THE MOLECULE OF MOREAnother component of psychosis is delusions. These are fixed
beliefs that are inconsistent with the generally accepted view of reality,
such as “Aliens have implanted a computer chip in my brain.” Delu-
sions are held with absolute certainty, a level of certainty that is rarely
experienced with nondelusional ideas. For example, most people are
confident that their parents really are their parents, but if you ask them
if they are absolutely certain, they will confess that they are not. On the
other hand, when a schizophrenic patient was asked if he was sure that
the FBI was using radio waves to implant messages in his head, he said
there could be no doubt. No amount of evidence could convince him
otherwise.
A good example of this phenomenon comes from John Nash, a
Nobel Prize–winning mathematician, who lived with schizophre-
nia. Silvia Nasar, who wrote about Nash in her book A Beautiful Mind,
recounted the following exchange between Nash and Harvard profes-
sor George Mackey:
“How could you,” began Mackey, “how could you, a
mathematician, a man devoted to reason and logical proof...
how could you believe that extraterrestrials are sending you
messages? How could you believe that you are being recruited
by aliens from outer space to save the world? How could
you... ?”
Nash looked up at last and fixed Mackey with an
unblinking stare as cool and dispassionate as that of any bird
or snake. “Because,” Nash said slowly in his soft, reasonable
southern drawl, as if talking to himself, “the ideas I had
about supernatural beings came to me the same way that my
mathematical ideas did.”Where, in fact, do these ideas come from? One clue comes from what
we know about how to treat schizophrenia. Psychiatrists prescribe
medications called antipsychotics that reduce activity within the dopa-
mine desire circuit. At first glance, that seems odd. Stimulation of the
desire circuit typically leads to excitement, wanting, enthusiasm, and