternatives to offer to the fascist Republican Party. For this I see at least two reasons: first, as I wrote three years ago, “Democrats of vision, courage, and ability are discouraged and, often, forced out. The result has been Congressional Democratic Caucuses filled with people who are at best very cautious and at worst weak and cowardly.” Second, as I have written numerous times, the Democratic Party is trying to serve both Mammon and the people, which is a fool’s errand. The Democrats do offer social insurance programs – but they are so miserly! Think of student loan forgiveness, then compare it with Donald Trump’s checks. Who could be persuaded by that grudging, limited support?

But, in any event, remember that the next time you run into a right (or left) winger who seems crazy, it may be that they really are crazy.