Saturday, May 1, 2010


Psych ER last weekend. Lady comes in because she feels like she is going to hell because she has sinned. A few weeks ago, she heard a voice talking to her and told her friends it was a demon. A few days ago, she learned that it wasn't a demon, it was actually Jesus. Now, because she mistakenly called Jesus a demon, she feels like a blasphemer. The Father, Son, and Holy Spirit are now punishing her for this sin. They tell her to urinate and defecate in her bed. Then they tell her to lick up the mess. They also tell her when to start and stop walking. She was unable to do anything until "Jesus" told her it was okay.

Why does psychosis so frequently contain religious themes? And why would your God force you to lick your own crap? Please discuss.

-Psych doc


Anonymous said...

Hillarious and sad at the same time

Anonymous said...

Can u just play into her delusion and tell her that god said she is forgiven?

Mark p.s.2 said...

I hear voices and I guess her voice-demon convinced her it was Jesus.
Under torture ( of hearing a voice 24/7) we all have a breaking point.

I don't understand your confusion of religion and hearing voices.The bible is full of hearing voices stories. Snake in Eden, Noah builds a boat. Abraham to sacrifice his son, Isaac.
What else can it be? A talking brain tumor?
Normal people drink alcohol to quiet down their voices.
As an ER doctor you only learn of the "bad" voices.
The "good" voices that tell people to love and take care of their family do not show up in the ER/ED.

For this woman I would recommend sleep ( with REM sleep), they say the hallucination of voices is the dream-imaginary world breaking through to the awake world.

Anonymous said...

Mark, you need to be on some serios antipsychotics. I bet they know u well at the crazy house.

Mark p.s.2 said...

To anonymous: Please tell me why I need to be poisoned by some antipsychotics?
Can you see the future?
Can you read my mind?

I suggest that you consume some antipsychotics and tell me how pleasant the drug is.

Anonymous said...

As a psych nurse I see this all.the.time. I have never fully understood why they always bring Jesus in to it. Perhaps it is something they cant explain so it must be Jesus? There are times when I have been told that Jesus is love and in the next breath they tell me Jesus is going to kill me.

It makes me say a prayer to get through the day. "lord, help me make it" lol

Anonymous said...

"Why does psychosis so frequently contain religious themes?"

I'd like to know how frequently, like 9 out of 10?

Anonymous said...

My atheist dad had a psychotic episode when he was first diagnosed with bipolar disease. It was really out of character. One of my guys at work with schizo has God and Jesus arguing in his head when he has a bad day. Poor guy.

ERP said...

Wow. I wonder if David Koresch had that kind of power over people.

Anonymous said...

Something a lot of academics with atheist tendencies will concede is that the idea of a higher power in the religious sense is something that they seem to have a natural ability to conceive of. Some research seems to suggest that much of the higher brain functioning that allows for socialization plays into religious feelings.

I want to offer a position between one of the earlier anonymous posters and Mark. With bipolar my own experiences with antipsychotics have varied from the very fast yet unpleasant risperdone to the very slow and gentle to everything by the kidneys lithium. What allows me to function in society isn't drugs though but rather conditioning and learning new habits.

If I ever regress to an uncontrollable naked terror though, want the drugs. I've been functional long enough to generally know when to start some for prophylaxis, but sometimes you just really want to live naked. Sanity is hard work.

DreamingTree said...

Maybe it's all in the temporal lobes:

I immediately thought of this research when I read your post.

Anonymous said...

I would say at least 60-70% of them tell me to "burn in Hell" , "Jesus knowwwwws!".

I agree that some feel its something they can conceive.

tracy said...

i think one of the main reasons that religion plays such a huge part in mental illness, both psychotic and non is many people were brought up in strict religious homes, where religion permeates e v e r y t h i n g so naturally it would enter into the course of any mental disease.

Just so damn sad.

Anon 2 i like your answer alot, however, i think Psychiatrist's are trained not to play in to delusions....

kbow18 said...

Wow - all you are looking waaaay to into this.

It's actually fairly simple. God is abstract. He is a means to an end. An explanation for what man cannot answer. I have always held the belief that all these different religions of the world are all worshiping the same God, supreme being, form of energy, whatever you want to call it.

So, when people hear voices - seemingly out of nowhere - the first reaction is to call it the handywork of what our society has always used as an explanation of the unknown. I am fairly confident in the statement that every person is familiar with the concept of a "God" - despite the many forms he is praised in.

The religions of the world have used this confusion as as means of control. They offer an explanation of the unknown - and since humans are so curious and naturally try to understand the world around us - it is comforting to most people to call the unknown "god" and random acts and coincidences "miracles"

I was raised Catholic. Have been to Christian ceremonies, Mormon, Methodist, and more.... I do believe in God - more or less. I believe in a higher power and that there is a higher state of conscientiousness out there. Call it Heaven, Hell, whathaveyou...

Would love to hear some thoughts on my thoughts.

Anonymous said...

What I want to know is why many schizophrenics feel the need to run into traffic to kill themselves (many times naked). I see this all of the time.

Born again Athetist said...

Regarding the 'why would God in His infinate wisdom require you to eat crap' question, I refer you to Ezekiel 4:12.

Born again Athetist said...

^^ To clarify, Ezekiel offers no explaination as to why God wants you to chow down on poo; rather I was illustrating that sometimes God wants you to do crazy things, possibly merely for the celestial lols.

Amy said...

interesting thought "born again athetist" however the verse reads "Eat the food as you would a barley cake; bake it in the sight of the people, using human excrement for fuel" not to actually eat the poo... either way this was considered a defilement of food to the Israelites.

Amy said...

sad all the same... Psychosis is a complex thing. Who truely understands how the brain works? I think besides the pt is hurts family/friends the most. The closest thing I can think to compare it to is the emotional upheaval, random and irrational fears that I went through after post-partum... knowing that what I was feeling was irrational didn't change anything other than to make me confused in why I couldn't control it. Thankfully once hormones calmed down I returned to "normal," but My heart goes out to those who can't go back or have never known what it was to feel "normal."

tracy said...

What an excellent post. You explained the feeling of mental illness so well and with such empathy. i am really glad to hear that you got to feeling better.
Thank you for caring.

Erica said...

kBow18 - I have an even simpler explanation for you: It's cultural.

Just like everyone who gets abducted by aliens just happens to typically describe them as whatever has been recently popular in sci-fi movies (you'll see the trends of descriptions changing from the 1950's to now, it's really interesting), people interpret delusions within the framework of cultural beliefs that will support them.

In the West it's God/Jesus/etc. I'm sure if you had a delusional person raised in a Zen Buddhist tradition they would be communicating with kami. So it goes.

Nurse Me said...

Because God and Jesus have a sick sense of humor just like the rest of us.

Anonymous said...

A simpler explanation is that the religious theme means nothing special. There are only so many conceivable sources for a disembodied voice that orders you around:

1. the supernatural
2. mind-control technology
3. hallucinations

What looks like a theme is merely the difficulty of coming up with an original delusion. That's why crazy people are said to hear the CIA in their heads as often as God. The only thing those two have in common is their reputation for being able and willing to screw with people's heads that way.

Now here's what I'd like to know. How come no one ever seems to believe that their hallucinations are...hallucinations?