Epiphany

Sunday, September 18, 2005

I had an epiphany late this afternoon…. which actually made me feel really dumb… :-O

The thing is… I never really woke up today even though I was supposed to be at work before 9:00.

I did manage to finish reviewing some proposals that have been submitted to a prestige conference in education. However, I was so not awake that, in order for me to finish reading these papers, I had to use the text to speech function of Dragon to let the computer read the proposals to me, rather than having to use my own eyes to read the text.

It is interesting that it seems to be so much easier to listen with my ears than to read with my eyes. This leads me to suspect that my extensive experiences with auditory hallucinations might have contributed to my bettered listening comprehension skills, rather than that of listening. lol

After I finally got back home, I had to take a nap before going out to see a play with my friend.

The idea of taking a nap had started forming while I was walking down Broadway on my way home.

I, all of a sudden, had this extremely dumb epiphany that it has to be the increase dosage of Seroquel that contributes to my tiredness and the need to take naps in order to keep me awake.

I felt so very dumb down by this epiphany because this should have been a common sense, rather than an epiphany.

While parts of me feel that it wouldn’t be bad for me to go into the hospital since everything would be taken cared of, another part of me do enjoy the freedom of living at large and not having to be kept on the gated 8th floor and be deprived of computing equipments.

I, then, tried to figure out whether there are things they do for me in the hospital that could not be done outside of the hospital.

The blog is equivalent to the journal we are encouraged to keep. The proposals I evaluated is equivalent to the discussion session about the daily news. My encounter with the new computer-related toys is equivalent to my beloved vocational therapy sessions. Furthermore, preparing donuts and coffee for students at my new job is equivalent to me volunteering to prepare the night time snack (i.e., sandwich) for my fellows in the coocoo’s nest.

The only difference is… I have the freedom of hopping on the train or subway. I also have the leisure of going to see a Friday night play rather than playing bingo, watching a video, and enjoying the Friday night party behind a locked door (This is the part that I have problem with).

I was not gonna drink alcoholic beverage since, in theory, one is not supposed to drink alcohol when taking medication.

However, after the play, I went with my friend to a bar for a quick drink.

I ordered Malibu with some kinds of juice.

It is not about the drink. It is about me having the ability to order a drink and drink it.

I have no intention is consuming more alcohol in the near future. However, I reserve my right to take a drink

What worse could it be?

I already have hallucinations and delusions. I am also already loaded with the highest dosage I could take.

Since the increase of the dosage, the hallucinations have been granted me with more breaks from them.

However, it would take a bit more time when I am so very drugged out by the controlled substance that I shall be too cognitively incapable to even dream about hallucinations and delusions.

Laugh all you could laugh and joke all you could joke. At least that would prove my mental condition to serve a purpose... lol

With or without a highly capable brain, I will still stand on my two feet and move on without hesitations.

Some days I might be not as quick and other days I might not be as competent to multitask. However, I will be functional either days (So am I trying to brainwash myself? Maybe. Yet, as long as it works and I shall see).

By the way, after my last posting, I turned around, not able to fall asleep.

All of a sudden, I had an insight. The posting was motivated by anger.. The anger that is associated with my inability to control the occurrences of the symptoms.

The anger is not even anything worse addressing. It is like the question, “who are they?” Non-sensical.

Dosage up, but, I promise you that I will not fall

Upping the dosage.... again...…

Thursdays are the day for me to get my check out on my mental health condition.

Used to be, I only have to walk a few blocks to get to the 8th floor of the student activity building where my beloved psychiatrist and therapist are located. Since I took on another part time job this past week, the trip has turned much longer since I actually have to take a bus to get to my dear professionals and to get back to work.

During the meeting with my psychiatrist, we came to the agreement that I have to up my dosage again. Essentially, I have started to acquire this telepathic capability (which could be translated into hallucinations). It also doesn't really help when I am sort driven up the wall by the anxiety induced by the auditory hallucinations that makes me feel like haunted by the spirits of speech.

Following are some of the delusions I observed today:

1. They are taking this laptop away (:-O) 
2. They are upset by my comments about the importance of validity in measurement and evaluation 
3. The guy who cheated me by selling me the 5 dollar cigarettes (instead of the 3-4 dollar market price) got busted by the police 
4. They are not going to give me an interview 

How do I perceive the whole situation?

The first thing I said to my therapist as I entered her office tells it all:…

"I have been busy commuting between the 8th floor here and the 8th floor at work.. as long as I don't go to the 8th floor there (the hospital) since I sort of enjoying being out there."

At the same time, do not ask who "they" are because that is a question quite non-sensical.

So, I went on about my business waiting for the night to fall.

The condition might fluctuate and the dosage might have to be adjusted. I will have to face the annoyance caused by the symptoms.

However, I will not fall for I have now determined that the only thing that could take me down is life itself.

All else in life is but delusions and hallucinations. Contents associated with these symptoms do not worth my attention for I have promised myself to live my life to the fullest any given today because, even though tomorrow is another day, nobody knows what will happen tomorrow.
Yes, Ratprincess reiterate... the ephemeral nature of life does not grant us unlimited resources and time to spare (at least, not everyone is lucky like Marcel Proust so that his procrastinating nature also procrastinate the arrival of death).

This might be a statement too strong to make... Yet, the terminal divide is, guess what, life and death.

Changes

Having changes in the dosage is never easy.

Last night, yours truly, Missy Fatty, decided to reduce the dosage of Seroquel by 1/4 because I have been feeling like a walking zombie for the past week or so. I have also started to get hit by cognitive constipations. Amotivation, flat affect and the sense of disassociation are some other added values.

It is a good excuse to say that one should always prioritize one’s health above all other pursuits. However, there comes to a time when cost-benefit analysis needs to be reconducted and alternative measures have to be taken.

I know this is about the time when I have to recalibrate myself and refocus on my long term goals. However, please don’t ask me how I know it. It is because the delusionals just have a way of knowing. (lol )

I woke up this morning with a headache.

It could be due to the fact that I had to wake up earlier than I normally would since I had to take my daddy to the airport. It could also be the cold that I caught or the weather is too hot. It could also have been contributed by the reduced level of Seroquel in me.

When I was sitting outside of the gym, being annoyed by my headache, I all of a sudden discovered that I could think, I could feel, and, I am back living in this world.

I could feel happy and really feel that sense of happiness again!

However, little did I know that the headache was the precursor of the roller-coaster kind of emotional ups and downs that I was bound to experience for the remaining part of the day.

When I was on the exercise machine, I was happy… very happy.

The regained ability to experience feelings and to think in sentences made me feel happy…. Of course, credits might also need to be given to endorphins.

When I arrived at work, I felt the resurge of motivations… to learn, to work, and, most importantly, to seriously start looking for a job again!

At that point, I had gone from a walking zombie to a headless chicken….

Well, I am not quite sure whether it is better to be a zombie or a chicken without a head. However, I think I might vote for a decapped chick at this time. lol

The auditory hallucinations did come back and they were causing some mild annoyance. However, they did not go nuts….

After I was high on drug (ya, Seroquel it is) for about 5 hours, I started to get hit by anxiety and more anxiety. At the same time, anxiety often manifests itself in me as high level of irritability.

This is why I do not claim myself to be angelic and would rather admit myself to be a b-from-hell. This way, when I am nice to people, people would recognize my niceness due to the deviation from the norm. lol

The highlight took place when my mama and I were shopping for some shampoo and conditioner.

At some point, I started getting really irritated by my mom’s questions and talked to her in a really loud voice.

I did not want to be nasty. However, it was really difficult for me to control it.

I apologized to my mom as we were walking back home. I told her I did not mean to be so… Just the change in my brain chemistry makes it difficult for my self-control.

She listened to me… and tried to make fun of it…

However, I could not appreciate her good will… I sighed…

I know it is too lame an excuse to blame everything on brain chemistry.

What about self-control, self-determination, and all those terms depicting how one’s will could weather it all?

Unfortunately, sometimes we might have to subdue to the forces of nature (or artificial nature lol) before we can take it back to ourselves.

I don’t know how long it will take before the neurochemistry arrives to a state of homeostasis. The only thing I know is that I hope this is not to be a long wait.

On the Street, a few things about delusions..

I was supposed to meet with my lawyer today. However, earlier in the morning, her assistant called me to reschedule our meeting.

Since I am on my way to return the demonstration unit (laptop), I decided to sit in the shade and start to do some typing.

This is the same spot I sat at about one month ago when I started trying to learn to deal with the auditory hallucinations and delusions.

I decide to start doing some experiment on myself and try to see how I am viewing the world surrounding me.

As I turned on my laptop, I realize that there are quite a few wireless hotspots nearby. As a result, I decided to get connected to the campus access point nearby.

While I am sitting here, rambling away, and looking at the pedestrians walking by, I am also sending IM messages to a friend of mine about going to shop for a vacuum cleaner for him.

The coolest thing was that I actually could tune into one of the net radios and start playing music on my machine. Well, with the heavy traffic in the background, it is sometimes close to impossible for me to really hear the music… Yet, just for the sake of trying it out..… lol

So, is there anything new that I hear and see?

Nichts.

Except for the heavy traffic on the street, there is not much going on in the vicinity.

Well, it is over-exaggeration to say that I perceive nothing going on the environment.

Once in a while, when I see people in group of more than 1 person (lol) engaging in conversations, I would still have the sense that they are talking about me? However, I do have to admit that the sense of paranoia has reduced drastically since weeks ago. In other words, I think or, at least, hope that this is a positive sign of my recovery from my positive symptoms.

When I was recovering from my first psychotic episode, it was very difficult to deal with the gradual break down of my delusional system.

As I mentioned before, at the point, I thought people knew me and were constantly discussing about my conditions. I thought many a thing has been promised to me including employment and green card sponsorship.

When I eventually realized that those were but my delusions, it was not too easy for me to handle.

Even though these were not real. For me, those promises were real for all those times.

It is a real sense of loss that I had encountered and the intensity of grieve is no less than what one might feel in real life situations.

I asked my psychiatrist whether there was any way to help me deal with the sense of loss. He told me that I just had to live though it, just like any other experiences in life.

That day, after I went back to school, I went online, trying to look for some support groups that specifically deal with the issue of recovery for patients with delusions. Unfortunately, my attempts were not successful.

There were and still are support groups for patients with depression, with addiction, and with many other things. However, at that point of time, I did not find too much facility provided to help people with the given condition.

Maybe people with delusions just don't walk to talk about their delusions, especially when they realize those beliefs were just their delusions (Believe me, it took me years to finally stop feeling ashame of those delusions of mine).

It is an interesting idea to be discussing about the issue of virtual loss. The loss of materials, fame, etc, as a result of delusions are just like the loss of gains that could have been materialized shall one be smart enough as to sell the equities at the highest point. Unfortunately, there is no gain shall there be no transactions.

If you want to understand the feeling of loss associated with delusions, just think about that sense of grievance you had to go through the last time you failed to buy low or sell high on the stock market… lol

Unfortunately, not all losses are virtual, and, when these losses are materialized, the truth might be far too cruel for the recovering patient to handle.

A lady I met in the psychiatric ward in Taiwan had a loss that could never be recovered.

I was having my internship for my bachelor’s degree then. Among the patients, there was this lady who was extreme eloquent and well educated. It was over 10 years ago now and, at the point, she had obtained her master’s degree in special education.

She was working at some school before she was committed to the hospital.

She seemed all fine during our conversation and I saw nothing wrong in her based on my observations.

One day, I asked the staffs about her condition as I was trying to go over her chart. I was informed that I could choose anyone else as my case study except for her.

She had delusional disorder.

In her delusion, Satan was coming down to take over the world. She observed the clues from everywhere… including the messages hidden on TV shows.

Satan wanted to use her baby daughter as a vehicle to destroy the world.

To prevent Satan from achieving this demonic goal, one Saturday afternoon, she crushed some anti-hypertension medications and mixed the powder in ice cream. She fed her daughter with the ice cream and she, herself, downed the remaining.

There are other details that I wouldn’t go into and what I have provided you with were actually in the news.

The bottom line was that she lived and her daughter died.

During time when she was in the hospital, she still had that delusional belief about the Satan’s intents and she had no regret about her own deeds.

It was not like she was a psychotath and she was being relentless and lack of remorse. She was just entrapped in her delusional system.

One day, she came out howling from her meeting with the psychiatrist.

The staff members came running after her and put her on extreme degree of monitoring.

Ya. That was the day when the medications and the interventions finally broke through her delusional systems.

She finally realized that the price that was paid for her mental health problems.

Could you blame her for what she has done? Yes and no.

Before we even come in to make a blame, she has her own grieve and self-blame to be taken cared of.

For the past few weeks, I have been trying to look at the positive side of the positive symptoms.

Why am I telling this story today?

The reason is simple.

Don’t discount the suffering of people have to go through to cope with their mental health problems.

At the same time, please also don’t discount the damages that could be done as a result of mental health problems.

Real harm could be done even though the beliefs are unreal. The best way to prevent virtual losses from being materialized is by self-understanding and professional intervention.

So have I had any real loss as a result of my psychotic episodes?

Yes. I was offered once a full-time position years ago and I was supposed to teach a class before my full time appointment.

Then I went through my full-blown psychotic episode the second time.

I went to teach a class or two and I never went back.

The first few sessions, I did not go because I thought that the president of the school had channeled with me and he had made arrangements to cover for me. After my delusional system was dissolved, I finally contacted the dean to apologize for my sudden disappearance.

Could I blame them for blaming me? No, because they have a school to run and I was the one who was being irresponsible.

Am I going to blame myself? Yes and no.

If I were to blame myself.. it would be my ignorance that is to be blamed.

When feeling down

When feeling down

Trend of thoughts…

Do nothing
Think about nothing
Feel lonely
Want to cry for nothing
Want to stay in bed doing nothing
Smoke
No boy friend
No job
No future
No life
Lost soul in limbo
Useless on this planet
Amounting to nothing
Time to quit
I should stop trying
End of discussion

飛蛾扑火

John Doe

The other day, as I was waiting for the green light on Broadway, I saw a homeless guy sleeping on the bench in the middle of the street.

This is the guy that I thought to have passed away and, all of a sudden, reappeared in the neighborhood back a month or two ago.

He was sound asleep… like a baby.

When I was looking at him, I fell really happy because he seemed content and happy in his dream. He still had that plastic thing around his wrist, which is a trace of hospitalization.

His condition seems to have worsened since his first appearance in the neighborhood (of course if my perception is correct...).

On a good day, I wonder whether there is anything that I could help him with… Unfortunately, it is difficult to help people unless they want help.

On a bad day, I wonder whether I am any better off than him… thinking how content he looked in his sleep (I know, this is a thought too very ungrateful given the amount of support provided to me. It is just my depressive trend of thought).

On 四塊玉

你是否問過自己這個問題--人生忙忙碌碌爭的到底是為了什麽?

關漢卿說的好:

南畝耕
東山臥
世態人情經歷多
閒將往事思量過
賢的是他
愚的是我
爭什麽?

何以知易却是行難呢?
一言以代之--- 提不起又放不下.

更糟的是, 在這條路上, 我們又被逼著去斟衍什麽是該提起的, 叉什麽是該放下的?

連這也放下吧! 可是, 這又是知易行難.

A Ratological Book

This morning, I missed half of my therapy session. Somehow, I had this smart idea that I would be able to wake up to attend a 9:00 session when I made the appointment. Also, I had this belief that my session was actually to take place at 10:00.

As a result, I woke up at around 9:30 only to find out that I slept through half of the session. I was late but I still made the effort to go in.

During the extremely brief session, I mentioned to my therapist about the flooding approach I have undertaken this round. Essentially, I am trying to flood the others with so much information that they wouldn’t want to pay attention to me. Yet, it is closed to impossible for people to get overwhelmed by my bloggings, given that, most people already have enough to read (thinking back at my never-ending effort to keep up with the back-issue magazines) and there is a very slim chance for anyone to be really paying attention to my writing.

The person that I truly want to overwhelm is myself.

You see, there is only so much reflection, interpretation and rationalization that I could perform. It is because my thinking is constrained by my prior knowledge as well as my creativity.

I knew that, at some point, the Goddess of language would take back its unlimited supply of spring water and my ratological discourse would eventually arrive at the state of depletion—like the IP addresses (lol).

It is irrelevant whether it is the medications that are asserting their influence or it’s the discourse that has gone dry. Why? Dasein or being-there is the answer.

The day of the graduation was a hallmark for me.

For the past few months, I have been juggling with the uncertainties about what is to happen after graduation, after my employment status expired, what I am supposed to do after I fall off the pay roll, and, what is to happen to my mental status. It is the expectation of my being a “official” lost soul in limbo that was killing me.

After the commencement, all those uncertainties are realities. I, thus, could happily live my life being there without having to worry about the expectations and speculations.

When expectation is not the focus of my concern, there is no pressure to push, to struggle, and to fight.

However, I do not mean that one should be lazy and use it as an excuse to not live one’s life to its fullest.

Rather, dasein allows me to set everything aside and take my time to process things step-by-step and one at a time--- sort of like, we slowly drove and he knew no haste. Now that I am there, all that I have to do is to be there and do whatever I could do there.

However, please don’t take me wrong by thinking that Dasein grant us a stress-free zone. There are still stressors, like in any other point in our lives—graduation is stressful, exams are stressful, and so are weddings.

At the same time, like what my therapist told me earlier in the year, the past few months has been proven to be a great learning opportunities. It allows me to look back at my own experiences and beat the horse to death (like what I did to my dissertation lol).

Sensing that my thoughts have gone dried, either due to the flooding effect or the influence of medication, I decide to have a paradigm shift in my writings.

It was yesterday when a professor of mine came into the office to look for my boss. I took a few courses in psychopathology with her before.

I was sort of difficult for me to bring up the topic.

I told her, “I want to write a book about mental health issues. I have done some writing so far. I wonder whether you could provide me with some feedback.”

My professor said, “Of course, any time.”

I sent the URL of my blog to her through email.

Yes, this is a paradigm shift. When creativities go dry, I will do some literature reviews to support my thesis. And, eventually, with adequate feedback from people I know, I will be able to publish a book—a book that will be instrumental in mental health education.

I had always wondered what I could amount to and I have always want to contribute to the common good. One major fear in my life is to live a useless life that does nothing more than wasting resources.

By sharing my experiences through blogging, I know I have made some positive contribution to 1 person or 2 (so I was told). However, by publishing my experiences as a textbook, I will be able to reach a greater population (isn’t that what textbook is for? Something students are forced to read lol).

Thereafter, I could tell myself, life has done me good by allowing me to make a little impact.

Since the expectation of my life has been met, I no longer need to dream about winning a Nobel Peace prize as an indicator of my contribution to the common good (lol). Finding a publisher might be something more realistic (lol).
  

Headsets: Unterweg Zur normalization

Today, I took daddy and mommy to the airport. They are going to Costa Rica to visit my uncle.

After I sent them off, I got onto the bus. There was a guy talking on the phone, with one of those hands-free headsets on.

This reminds me of a scenario I encountered the first time I came out of the coocoo’s nest.

At that time, the hands-free headsets were just starting to become popular.

One day, as I was strolling down the street, I saw this well-dressed gentleman engaging in some pretty serious conversation with no one else.

When I saw him conversing with no one so very enthusiastically, I thought to myself, “He needs medication.” It was not until I walked past by did I realize that he had the headset on and was talking on the phone.

Through out the years, the hands-free headsets and cell phones have gradually turned into commodity. It is very seldom, nowadays, to walk down the block without noticing people in the cell-phone nation.

In other words, it has become a norm to see people engage in discussions, quarrels, and story-telling about their entire life while no discussants are in present.

I came up with this brilliant idea after I encountered that well-dressed gentleman on headset, whom was misdiagnosed by me as someone with positive symptoms in partial remission.

What is that brilliant idea?

Let me go side track a bit first (As you might have realized, my writing sometimes goes all different directions. It is my dream to become Marcel Proust II... just don't have his SES to live his kind of life lol).

When I was volunteering in the psychiatric ward in the hospital, I was told that the duty of the volunteers was to engage in normal conversations with the patients. Essentially, the volunteers are instrumental in reshaping the patients’ modus operandis in how they interact with the “greater population.”

This is partially done by ignoring patients’ discourse about topics such as religion, politics, and their mental health conditions. At the same time, neutral topics such as the weather conditions and sports are promoted.

It is hoped that, eventually, the patients will be conditioned to engage in conversations with “normal” topics, rather than the more controversial ones.

However, it was very unfortunate that this tactic did not always work. How long could a discussion about the weather last? How many times could you engage in weather-related conversations with the same person?

The icebreaker might work for the patient with amnesia, whom struggled to remind himself of who he is by stacks of pictures. However, such a topic might turn to be too old for the narcoleptic patient, who used to be a professional baseball player and ended in the bed because his body could not stay away for more than a few seconds.

Also, since I am not a big sports fan, it was sort of difficult for me to talk about sports.

Moreover, a lot of times, patients would get released from mental health institutes while positive symptoms are still actively present. Some get released because of financial issues. Others try to be released because they yarn to get out of the confinement of the hospital. This could be done by trying their best to be normal, to cooperate with the staffs, and, to let the staff members believe that they no longer experience positive symptoms or the severity has turned minimal.

How do I know? Because I am one of them and I do not believe I am the only one.

What about the staff members in the hospital? I believe they know it, too. I figure their role is to keep the patients till they are stable enough to go and live at large.

It took me months after I was released from the hospital to come to the realization that what I believed was going on in this world was but my delusions.

I recall that weeks if not months after I was released from my first hospitalization, one day, I finally was able to tell my psychiatrist that I was feeling depressed. It was because I did not know how to deal with all the things I was promised and lost due to my hospitalization. These included a scholarship to complete my study, a job offer from Microsoft (Don't ask me why it was Microsoft but not Intel or Cisco lol), an honorary degree from some department, and, the sponsorship for a green card. The only thing I did not think about was finding myself a rich and handsome husband (Let’s call it teenage rebellion lol). I felt sad because people have forgotten about me and nobody cared anymore.

My psychiatrist looked at me and told me, “It was your delusion.” Just like what he told me before I institutionalized myself.

It took me some more time to finally accept the fact that it was my delusion because it was my belief and it was my mental model about the world surrounding me. I even went into depression for my delusions (Yet, I hope it was my premonition because I did get a grant to sponsor my psychotic dissertation after all lol).

Based on my naïve theory about how things work, I believe that, a lot of times, patients are released from institutions while positive symptoms are still actively present. It is the hallucinations and the delusions that make people screaming and yelling at the pedestrians, or talking to themselves.

When people encounter these fellow coocoos of mine, it is inevitable for them to regard them differently. How people react to the abnormal behavior, unfortunately, will impose extra amount of stress and will further reinforce the build-up of these patients’ hallucinations and delusions.

Yours truly, thus, came up with this quixotic idea.

What about giving the coocoos a headset before letting them out? In this case, their self-talking would be normalized and it might help to off set the stress induced by how the outside world views them. If there is enough funding, we should even give them a CD player so that they could focus their attention on the music rather than the hallucinations and delusions(lol).

Will this work or not?

I don’t know and it is but a hypothesis of mine. One thing I know is that, even if it might work for some, it will not work for all.

By the way, there was something I learned from the whole 9 yards. The road to accept the fact that nobody really cares because it was my delusion is the same as handling the fading of the novelty effect. As a result, my psychotic experiences help me to deal with the fact that visitors to my blog site has gone from 25 hits per day to 0 hits (lol).

More specifically, what I learned was, today’s news is tomorrow’s history. The only thing we could hold on to is our life because, as long as we are still kicking, life goes on and I continue to write.

This leads to the second positive impact of mental health problems—providing a secure environment for learning and exploration while there is nothing to loose (lol).

Impaired Metacognition: Part II

Today, my family were invited to a function discussing the relationship among the States, Taiwan, and China in Flushing.

During the day time, I was all focused on listening to the speakers, not at all distracted.

What do I mean by not getting distracted? At some point, one of the speakers used the expression “the tunnel” and “barking at the wrong tree.” Those are two of the expressions I used in the previous postings. Even though I know they are common expressions in everyday English, I could not help but think, “Was he making references to me?” However, I was able to refocus on the talk and not engage in further deliberation about the given matter.

As it approaches the dinner time, my imagination (or, more specifically, my unconscious imagination) started to go wild.

The longer I sat down at the dinner table, the stronger the sense I got about the possibility that people were talking about me and my stories. When people in the far away table were engaging in their conversations and enjoying the festivity, yours truly could not stop to feel that I was the center of their conversation.

I was cognitively aware of the irrationality in my perceptions. I tried to control the build up of my irrational thoughts. However, I was loosing control over the delusions of references that were popping up left and right.

Granted, some people were looking at me, at the dining table or on the street. The perception that people were looking at me does not, in and out itself, constitute delusional experiences. What makes the experiences delusional is the bias with which my perceptions are interpreted.

When most people perceive that other people were looking at them, competing hypotheses would be generated to explain the given perception. Following are some examples of the plausible hypotheses based on my naïve theory of human mind:
People look at me because--
I am cute and they are attracted to me
My top is too flashy
I have something on my face—food or someone’s lipstick.
Most of the times, these would be the dominant hypotheses used to explain the perception that other people were checking me out, provided that the perception is valid.

Or, I should say that these are the hypotheses I could think of when I am “normalized” (lol).

However, despite of my awareness of the aforementioned alternative hypotheses, my state of mind makes it impossible for me to reject the null hypothesis that people checked me out because they knew about my stories and they were talking about me. Of course, auditory hallucinations make it even harder for me to reject the null hypotheses (Guess this is the story of my life, reenactment of the results of my dissertation lol).

Where am I going with these BS?

As I mentioned before, it is assumed that metacognition is comprised of the monitoring and controlling components. Moreover, it has been suggested that impairment in metacognition might have contributed to the occurence of delusions.

When referring back to the above scenario, it seems that my self-monitoring capacity remained intact—
I am aware of the irrationality in my interpretation of the events
I am aware of the competing hypotheses that could be used to explain my perception
I am aware of my bias towards the null hypothesis
I am aware of my own inability to make adjustment to my biased modus "interpretation"
I am aware that some of the things I hear are actually auditory hallucinations
So, where did I go wrong?

If the metacognitive model holds true, I would say that what went wrong was my ability to perform self-control, rather than self-monitoring.

For me, self-monitoring concerns one’s ability to observe one’s own state of being. In other words, it is at the perceptual level and it requires analytical skills.

On the other hand, the so-to-speak breakdown in the self-controlling mechanism is manifested in one’s inability to make appropriate adjustment to one’s interpretation about events, provided one’s self-monitoring capacity remained intact.
In plain English, I might agree with the notion that there is some impairment in the controlling component of the metacognitive model when I can not change how I interpret my experiences despite of my awareness of the biases and irrationality in my frame of references.

However, is this really impairment in my metacognition?

I don’t really think so. But, of course, that is but my really tired and loco interpretation.

Referencing back to the classic cognitive theories, we would find that one’s past, to a certain degree, dictates one’s modus operandi in the present. It is because one’s past resides in one’s long term memory in forms such as schema, scripts, mental models, and patterns of attribution.
As people continue to interact with the environment while referencing to their long term memory, the environmental effects make it inevitable for people within similar environments to become more alike and people in different environment to move along differential developmental tracks. Cross-cultural differences exemplify the outcomes of the simultaneous process of diverging and converging at the macro-level.

At the same time, as I have elaborated in previous postings, just like Rome, delusions are not built in one day. At the micro-level, s time goes on, it is inevitable for the delusional to develop a propensity to attribute observations in a way that is deviated from the norm. As a result, provided with the same environmental cues, delusionals might gradually develop a pattern in attending and interpreting environmental inputs that is different from that of a normal person.

In other words, both the normal person and the delusional are capable of performing metacognitive tasks, namely, self-monitoring and self-controlling.

However, a context is required for one to exercise his or her metacognitive skills and the context contains both the environmental inputs and one’s past experiences. Given the same environmental inputs, provided adequate ability capability of performing metacognitive tasks for both the delusional and the normal person, I feel it should be one’s past experiences that result in differential experiences, rather than the impaired metacognition.

Of course, my analysis might not be applicable for all delusional cases. For instance, when a delusional is extremely distracted by hallucinations, the distraction might result in the reduced amount of cognitive capacity that could be allocated to perform metacognitive tasks.
Disclaimer: I am not responsible for the plausibility of instilling falsified beliefs through my writing since my analyses have been based on data gathered from myself N=1.

Commencement

Yesterday was the day of commencement.

It was a very interesting experience because, after all the years of not seeing the light in the end of the tunnel, I see the beginning of a tunnel in blackout again—the pursuit to find a full time job.

Guess, life is all about getting in and out of tunnels. lol

Before I got hooded, I, along with my fellow new born doctors, was informed that we should make a point of not to trip down ourselves on the stage since it had never happened before.

When they made that announcement, the lady next to me and I both had this great idea, “Well, since that was a route never visited, maybe we should try it out….” (Didn’t they say exploration facilitates learning lol)

Ended up, I did not have the guts to tumble in front of the whole room because I do not particularly like the pains associated with falling.

I was happy and I did show my happiness on the stage.

As I walked on to the stage, even before my name was called, I sent my kisses to all my families, bosses, and friends.

I was so happy that I gave a happy hug to the Dean, the President, and the trustees.

As I came down the stage, I saw my boss and I threw my arms around him to thank him and all the people at work for all their supports and caring.

I think the cap and gown had put me in a hugging mood cuz I could not stop hugging people all the way into the reception.

So now I am a doctor… finally, it is official.

What am I going to do next? When could I find a position that would allow me to make use of my full potential and to do something better for the world?

The tunnel is still dark. Yet, thank God that my lighter still works (lol), and, at least, it shades some light into the road ahead, though, the scope is limited.

My family and I bumped into my boss George on his way home. We were talking about the graduation ceremony for the doctoral candidates.

The name of George Weiss popped up in our conversation.

George Weiss is the founder and “funder” of the say yes project, which provides people in the lower SES with the assistantship to pursue higher education.

I told my boss that what George Weiss does is exactly what I want to do and what I have been dreaming of.

One day, if I could amount to something and if I could have access to adequate resources, I want to start a foundation. The foundation will provide support for theory-based and scientifically tested projects that aims to better the life of people who live with mental health issues.

What would be the underlying themes behind these projects?

One word—Education (even though it is something so very easily forgotten lol).
How could education better the life of people with mental health issues?

1. First, knowledge is power, to a certain degree. The knowledge people acquired might help them better understand their own problem and, consequentially, their self-understanding might be translated into the development of help-seeking behavior: both in-sourcing and out-sourcing. As a result, they would be able to achieve their full potential and contribute to the society—I call this the conservation of human resources.
2. Second, enhanced education could allow the general public to gain a better understanding about mental health issues. This would help them demystify their understanding of mental health problems. Moreover, there is a need for a paradigm shift in how mental health problems are conveyed to the general public—and this shift goes back to the aka “positive psychology movement.” Other than educating people about how debilitating mental health problems might be, people also need to be informed about cases that demonstrate the resilience of veteran patients.
3. Third, we are living in a world where information technologies have turned into commodity (at least in the developed countries) and computer skills are turning into basic life skills. There is a need to find a way to incorporate information technologies as part of the treatment plan. Of course, before we identify the issue of “how to”, there is a need to locate long-term source of funding to ensure the sustainability of the outcome.

Of course, there are many more things I could think of.

Yet, I gotta stop thinking at this point since I might trip if I look to far ahead… lol

Mama is calling… Time for my beauty sleep!
BTW, I will work on the second part of the analysis on the metacognition model. Gotta put it off for the family reunion and some other mundane tasks in life...

Impaired Metacognition: Part I

Tomorrow is graduation. When I woke up this morning, I started to feel the stressful kind of feeling. As a result, I postponed all the appointments I made for this week till tomorrow to offset some stress load—including my therapy session… lol

Last night, I was trying to work on some writing about metacognition and delusions.

I once read that it was suggested that people with delusion might have impaired metacognition.

Since I have not been exposed to the source literature, I decided to look for some journal articles, which address the specific issues. Well, like what Confucius said, it is useless to engage in my ordinary reflections without learning something.

However, the article I picked up was not the original article that proposed the role of metacognition in delusion. The article actually aimed to refute the given proposal.

In short, metacognition is one’s awareness about one’s own thinking. For instance, it has been proposed that metacognition includes both the monitoring and controlling components.

If we refer back to the cognitive model presented in an earlier posting, I would argue that metacognitive skills are stored in long term memory and will be called into working memory when needed. Since metacognitive skills are not a given, one would assume that practice would make perfect and, thus, would enhance one’s mastery in metacognitive skills.

But, what does the impairment in metacognition mean?

Well, after I finished reading the first 20 pages of the article, I decided to give up my writing and went to sleep. What I learned after all those pages was that it was originally hypothesized that delusions arise because the delusionals mistaken their imaginations as their beliefs. In other words, there might be impairment in the delusionals’ ability to perform self-monitoring or to control their perceptions gathered through the self-monitoring process.

Well, please don’t quote me since I was half falling asleep while trying to figure out what ideas they were trying to convey.

When I was trying to fall asleep, I was so happy that I am only delusional but not those whose profession is to understand what delusions are (lol).

Actually, as I was plowing through the writing, I started to have the feeling that the way they presented the arguments is fairly similar to how my delusions came about during my first psychotic episode (Oops, sorry, it was just my delusional thoughts. Please also believe me when I tell you that I value all theories and their implications :-D).

There are a sound structure and sound logic behind their arguments. Yet, somewhere along the line, I started to wonder how they had come upon the beliefs the researchers held and that really required some imagination (Don’t take it offensive. The way I see it is that imagination is sort of the basis of my dissertation.).

When I was on the subway today, I tried to understand my experiences based on the metacognition theory (As I mentioned before, the tactics I use nowadays to distract myself from the delusion of references is by focusing on understanding the experiences). At the same time, my discussion with a friend of mine on the train helped me big time in clarifying my understandings.

As mentioned earlier, one major thesis of the theory was that the delusionals tend to mistaken their imaginations as their beliefs.

When I look back at my own experiences, I find it difficult to agree with such thesis.

It is my belief that the development of delusions is highly correlated to the experiences of hallucinations. However, hallucinations should not be labeled as imaginations for the following three reasons:
One has no control over the occurrence of hallucinations,
One could not actively generate auditory hallucinations (well, it is possible to generate internal voices but I will not label these as auditory hallucinations), and
Hallucinations are real sensory perceptions (Please don’t tell me that the voices I hear are imaginary. You can double check it with some kind of brain imaging techniques).
At the same time, it is my belief (or imagination lol) that hallucinations are the building blacks for delusions because the contents of hallucinations could gradually contribute to the development of a “delusional mental model” about the world surrounding the delusional. The sensory perceptions provided by hallucinations could eventually lead to the strengthening of the hallucination-related contents and result in the propensity for the delusionals to retrieve hallucination-related contents when trying to interpret events in their surrounding—this goes along with the Network Association and Attribution theories.

The consistent non-imaginary inputs (unless you want to call the hallucinations as the unconscious imagination) would eventually provide the delusionals with sufficient grounds to form their beliefs. In addition, sometimes things people say and do might actually coincide with one’s delusional worldview. These could serve as confirmation for the delusionals' hypothesis testing.

If you hear people saying that you are beautiful 1 millions times, you eventually will start to believe it. Moreover, I bet there will be at least once when someone really say it to you in plain English.
In other words, what the delusionals have are actual beliefs but not mistaken their imaginations as beliefs.

Is it abnormal? Have you heard of this thing called learning, education or brain-washing (lol)? After I spent this past 7 years in my school, I have learned to believe the implications of constructivism. Would you attribute it to my impairment in metacognition? (lol)

With my postings today, I am only providing my response for the imagination and belief part of the thesis for the metacognitive model. I will have to sign off now since I have to wake up early for my graduation ceremonies tomorrow.

Disclaimer: I am not responsible for the plausibility of instilling falsified beliefs through my writing since my analyses have been based on data gathered from myself N=1.

My parents

Some of you might wonder... all these dirty laundries that you reveal, do your parents know about it?

Yes, I told my mom as she arrived two weeks ago. She was happy for me except for her concern that I might get too tired.

Daddy just arrived last night and I haven't had a chance to chat with him about it. Yet, I assume that, while I was still sleeping this morning, mom must have told him my recent condition, etc.

Earlier tonight, as I was working on the previous writing, daddy asked me, "What are you writing?"

I told him, "I am writing a book."

I told him to not be mad (the Asian cultural thing remember). He asked, "Why should I be mad?"

"I am writing a book to tell people all about the mental health problems I know and how we might be able to prevent and intervene their occurences."

Daddy smiled happily.

IPO

Last Friday, for the first time, I officially showed someone my blogs. Today, I told my co-workers the URL to my blogs. In other words, I am making an effort to make the documentations public.

Sometime last week, the system analyst asked me when I will show her my blogs. I told her, “Give me one week.” Both she and another friend of mine asked for the URL again yesterday. However, I told them again that I was not ready.

What do I mean when I say that I am not ready?

First, I want my verbal diarrhea to be meatier. I am not discounting the importance of phenomenology. Most postings up to this weekend are more descriptive and have been analyzed based on my naïve theory. However, I felt such narratives would be insufficient without my two-cents that ties back to the theories I used for my dissertation.

Second, I want to make sure that I am stable enough to take the pressure. The increase of the dosage totally helps because now it feels like I am wearing a helmet. lol

The first time I went psychotic, I wanted to take on the world and to show them how strong I was. Two weeks ago, I started my blogs because I wanted to take on my positive symptoms. Along the way, I came to the realization that I was barking at the wrong tree. It should be me myself that I take on rather than anyone or anything else.

This is not the first time and, unfortunately, this will not be the last time that I feel the entire world is preying on details of my condition.

The issue is not when I could stop the fear of being identified or when people could stop viewing mental health conditions as a weakness in one’s character or a stigma.

Rather, the question to be addressed is when I could start accepting the variations in my own life. Anything else is irrelevant.

Being in a transitional state in my life does not make it easy for me to deal with such an issue. Ironically, this is the best time because I am done with my dissertation, will soon fall off the payroll, have not found a full time employment, and, have one more week to go before my graduation ceremony-- I have all the time in the world while running out of time. lol

So, I said to myself, “Bring it on and let it go.”

Let go of what? Let go the fear and train myself to get with it.

Will I be able to train myself this life skill successfully this time? Maybe.

One thing I know is that, even though some might suggest people to ignore the auditory hallucination, I have, to a certain degree, trained my auditory hallucination to start using first person narration.

Ya, you want to talk. That’s fine. Just say, “I do research on myself” but not “She does research on herself” anymore.

Will the outcome carry over to the next episode? I am not sure.

At least, I believe that practice makes perfect. There are always second chances.. :-O lol

Delusion of references: Part I

I took my mom and a friend down to China today to have some soup dumplings or juicy bums at this restaurant called Joe’s Shanghais restaurant. They make the best juicy bums I have ever tasted here in the states.

Going outside of the neighborhood provides a good way to evaluate the degree of severity for the delusion of references that I am experiencing.

When I was in the restaurant, there were some Korean guys at the next table. They were going about their own business, talking and laughing. Some part of me started to react with the irrational though that they were talking about me.

Similarly, on our way back, I found some people checking on me on the street, in the subway station, and on the subway. A bunch of these people knew me.

There were some guys at the other side of the train. I heard them talking and laughing. I felt they were talking about me. However, the contents of their conversation are not audible to me.

These are examples of the delusion of references.

Based on the conventional cognitive theory, people constantly assimilate inputs into their mental model. In my interpretation, a mental model is essential a type of knowledge structure resting in one’s long term memory that is readily to be retrieved and utilized in our everyday functioning. It provides us with an understanding of our surrounding by specifying the components, the relationships of the components and, how the components and relationships work together (Hopefully, my advisor would agree with me on this or they might take my doctor back lol).

For me, a delusional system is a mental model developed by the patient in reaction to their everyday experiences, which is no different from that of the greater population.

What would be an example of a delusional system?

During my last psychotic episode, I had this belief that I was telepathic and I could channel with people, God, devils, ghosts, and those otherwise not specified. At some point, I was informed that I was chosen to be a “Buddha” and I was supposed to suffer for the entire world. My nemesis at the point was supposed to be someone between good and evil. Because of her, there came the state of apocalypse. Everybody died, including God, Buddha, Ala, the Pope, and many others, except for me. I would like to join the rest but I could not die. There were volcano eruptions and earthquakes all around the world. I was told that the only thing I could do to save the world is to have a good heart and to do no harm to the others. Eventually, my resilience paid off and life turned back to normal. But, not too much later, the coin flipped and there came the apocalypse again. This time, the deceased turned into energy, molecules, and evaporated.

And, by the way, within this time, I finished collected at least 90% of the data for my dissertation (n=115). Thank God that all data has been captured automatically. Except for the fact that I might have experienced anxiety attack once or twice during data collection, my faulty mental model about the world should not have confounded with the validity of the data that I collected. lol

That was not the end of the story but I think you have gotten a gist of the degree of complexity a delusional system could entail. Therefore, there is no need for me to lay out the entire story.

So what is the role of delusion of references in the whole 9 yards?

Delusions of references are sort of like the Mickey Mouse cases of delusions. Yet, it definitely is the building block of a complicated, unbreakable and robust delusional system.

So how do the delusions of references assert their influences on the development of the delusional system?

Earlier, I mentioned the idea of mental models. Mental models could be perceived as a sub-type of schemata which are rules that direct people’s interpretation about information by helping people make sense of the new information based on what they already know (i.e., prior knowledge). Since the schemata in prior knowledge might not always be a good fit for the new information, the rise of new knowledge requires constant and reiterative processes of model fitting and modification. At the same time, different people might come up with different understanding when they are presented with the same information due to the differences in people's prior knowledge about the specific information.

In one classic study, the authors aimed to examine the impact of introductory passages on people’s recollection about a story. While participants in the experimental group were asked to read an introductory description about an unmarried college student who was having concerns about pregnancy, the participants in the control group were not given the introduction. All participants were then asked to read five boring paragraphs representing events such as making a cup of coffee and going to the doctor. It was found that the introductory passages were able to have a significant impact on participants’ interpretation of the boring texts presented subsequently. This study is known to have demonstrated the impact of the script effect, while script is, in theory, another subtype of schemata.

So can anyone guess what the schema and script theories have to do with the delusions of references?

Essentially, each every time one encounters the phenomenon called the delusions of references, one actually take on the role of a “constructivist learner” and actively engage in the aka “generative learning.” (lol) This encounter requires a person to observe the environment, seek information, conduct hypothesis testing, and provide interpretations. Most importantly, all of these tasks are performed with genuine intrinsic motivations.

This is more or less like the process of working on a dissertation. You start from gathering information night and day looking for a topic. The point you come up with a research question is the point when you find the bias in your frame of references. All the work you continue will be a means to build up a logical system to support your bias. (Please don’t blame me for this opinion. Have you ever heard of bias-free research? lol)

Let’s get back to the issue of delusions of references. Each encounter with the delusions of references is equivalent to a learning process and would result in the changes in the individual’s prior knowledge, which is part of the long term memory.

If you encounter such experiences once or twice, there might not be much change in your knowledge about the world surrounding you. However, if you encounter such experiences on a moment-to-moment basis (60*60*24) for a few days, chances are, there will be a great shift in your understanding about the world surrounding you as well as in your belief system.

Think about it this way, if you overhear from some pedestrian who passed by you that your bank has gone bankrupt, you might not believe it. If you overhear it 3 times, 4 times, and many more times, you would eventually start to believe it.

For an ordinary person, you might call the bank or go to the bank to double check the validity of the information before you take any further action. If you go to the bank and you found out the bank is doing fine, you will attribute it to misinformation.

However, for someone with delusional problem, once he or she develops the delusional belief, even if he or she goes to the bank and found out the bank is still kicking, he or she would still not believe that was the reality. Rather, attempts will be made to develop some kind of conspiracy theory about how the opening of the bank is actually a hoax. Moreover, the intrinsic bias in their belief system results in their propensity to accept only information that confirms their hypotheses. Since it is very rare for the delusional hypotheses to be positively confirmed, people with delusions are stuck with conspiracy theories with greater and greater scale to compensate for the lack of confirmation.

The question now would be, “So what exactly constitutes the experiences of “delusion of references?”

This is the most creative part of my psychotic interpretation. However, it’s past 11:00 and I expect my mom to start bugging me for not getting to bed yet. I will have to leave the grand finale till later: the cognitive theory of multimedia learning- the expansion pack. lol

Is it auditory hallucination that you are experience? :-O

Friday, May 06, 2005

Someone once asked me about the experience of having auditory hallucination. The reason he asked was partially due to his disbelief that someone functional and cognitive like me would experience the positive symptoms.

Essentially, a hallucination is a sensory perception in the absence of actual external stimuli. In contrast, an illusion is a perceptual distortion for a real stimulus. The commonly experienced hallucination could be experiences in all different modalities – visual, auditory, olfactory, etc.

I still recall the time when I was in my undergrad, taking my abnormal psychology class. For reasons unknown, I just found it extremely difficult to distinguish between these two phenomena.

When I had my internship in a mental health hospital, I had my encounters with numerous patients who showed the symptoms of hallucinations. One of the girls told me that she saw things that did not exist, or, you might want to call it “visual hallucinations”. Ya, the thing the guy in “The Beautiful Mind” experience to date.

I did not understand her experiences then and I still do not understand the experience of visual hallucination today. This is because my extensive empirical experiences do not include visual hallucinations (lol). And, if I have a choice, I would choose to be ignorant about such experiences till the end of my life.

After years of volunteering in the mental health hospitals and after my studies in psychology, I thought I knew what it meant to be psychotic and I thought that I could fully empathize with patients with mental health problems. However, I was proven wrong when I encountered psychotic symptoms for the first time.

You see, even with depression, it took some time for me to finally develop the ability to laugh at it. However, it was a shocking experience for me when confronted by the fact that “I have crossed the boundary between neurosis and psychosis.”

I was already deep in my delusional state when I eventually convinced myself that I need even more help than I was already receiving. In short, at that point, I thought I had the special talent of telepathy. Like any other ordinary delusional stories, I knew I was being watched and people were spying on each every step I took or I was about to take in my everyday life. They had even set up some extremely high tech devices to remotely detect and decode my brain waves and broadcast each every thought of mine.

My psychiatrist told me that I had delusions but I did not buy it. Eventually, I started to realize that all those real-time gossips that I heard were interfering with my normal functioning. I think that was one Saturday when I decided to go to the computer lab in school to do some work. No one else was in the room except for me.

I heard someone playing radio in the office next by and people were broadcasting each every of my moves and thoughts. At some point, I decided to go to the office door… I rested my ear on the door, trying to hear exactly what was going on in there. However, there was no sound. Silence was what I heard.

I thought to myself that maybe it was someone else in the other room. There were two consultants on duty and none of them was making a sound. I thought maybe there was someone in the hallway. I walked into the hallway and found not a single soul.

This was the time when I realized… I was experiencing psychotic symptoms or I was really telepathic.

I tried to put my mind together and get some more work done. However, the voices were distracting that, sitting in front of the computer for hours, I still could not write a complete sentence. At some point, I looked at myself and admitted to myself that I was gradually loosing my concentration. I picked up my stuffs, got back home to put things down, and, went to the emergency room.

I committed myself into the hospital. While they were still waiting for a bed to clear, they put me in bed in the emergency unit of the psychiatric ward. Behind the locked door were the nurses on duty and me. Except for their occasional conversations, the whole place was all quite. However, there was never a second that I was left in silence. I started to get more and more scared. When the psychiatrist came in to check on me, I begged her, “Please help me! I will do whatever it takes to keep my cognition!”

I finally got out of the hospital and eventually got off my medication. I thought that, after my experiences, I should be smart enough to avoid myself in going back to the coo-coo’s nest. However, that belief was proven to be wrong. When the second psychotic episode took place, it was a brand new set of experiences and they took me totally off guard. I was hospitalized again, except for, that time, I was involuntarily committed.

It was over 2 years ago when I was last hospitalized. However, my hallucinations did not seize to exist. In fact, hallucinations have turned to be part of my normal life.

I know there is a norm in life. In a perfect situation, I should be able to gradually regress back to the norm. However, sometimes we need to make a sacrifice, live with the bias, and, adapt to our own norm.

Getting back to the original question, “How do you know that you are experiencing auditory hallucinations?” Personally, the feeling of being in the center of the gossip often come along with auditory hallucinations. Why? It is because the internal voices are talking about you yourself. Duh! lol

So how do you tell between real gossip and auditory hallucinations?

Well, it is easy. Place yourself in an environment where there is no one else or where no one is talking. If you hear people talking, congratulations, you have been selected as the special someone to embrace what the ordinary people could imagine. lol

Of course, sometimes it is not so easy to find a complete silent environment. For instance, I haven’t been able to find a minute of silence since I got back home. My dear mother has been discovering things in my room, including those whose existence I have no idea of. lol

In this case, put yourself in an environment that is a distance away from the crowd. Listen to the surrounding. When you hear someone talking about you, try to hear exactly what they are talking about. If you could not decipher their conversation after you conscious effort, you might not have heard their conversation.

Of course, there is no closed-form solution to identify auditory hallucinations. These are but two methods I use for the purpose of self-monitoring. If I could fight it off this time in one piece, it means that it sort of work for me. However, there is no guarantee that it would work for the whole life time. At the same time, it might work or might not work for the others since the symptoms often catch us off guard and there are no fool-proof methods of prevention.

In one study that was published in 2000, it was found that, out of 13,000 “non-institutionalized” subjects recruited from the United Kingdom, Germany and Italy, almost 39% of them reported to have experienced some form of hallucination. If the results of this study hold true for the greater population at the current time, wouldn’t there be nothing to worry about for people with hallucinations such as those in the auditory modality?

To be honest, auditory hallucinations, in and out of themselves, are not so scary (at least, based on part of my personal experiences). Sometimes, they could be quite entertaining. It is more or less like listening to a radio show that is dedicated to oneself in one’s own mind. When you have more than one voice and they engage in conversations, the experience is more or less like listening to the conversation of the narrators in the Iron Chef TV program.

So what make the hallucinatory experiences, such as auditory hallucinations, so bad a thing?

First, I believe their “uncontrolled” development is linked to, if not the cause of, patients’ gradual loss of ability to concentrate and, subsequently, to perform other executive functions.

Second, I believe hallucinations are necessary (but not sufficient) for the development of a delusional system.

Ya. I do have my psychotic theory of psychosis (lol).

I would have loved to continue elaborating on these two points all night except it’s time for my beauty sleep. Hopefully, I will be able to find some time tomorrow to describe the essential role of auditory hallucinations on the development of delusions based on the cognitive theories that I tested in my dissertation.

Professional help

I went back to see my therapist today.

During the meeting, I mentioned to her about the blog that I have been posting and provided some insights about its usage.

Exactly one week ago, there were two reasons underlying my decision to start documenting my progress publicly. One of them was that I decided to go head to head with the symptom that my mental health problems were being publicized.

Yes, I decided to take the behaviorist approach of flooding. My thought was that, if it is inevitable for me to go through my auditory hallucinations and, consequentially, the aka radio broadcasting experiences, I might as well publish everything over the public domain. When all is out, what is left to be broadcasted? lol

However, that decision does have consequences because, now that everything is out, there is more reason for me to believe in the delusional perceptions and this surely imposes more stress on me. (Unless you are as headstrong as I am, or, even if you are even more headstrong, think twice before you proceed… lol)

My therapist suggested that, to reduce the amount of stress on me, maybe I should consider writing things done privately, rather than posting it publicly.

I stopped and pondered before offering her my response.

To was my realization that it doesn't really matter whether it is in my delusions or in my reality that people know me living with some problems. The issue to be dealt with is not how others might stigmatize a person with the propensity for psychosis, rather, it is about how I value myself.

So how is the result of my self valuation manifested in the positive symptoms?

Let's do some really simple analysis about the auditory hallucinations that I have been experiencing (the minor annoyances). I will not take into consideration the auditory hallucinations that are part of the referential ideologies since these experiences are associated with the interpretation of real stimuli that I picked up from the environment.

There are basically three types of contents for these auditory hallucinations. Guess what? Ya, positive, negative, and neutral. lol

An example of neutral comments would be something like “that’s the girl with a smoke”. “She is psychotic!” is an example of negative auditory hallucinations. The positive voices would say things such as, "I admire her", "she is strong", etc.

Sometimes these auditory hallucinations actually get me feel pretty defeated because they have been pretty similar for all these years. I actually complained to my therapist several times about how lack of creativity my auditory hallucinations have been. It might be scary but it would be nice to have a change. lol

That was a little side track, anyway, similar to the dialogues experienced by other people with auditory hallucination, these internal dialogues seem to manifest the extreme degree of egocentrism in me. They also signify my intensified degree of obsession about how my personal attributes might be perceived by the others (and I believe this is why the internal dialogues are presented as third person narrations).

So what do all these mean?

It struck me that, maybe, the real problem I need to face is my ability to truly value and appreciate myself. Also, despite of my BS about how I believe in the idea that “mental health problems are not a problem with characters,” I might be the person who really could not accept me as myself or, the packages that come with me.

As a result, I looked back at my therapist and replied, “Yes, I could stop posting my blogs in public and do it in private. Maybe that might reduce some of the stress. I can even take the entire thing down. However, I will not do it.”

Why?

Call me a war lord if you want to. However, after I took on my own symptoms days ago, I now realize that the symptoms are but the messengers. Like what they say, my best enemy is actually myself.

Don’t take me wrong and think that I am blaming myself for the mental health problems. I have to live with it just like anyone else with other chronic health problems, for instance, heart conditions. However, in this era, people are still lacking a solid understanding about mental health issues.

I am not only talking about the general public. I am also talking about those professionals whose job is to treat patients, to create treatments, and, to study about the etiology of mental health problems. However, most of the problems could only be dealt with but can not be cured. The significance of labeling is important to the selection medication. Yet, it is actually the symptoms that are more important than the labeling.

Back a while ago, I encountered a guy who does medical research. I asked him what he does, he replied, “I know everything about dopamine.” Well, maybe he was just trying to impress a girl that he met at the bar but he tried it on the wrong one. I looked at him and I said something like, “You don’t know jack about dopamine. Otherwise, I would have been cured and freed of auditory hallucinations.” To my amazement, his response was, “That’s schizophrenia.” If he were taking a quiz in my abnormal psychology class, he would have failed. However, I am the person without a job with benefits. lol

Also, to be honest, there hasn’t been much consensus about my diagnosis for the past few years. I have been diagnosed as having delusional disorder, bipolar disorder, and schizoaffective disorder, in addition to depression. After I while, I just let them call me whatever they want to call me because, the bottom line is, give me the drug that I need to become stabilized, everything else is negotiable. lol

You see, if it might have been the lack of knowledge that contributed to witch hunt, the same could have contributed to people’s fear about individuals with mental health problems. And, believe me, I am one of them.

However, there is a difference between my fear and those who don’t struggle with it. My fear about mental health problem is about my inability to deal with it without causing major problem in my functioning as well as its revisit. On the other hand, sometimes, people’s fear for crazy people is due to their lack of understanding or due to how the media have portrayed people with mental health problems.

For me, we all are entitled to our fears regardless what the origins of our fear are.

However, it is inevitable for me to start finding myself a way to deal with these fears.

It is why I am setting up this life skill training sessions for myself in my everyday life. You see, I could stay at home and remain in private till I become a certified social phobic. Yet, that is what I will not do.

Rather, I will put myself to face whatever I have to face.

Essentially, there are only three possibilities for the reality. First, I might really have mild delusions which lead me to sort of believe that people I haven’t even encounter knows about me and my condition. Second, people might really know about my conditions. Third, nobody, except for those people whom I talked to and who love me, knows about it.

I have decided that it is of no significance whatever the real scenario might be because that is not the point.

In my last two episodes, I went on with my life and I was determined to fight it off.

This time, I am having a paradigm shift. I have come to the true realization that it is the art of ignoring that I need to master and it is myself that I have to fight.

Since self-defeating is the last thing I need now, I will keep a rain check on that engagement ;-)(lol). At the same time, believe it or not, ignoring is a task much harder to learn than training myself to write with my left hand; as a result, I will start from concentrating on the things I do in my life.

I should mention, though, I will not be me today without these people studying those neurotransmitters running around in our brain. Whenever I think about two of my uncles who suffered from Schizophrenia since their early adulthood and who never could have achieved their full potential, I realize that modern atypical psychotic medications have spared me with a life to live.

BTW, positive symptoms appearing as usual.
 

Cognitive constipation and Obsession

I ask myself this question, if no one else does, "Do I have nothing else to do other than generating all these blogs?"

Well, there are several reasons behind the blogging.

First, I want to share my experiences with those who go through similar struggle some time in their life or those who are lucky enough to never have to live through these experiences. If anyone every comes across my blogs, I hope you will learn something through them.

Second, I am more or less creating a documentary with text. I find it really interesting to share my everyday experiences with other people in real time. This feels more or less like a faceless reality show.

Of course, I am aware that there are so many blogs over the Internet and there is not much of a chance for anyone to really stop by and read my postings. However, so is life and it is similar to all productions.

I actually suggested to a friend of my who is a MRI specialist to document the progression of my brain through out the entire time-- from a state of semi-stabilization, to a state of psychosis, to a state of recovery, and, hopefully, to a state of partial remission, if not full remission. Well, he did not see any point of keeping track of how my brain might change through out the entire time because "n=1 and results are not generalizable." Well, good luck to him and his fellow researchers. I am not even sure whether they would ever to find a big enough n to successfully carry on the study.

Well, believe it or not, based on my clinical experiences, it is closed to impossible to find patients who could identify the entry point and all the points in-between for research purposes. It is essential to conduct research based on stringent methodology. However, if the purpose of research is all for publication but not for the sake of inquiry about the plausible truth, there is something fundamentally sad.

Third, via writings, I am attempting to find a channel for catharsis. I understand that, at a time when I am highly irritable, small things could turn into big issues. Since unresolved issues tend to have a detrimental effect on human psyche and, possibly, would resolve in maladjustment (lol), the least I could do is to help myself, on a daily basis, work through and think through the little things one at a time.

Fourth, the writing activities are a way of indulging myself in something I always want to do but never find the time to do.

Believe it or not, despite of my verbal diarrhea in blogging, I have gradually achieved the state of cognitive constipation.

What is cognitive constipation? It is the experiences of blocked thoughts. Sometimes, medications might block you thoughts so very well that you don't even feel the flow in your thinking. That could make you feel that you are becoming dumber and dumber. Sort of like the kind of experiences people encounter when they enter a new environment in which they need to communicate with a foreign language. This was what Zyprexa did to me.

With Seroquel, the experience of cognitive constipation is much different. I am completely capable of performing all analytical tasks and ordinary cognitive functioning. I could also form highly intelligent argument or bullshit (lol). However, I have difficulties with inductive reasoning.

The second time I encountered my full blown psychotic episode, I stayed away from Zyprexa and switched to Seroquel. It was because I was in the middle of running my experiment for my dissertation study and was about to begin analyzing my data. At that point, I felt that I could not withstand the block of cognitive flow.

I never really felt the total block in the flow of my thought after I started taking Seroquel (at least I do not recall). Moreover, after I got out from the hospital, I went directly back to work on my dissertation. I was able to analyze my data using all different kinds of higher level statistics methods and was totally capable of interpreting the results. Within one month after I was discharged from the hospital and while I was still in the dire of delusions, two of my papers were actually accepted to be presented in a conference. However, I eventually came to the realization much later that I was still cognitively constipated, just like how I feel now.

Under the treatment of the medication, I could do everything except for some specific type of inductive reasoning. In other words, I could not work on the discussion section. The dosage of Seroquel actually had to be reduced so that I could start working on the dicussion section (lol).

However, haven't I been providing all the discussions about all the events all these time? Yes, I have been. Yet, most of these discussions have originated from open topics. It appears to me that the difficulties I have are topics with constraints. For instance, given the results of the statistical analyses and provided the theories, what do we learn from the study? That I can't do.

Well, all these are good reasons for my blogging. However, I do see myself spending too much of my time lamenting about my experiences.

Since I am still relatively analytical and since I have a quiz next week in statistics, I am gonna switch now to do some other lower level cognitive tasks... preparing for the statistics exam!

By the way, I am forgetting the most important point of why I am keeping this line of blogs alive... It is a test for myself and a life experiment for my own case study. I am inching away conducting my own research about the impact of blogging as a vehicle of providing mental health intervention. lol

The Delusional Social Justice

Ok. I know I was forming a bit of delusion due to the inferential ideologies and auditory hallucinations.

Well, I was hanging out with this friend of mine today and, before we headed for dinner, he wanted to drop by the joint that I said I wouldn’t set my foot in again. On our way down the street, he kept on persisting that I should go hang out there with him and some other friends of mine who are the usual suspects. I told him “No” and “No” again and again. However, he kept on telling me it was irrational for me to not step in there.

I told him I wouldn’t because, at this point, I have to remove myself from any situation that reminds me of the triggering event. You see, hanging out drinking might not be the healthiest thing I could do to maintain my mental health. However, stepping my foot into an environment where negative associations have been formed is surely more detrimental than the drinks. One thing I learned from my life is that I choose the battle to fight and I sort of trust my instinct—to a certain degree.

I tried to explain but he would not listen. If anyone has been following my writing, you would have figured out that I am stubborn. This friend of mine is no less stubborn than me. But, he has no insight of himself being stubborn lol.

Sort of like what happened last weekend, he kept on pushing and telling me that I was being--- blab bla bla… It is an amazing thing that he works for the mental health institutions as a researcher. However, he really needs some empirical experiences to understand what mental health issues mean.

He was informed of my positive symptoms and the increased dosage in my medications. How rational would you expect me to be? However, it seems like he hears the sounds but not the music. It is difficult to explain to people what music is like if they can’t even hear it.

At some point, yours truly, the grumpy tiger, finally meowed. I told him in the face, “Shut up! Shut up!” He finally stopped. Thank, God, I had my voice today. However, he continued his pursuit to convince me about how irrational I was. I told him that, if he doesn’t understand, he should admit that he doesn’t understand.

Call me unstable or whatever you want to, I will admit them all without hesitance and I am working on them. And, believe it or not, I don’t recall in my life ever used the phrase “Shut up! Shut up!” in any argument. I did today.

Was that solely my fault? I was at fault because I was being impolite and I apologized to him later. However, I guess what really aggravated me this time was his detachment from real human experiences while claiming to be an expert, other than I couldn’t really take broken records nowadays. Well, a sense of anger was what I felt then but sadness is what I feel now.

Why such change? It is because it is the reality in life.

Apparently, being told to shut up did some damage to his ego and he started being passive aggressive towards me. He started saying small and negative thing about me again and again. It was amazing that I was able to totally block his either conscious or unconscious attacks (of course, that was just my perception). The matter of fact is that there was actually something more important in my mind.

After I told him to shut up, he finally went to the joint along while I was waiting downstairs. When he came back down, he told me the bartender was not at work. That made me worried. I could go on my life with my little struggles; however, the last thing I want is that my own little struggles would do anybody harm.

It would be my fault if that guy really lost his job. Miseries love companies but not in this way.

I told my friend that I wanted to stop by the deli downstairs to that joint to make sure that guy still has his job. I explained to him that, if because of me anyone has to suffer, I will try my best to right the wrongs.

I don’t know which part of the language he did not understand or maybe there were something else he failed to inform me about. However, one thing people don’t understand is that, at this point, there is nothing new under the sun. The power of creativity associated with delusional thoughts might have been underestimated lol. I was barred from the joint? Or, the entire neighborhood knows I am not normal? Do me a favor. There is nothing bigger than life. The only thing I care about now is that I struggle through the bumpy time and I do no harm along the road.

Because the deli was busy, I decided not to bother them. On my way home, I took a detour to stop by the deli. I bought a chocolate chip muffin and asked my question, “Is that guy still working upstairs?” “He works in the day time.” That was the reply. I was happy. I said, “Good! Good!” I smiled with a relief.

You might call me psycho and tell me that I was acting on my irrational thoughts. Let me put it this way, psycho or not psycho, I embrace it all. However, the “do no harm” principle could not be violated.

What about the symptoms? Well, they are getting to be sort of annoying and boring. I am trying to brush up the skill of ignoring… if only I could find it. At least, one lesson I learned today was that I could not stand broken records and I am much more easily irritated. Most important of all, I should stay away from my friends for a while before I lost them all lol.

The good thing is, Mother is coming on Monday and I would be a goodie-goodie girl. And my mother will always be my mother… lol

Another day in Paradise

I have to admit to myself that some sort of delusion has been formed.

I am still aware that it is a delusion since I have never gotten any confirmation about anyone I don’t know was talking about me. Ok. That’s called the grandiose delusion. What this means is that, reality is not yet too much away from earth. lol

To cut the story short, in my delusion, a huge percentage of the University has been informed in some way about my drama. This is either via word of mouth, email or some website that publicizes my case. This is not the first time when I incorporate the modern technologies in my scenarios. What this means is that the contents of delusions do catch up with the Zeitgeist.

Also, either the bartender got fired or he 86ed me so that I should never get back to the joint again. Some people are in my league while others think I am all bullshit (oops, pardon me for my French). Of course, when I walked down the street or sat on a bench, the usual suspects still picked on me… auditory hallucination, referential ideology, and the sense of distress.

I believe the medication is doing its work, just taking its time. Since my mother is arriving next Monday and I intend to get much more stabilized by then, I am starting to have the feeling that maybe I should talk with my psychiatrist about upping my dosage even more. However, this is just a though. Believe me I am no fan of medications.

I started my day at 9:00 all energetic and, by 2:00 o’clock, I started feeling sleepy. By the time I got off work, believe me, I could not stop yarning for the entire 10 blocks home. I observed some new side effects today. I went right into bed as I stepped into my door. However, even though I was really tired and sort of sleepy, I just could not fall asleep.

I eventually got up and decided to take a walk outside. As you might guess, I also aimed to test my condition again.

I walked down the street aimlessly until I finally stopped at the Statue of the Alma Mater. I sat on the bench for a while, reminiscing what happened before my last hospitalization. This was one of the last stop before the emergency room last time. At that time, I was worried about the life and death of all the people I knew. It is still painful revisiting the old delusions.

However, when rethinking my past and comparing it to the present, I realized, maybe not the first time, that the bottom line is that I long for recognition. I want people to recognize the quality of my research, my work as well as recognize my struggles. This is why I perceived that people were talking about me. Ya, it does not take a rocket scientist to figure this out. However, it is difficult to admit to it, the sense of grandiosity.

Well, for me, it is actually getting a bit boring reporting my symptoms. It was just like I actually got bored about complaining when I was sliding into the dire of depression. For the sake of documentation, today, I started perceiving some degree of memory loss. I forgot what I wanted to do and, within a conversation, I forgot what I wanted to say more frequently. My affect has also turned much flatten. Worst of all, I could not stop thinking about food and eating. Moreover, meat has been in my mind, especially beef… No wonder they provide 6 meals in the coo-coo’s nest and didn’t I mention in one of my previous posting that I would gain a few ponds? lol

As you could see, at this point, the triggering event is no longer anything significant to my current condition. One thing I learned all these years is that, if the system should crash, any event could be that triggering event.

The end of a new beginning

It might sound ridiculous. However, it has been the dream of my life to capture my experiences in real time, with a wishful thinking that it might be of some help to someone else going through the same thing.

It was a long way home. Only 10 blocks but it felt like eternality.

Coming out of the school, there was this guy and this girl laughing at me. Of course, I was unable to capture anything they said exactly. Walking down the block, people recognizing me and they knew I was the girl who caused all the troubles.

When I walked by one of the neighborhood bar, the bouncer was sort of make fun of me behind my back.

Then there were these three guys. They did not look happy at the sight of me, and, when walking passing by me, I overheard one of them said, "he was just doing his job." That comment made me feel worried.

This feeling of being watched and criticized started to make me feel an increasing sense of anxiety. Walked inside of my building, the security guard did not seem to be to enthusiastic in greeting me.

Worst of all, I started to have the feeling that the bartender’s job might be in a state of insecurity. That makes the sense of anxiety become even stronger. I have the feeling that I might be at fault for somebody else’s suffering, while do no harm is the principle of my life.

One thing people with paranoid do is that they have the feeling that each every of their step is watched. For me this translate into the perception that people are getting information about me through my blogs. In other words, this is starting to feel like the real thing. I am starting to feel that people knows the real identify of Ratprincess and they could actually associate my postings with me.

This thought leads me to write out this posting before Seroquel knocks me down.

With this posting, I want to tell people that the bartender just did not know what to do with me and no harm should be done to him in the name of social justice--- words spoken on behalf of my delusional self. At the same time, this is a challenge to the common symptom of broadcasting thoughts—I will do the service myself over the Internet.

I am pretty sure now that Zoloft has finally taken control over the symptoms of depression. What I have to deal with next is to make sure the adjustment of serotonin level does not go over board and push me higher up to the reign of psychosis.