The day was off to a terrific start. I got a lot of things done this morning, important things too, and an emotional distill of satisfaction and ease now are my byproducts. But today has just begun.
Out the door me and my provocative schizophrenia cohort depart, and I am still feeling the days good vibe. I drive to the post office as I have some personal business to conduct. And it is here that the timbre to my day changes score, and in a most abrupt and brutal manner.
Does psychosis come with capacity for choice? If schizophrenia is a thought disorder, is not the psychological sentiment that as humans we have some control, or choice, regarding the thoughts we think? Popular psychology tells us to “think positively.” Is this not a dictate urging choice in that which we think? If my logic follows correctly, therefore, schizophrenia entails a disorder of thought; if thoughts are accompanied by notions of choice, then schizophrenia portrays with a chosen quality? I will return to this fundamental consideration in a moment, but for now, I must attend to my business at the post office.
I enter the entrance and fall into queue. My easy morning temperament persists, but now all things and all matters change in a very abrupt and immediate manner. I hear a persecutory voice but it has no human origin. I retort in my thoughts, “I just heard a voice, that definitely was an auditory hallucination, no one uttered, Robert; it is an impossibility.”
It seems my auditory hallucinations have returned. And as I wait in queue, I hear a few more persecutory shouts from the dark. Now let us return to my hypothesis. Does psychosis, being a fundamental thought disorder, come with any capacity for a choosing? My vignette, which actually occurred, now places me in a very unnerving existential quandary. At this very moment, I feel like a choice begs. My options, as I can see it, are as follows. One, I diligently self-talk what I am hearing are nothing more than benign auditory hallucinations, and nothing more. Option two belies of entertainment. Do I entertain these auditory hallucinations as real, actual, possible, and/or true?
My crux now dictates and decisions must be made. What reality do I choose? Can I shrug off the auditory hallucinations as simple neurological snafu? By capacity of willful choice, am I able to shirk and relegate the persecutory noise as extraneous improbability?
This very push-pull vignette describes an onset of psychosis and it is cognitive experience. My imposition has wagered its menace once again. Am I mentally strong enough today to relegate, or do I asunder under the malevolent persuasion? Can I actually choose my reality?
If I were a scientific determinist, the answer to this question would be “no.” If I were a quantum physicist, I would respond by “yes.” But make no mistake, in response to my psychological dilemma, decisions are impelled and therefore necessarily required. Decisions, decisions, decisions. In my experience with schizophrenia such crucial decisions can then dictate my ensuing experience. The essential problem in the choosing, however, is the forceful persuasiveness of the intruding psychosis. The psychotic purview cannot appear more verace. Furthermore, it is also temporally persistent in its wagered malice further reinforcing its supposed reality. By its black veil of veracity, follows my befuddling cognitive dilemma. And I do not hesitate to add that the psychotic perception carries a more abundant influence than it is rational binary, and the comparative score is a sporting blow-out! It takes me a tremendous energetic self-talk to veer from the psychotic influence. Some days, I prevail, and other days I succumb. But I do attest, a choice seems to avail. After all, it all involves thoughts and thoughts come with perceived capacity for choice. Is this not the very skill taught in formal education and psychotherapy? That is, properly attending to your thoughts with a sense of mindfulness? But let us not be myopic altogether for schizophrenia abides by nuance and complexity, rather than such an elemental simplicity. Perhaps my diatribe regarding cognitive choice, specifically in relation to schizophrenia, is simply a matter of a flawed starting point, or premise. And so, what becomes of the reconciliation?
In response to my imposed schizophrenia, I have learned to abandon binaries and embrace possibilities. For me, at once decisions were of a fundamental yes/no quality, a la a binary choosing. Now, however, because of my schizophrenia, I embrace a “both/and” typical paradigm. By this more flexible cognitive perspective, possibilities emerge and forge to the forefront of my thought processes. I know schizophrenia to have but a singular vulnerability; that is, it recurrently reveals by an obfuscated, clandestine, and clever paradox. But, by such an ontological recognition, the pieces to my puzzle begin to temporally dismantle and disconnect, and the whole of psychosis stubbornly falls prey to now availing contrary evidence. And with my brand new cognitive schema, follows a most certain lighted and affirmative sense of relief!
Paradox persistently swirls in schizophrenia. Schizophrenia often veils by exclusively predicated binaries, but it just is not so. In the end, therefore, I must conclude as follows. “Yes,” I do have control over the thoughts I choose as my abidance. And then, at the same time, “no,” I do not have a characteristic choice because biology and neurology determine. And so the schizophrenia paradox reveals and then resolves, that is, in reference to this particular existential occurrence and permutation. But I assure, further variances are yet to follow! But by paradoxical acknowledgment, the singular vulnerability of my schizophrenia is again recognized, and in my mind, once again duly reinforced.
So at the end of the day, I choose a quantum worldview, nay deterministic. And so from my singular perspective, Bohm prevails over Copernicus, and by manner of a decisive yet spirited thumb-wrestle! Who knew the answer to schizophrenia was a quantum smile?!
—Robert Francis, LCSW
For more content from Robert, please see his literary release On Conquering Schizophrenia; From the Desk of a Therapist and Survivor. It is available everywhere (including Amazon!).