Bizarre Obsessions

Repost from the old site.

OCD (Obsessive-Compulsive Disorder) is a very strange illness. Although it is lumped in with the anxiety disorders, some have observed that it has qualities about it that imply that maybe it should be moved elsewhere. On tests, OCD’ers have showed similarities with schizophrenics on certain variables. The suggestion was made by the researchers that OCD may be related to schizophrenia.

Nevertheless, OCD generally does not lead to schizophrenia, nor do anxiety disorders lead to psychosis. That is old psychoanalytic stuff. According to psychoanalysis, as the person “regressed”, they moved first into neurotic “defenses” (the anxiety disorders) and later into psychotic “defenses” as the decompensation progressed. This early thinking has been largely rejected in recent days. But some still rings true.

An old Abnormal Psych book from the 1950′s, big on the decompensation stuff above, said that when a person recovered from a mental illness, they generally went back to a the personality they had previously. That sounds about right?

Anyway, most people afflicted with an anxiety disorder would have a hard time believing that they are utilizing some sort of a defense, because they are so horribly miserable all the time. I feel the same way about a psychosis. Whatever is going on, it cannot be any kind of defense mechanism. Defenses are designed to help us cope, not to make us go nuts!

Since OCD is so terribly misunderstood and the general public has such an ignorant attitude about mental illness, I want to delve into the topic of bizarre obsessions. I will list some bizarre obsessions that I have read about and heard about from sufferers:

1. A man is afflicted with thoughts that he is a fish. He checks himself in the mirror for tiny gills and reads dictionary definitions of fish and wonders if he has gills. He feels terrified whenever he sees pictures of fish. He tries to stop the thought every time it comes into his head and describes it as crazy.

2. A man is terrified that the Night Stalker is going to kill him. No reassurance can stop these fears. The problem? The Night Stalker is safely locked away in a maximum security prison and cannot possibly get at the man.

3. A man is worried that he may possibly be the Devil. This would account for continuous thoughts of committing serial murder, torturing victims, pedophilia and cannibalizing victims.

4. A man has thoughts “Aliens are sending me messages”. The thoughts come in “red neon Technicolor like the signs in Las Vegas” in his mind. He spends all his time resisting the thought and describes it as crazy.

5. A boy has thoughts that he “has to kill his grandmother”.

6. A young woman has thoughts that “wolves follow her everywhere she goes” and that every time she walks anyway, she feels compelled to “walk north”.

7. A man has the thought that there are tiny razorblades on his fingernails, although he admits that he can’t actually see or feel them. Hence he is afraid to touch people.

8. A woman is afraid to walk past garbage of any kind, especially trash cans, because she is afraid she might “lose a little bit of her essence” every time she is goes past. So she avoids garbage cans.

9. A man fears that his overwhelming sexual guilt comes out of his fingertips and goes onto any printed paper, or any surface that can be written on. The sexual guilt will flow out of his fingertips onto newspapers, magazines, etc, and his sexual guilt will be available for everyone to see. Hence he licks his fingers all the time to prevent sexual guilt from flowing out of them.

10. A man fears that the ghost of the dead Jeffrey Dahmer is coming into his body and possessing him, and is causing him to have terrible thoughts about murder.

11. A man gets the thought, “They are poisoning me” sometimes when he sits down to eat. He goes ahead and eats the food anyway.

12. A lawyer throws away his coffee several times a day because he fears someone may have poisoned it.

13. A 29 yr old woman obsessively reads the paper to see if she has committed any murders. She constantly worries that she may have murdered someone.

14. A man worries that he may actually be a woman. Not a woman in a man’s body as in a transsexual, but that he actually is a woman. He spends hours studying his body in front of the mirror trying to figure out if he is a woman or not.

15. A man worries if his dog is really his dog. Perhaps it really belongs to someone else? As he continues these worries, he begins to worry that his dog may actually not even be a dog. Perhaps it is some other species?

16. A man constantly worries that he is hearing voices and hallucinating. Upon questioning, it seems that he is just hearing everyday noises and worrying that maybe they are voices or hallucinations.

At first glance, the overwhelming majority of people looking at these symptoms would say that these people are psychotic and that these thoughts are delusions. Unfortunately, many clinicians will also diagnose these people as psychotic and say they suffer from delusions. The problem is that not one of the people above is psychotic and there are no delusions in the series above.

It’s simply OCD and the thoughts are obsessions, not delusions. The difference between obsessions and delusions is a difference that continues to elude some clinical psychologists and psychiatrists.

The way most people immediately said Seung-Hui Cho, the VT shooter, was psychotic shows that most people associate any kind of strange thinking and behavior with “psychosis”. Most clinicians also said Cho was psychotic. I continue to argue that we lack clear evidence of psychosis in Cho’s thinking and behavior.

Psychotic people have enough problems as it is; although I’ve never experienced it, it’s clearly not adaptive, and in many cases its very painful. They don’t need to be lumped in every deranged homicidal maniac who comes along.

Likewise, folks with OCD have plenty of problems as it is without being called “psychotic”, “schizophrenic”, etc.

Sigmund Freud was wrong about OCD in some ways, but he was limited by his era. Nowadays, Freud would surely be a biological psychiatrist. He has some interesting things to say about OCD. First of all, he said: “This is certainly a crazy illness!” On the other hand, he also said, “They are not psychotic.” He also hinted that the illness may be biological in nature.

For schizophrenia, Freud felt that there was something wrong with their brains. He suggested that in the future, we might be able to find something wrong with their brains. He also said that talk therapy was of no use to schizophrenics.

As you can see, for all the derision heaped on him, Freud was right-on in some very crucial observations about common mental illnesses, observations that continue to hold up in our biological era today.

More on Schiz OCD

Repost from the old site.

This is an update to a previous post about schiz OCD, which is a particular subtype of OCD, or obsessive-compulsive disorder, an anxiety disorder which I suffer from. Fred Penzel, one of the world’s top experts on OCD, wrote to me and chided me for writing about all these different types of OCD, saying that they were all just the same thing.

Well, I will beg to differ on that. Sure, they are all just the same thing in a way, but it is important to elucidate the different types for differential diagnosis – in order to help clinicians to determine what is the proper diagnosis for individuals. I say this because people with many OCD subtypes are often misdiagnosed. The misdiagnosis is usually psychosis, schizoaffective disorder, schizophrenia or bipolar disorder.

Harm OCD is the fear that one is going to hurt or kill someone, or people in general. I spoke to one sufferer, a millionaire, who had not left the house in three years other than for short trips. After reading my articles, he was finally able to go out longer than he had in years. He’s terrified that he’s a serial killer and that he’s going to attack people or try to kill them when he goes out.

An excellent therapy for people like this is to tell them to put a knife in their pocket and walk around town with it, going in stores, sitting down to talk to people. I recommend especially going into stores where the clerk is alone so the patient could potentially “kill the person and possibly get away with it”. Remain aware of the knife in your pocket as you talk to the clerk alone in the store.

There is another therapy that one therapist is using for harm OCD. The client comes in and after he sits down the therapist pulls out a knife, holds it and says, since you’re a possible serial killer maniac, I am going to need to arm myself with a knife when I talk to you. The session is then conducted as the therapist nervously toys with the knife, watching the client’s every move.

Periodically the therapist jumps up and holds the knife defensively, yelling, “Hey, don’t move like that! I could have sworn you were making some dangerous moves in my direction. This could also be done with a close friend or a mature family member if you trust them enough.

The “therapist” makes it known that since the client is a total maniac, the therapist will need to be armed at all times when the client is around, because “you never know what a psycho will do”.

Other therapies include reading books and watching movies on serial killers, writing essays on why the thoughts are actually real killer thoughts and not just OCD, and making tapes of murderous fantasies and listening to them over and over. These have worked pretty well.

A common symptom of harm OCD is knife avoidance. I had a teenage girl come talk to me a while back who just started getting the harm symptoms. She had them all the time now and was cutting school because she could not study. She came from a traditional Hispanic family and she was afraid to tell them about the symptoms. She was terrified and secretive about the problem and had taken to avoiding knives.

She periodically opened her parents door to check and make sure they were still alive and she had not killed them (OCD makes you doubt your own memory in a very weird way). I told her she wasn’t going to get better on her own and got her to make a doctor’s appointment with a clinician.

The important thing about harm OCD is no one has ever acted on these thoughts that we know of.

It is important for clinicians to understand harm OCD because many clinicians falsely think that the person is dangerous and try to consider other dx’s such as psychopathy, sociopathy, antisocial personality disorder, etc.

I am starting to get a lot of mail from people with POCD, or the fear that one is a pedophile. I also wrote an article about that. I haven’t yet figured out any good therapies for these folks. I know that all the ones I have talked to so far just have POCD. Unfortunately, I do not think the pedophiles show up for therapy unless it is court ordered.

I just tell them if they are around, say, little girls and they get these unpleasant thoughts, to just go ahead and think them and don’t worry about it. I am convinced that the problem here is not so much the thoughts but the way that the person reacts to them. There is no harm in thinking sexual thoughts about minors as long as one will not act on them, although for most people it will be more of a passing thing.

I have talked to people who have been angrily challenged by their therapists about whether or not they are really pedophiles. One said, “Ok, look, you can’t hide behind this OCD thing. If you have these feelings you need to tell me. It’s a serious condition.” Most POCD sufferers will get totally freaked out by this. POCD is little known and I believe most clinicians are ignorant of it.

One therapy that I have heard of is to go to parks where kids hang out and just stay there until you can’t take the anxiety anymore.

The obsession that one is gay is very common. Some therapists that do not understand HOCD, or Homosexual OCD, think that the person is really gay or might be really gay. This leads to sessions about whether or not the person is really gay. As HOCD sufferers are already freaking out about whether they have HOCD or are just “coming out of the closet”, this approach is not helpful.

Which brings us to schiz OCD. Here is a 40 page thread full of people with OCD who are terrified that they have schizophrenia or are psychotic. What usually happens is that they have a fear of going insane like a lot of people do. They do research on schizophrenia and psychosis and worry they might get the symptoms. Wa-la, they get the symptoms!

They read about delusions and they get “delusions” – the same ones they are reading about. They read about hallucinations and then obsess whether or not they are hallucinating, hearing or seeing things. They are not hallucinating at all – they just think they are!

I went through that whole 40 page thread and did not see one person who was either psychotic or had schizophrenia. You can tell by the nature of the symptoms and also the way that they communicate in their posts. People with OCD are pretty sensible and rational when they speak and write. This is the paradox of the illness.

As my first therapist said to me 24 years ago at USC when I was having horrible symptoms, “You know, sitting here talking to you, you seem like a really rational, reasonable person. So how come you’re acting so crazy?” Indeed. My symptoms were largely hidden; I was getting a teaching credential at the time and doing student teaching.

I was quite busy. I also somehow had a very active social life and a beautiful girlfriend with whom I was having a very passionate relationship. At the same time, I was going out of my mind. I was pretty much terrified all the time, though I tried to cover it up. The horrible thought started about an hour after waking and went all day with no stopping it. Sleep was a blessing as it was the only thing making the thought go away.

The thought had a simple theme which I will not go into here. I remember my heart slamming away in my chest as I walked across the USC campus. This was how I spent my middle 20′s. I got high on coke, booze and pot, went to countless parties and clubs, somehow managed to date all sorts of women (How the heck did I pull that off?) and should have been having a blast. Instead, I was in my own little Hell of sorts.

Untreated schizophrenics have a way of talking that does not make sense. This is called “loosening of associations” or “thought disorder”. If you have ever had a conversation with an untreated schizophrenic, you know what I am talking about.

I recently got a mail from a woman who has been diagnosed with schizophrenia twice (once by a psychology professor) and schizoaffective disorder once. She had a prior OCD dx and a long history of depression. Social functioning is good with a circle of close friends. She is now trying to get back into school again. She was working, even at the height of “psychotic” symptoms, as a secretary.

We can see certain things here. Untreated schizophrenics typically lack good social functioning. The illness just ruins all of that. It is not possible for an untreated schizophrenic to be employed and function well at a decent occupation – schizophrenics cannot work unless they are on meds. Schizophrenics also cannot do well in college courses if they are not being treated.

Here are some of her symptoms:

Watching TV and a thought pops into her head that the people on the TV are talking directly to her.

On the computer and a word pops out on the screen and she gets the thought that it has special meaning for her.

Thought pops into her head that she is Jesus or God.

Man walking behind her – thought pops into her head that maybe he is following her or going to harm her, so she hurries away.

The next reaction after she gets the thought is confusion, and she wonders what is real anymore. There is a part of her mind telling her that the thoughts are true and another part fighting them, trying to stop them and panicking because the thoughts are crazy and insane and this means she is going insane.

Psychotic people do not operate in this dual mode of thinking while suffering delusions. The term delusional fixation was not coined casually; it has real basis in reality. To put it bluntly, if you think you are going psychotic, then you cannot possibly be going psychotic.

I have spent some time with psychotic people. I was best friends with a young Black guy who was going through the early stages of paranoid schizophrenia. I hung around with him just about every day for a year or so.

He was hearing voices a good part of the time. We would be driving in the car and he would say, “You hear that?!” and point to the radio. Voices were coming out of the radio. I said I did not hear it and he accused me of lying. After a while, I told him that my hearing was very poor and that was why I could not hear them.

I was never really afraid of the guy, but I had to quit hanging around with him because he just had too many problems. He was untreated, worsening, and still trying to manage his life, move out of his Mom’s house, go to school, pay bills, get an apartment, and get a job. He could not manage to do any of these things, and I was driving him around everywhere trying to help him get his life together.

It was definitely an interesting experience to be around this person. This guy had no idea whatsoever that he was ill and he thought the problem was all other people. He fully believed all his delusions and and to him the hallucinations were real.

People were putting transmitters in the radio, the vents and under houses to send nasty messages to him. He wasn’t hearing voices at all. Everything was fully real to him. Of course, it’s impossible to get these people into treatment as they don’t see that they are ill.

Looking back at the woman above, I do not believe she is schizophrenic at all. Further, extended courses of a variety of atypical antipsychotics have produced absolutely no benefit whatsoever. The only drug that gave her any benefits at all was a high dose – 80mg – of Prozac.

A schizophrenic with extremely mild symptoms like this would surely benefit from an atypical, not to mention numerous different ones. The fact that the “delusions” were only ameliorated by high dose Prozac gives a clue to the OCD nature of the illness.

I think the problem here is the woman’s reaction to the thoughts and not the thoughts themselves. As therapy, I would tell her to stop reacting to the thoughts and relabel them as “stupid”, “crazy”, etc. Tell yourself that OCD is trying to make you fear things that are actually harmless. Ignore the thoughts or blow them off.

If there is a guy walking behind you and you get a thought that he might harm you, just stay there with the thought and don’t run. If he seems harmless enough, stop for a bit until he catches up and ask him the time.

The truth here is that you cannot run from your fears. OCD is a process of running from one’s fears. As long as you are running, you stay ill. Your fears are like a deep, dark swimming pool. No matter how scary, you just have to go to the board, swallow hard and dive right in. Then you climb out and do it again. You do it over and over and eventually you just get used to it, because your body does not want to feel anxiety all the time.

Eventually, tolerance results via the body’s natural process of adapting to fears. If there is some thing or situation that persistently frightens you or causes you anxiety, the thing to do is to just repeatedly put yourself in that situation and then fight the urge to run away from the fear. By staying with your fears, eventually they dissipate.

What Is Schiz OCD?

Repost from the old site.

Well, to be honest, it’s nothing, officially anyway. It’s just a colloquial name given to a certain type of OCD, or obsessive-compulsive disorder, this type being a pure-O type, or obsessions without compulsions*. I have recently discovered, after hanging out on some OCD boards, that schiz OCD is actually quite common, though it is a very disturbing type of OCD and is probably also often misdiagnosed.

The person with OCD starts out worrying that they either have schizophrenia or are going to get schizophrenia. They start to read all about schizophrenia, including all of the symptoms. Then they start to misinterpret stimuli in their environment as being due to hallucinations.

They hear noises in the environment and think that they are hearing voices or hallucinating. They see things out of the corner of their eye and start worrying that they are having visual hallucinations.

Keep in mind that it is considered normal to hallucinate for brief periods on rare occasions. It is not uncommon for normals to report hearing indistinct voices for 5-10 seconds a couple of times over a 5-10 year period – a person who experiences such an experience will likely say, “My mind is playing tricks on me.” Transient hallucinations are not necessarily pathognomic of anything.

The real problem with schizophrenia is that the person is afflicted with frequent or continuous tormenting voices that the person insists are real.

Then they start worrying that they are going to get schizophrenic or psychotic delusions. Pretty soon, “delusions” or “psychotic thoughts” start popping into their minds. In more serious cases, the “delusions” or “psychotic thoughts” repeat endlessly in typical OCD style.

Some are reporting just about every schizophrenic and psychotic thought and delusion known to mankind (they are either getting them out of the books or making them up on their own). I am doing amateur therapy now with a man who has experienced hundreds of “psychotic delusions”. It is clear that, at the moment anyway, he has OCD.

Some of these folks have committed themselves to mental hospitals, often repeatedly, insisting that they must have schizophrenia. At the hospitals, the doctors are not very nice to them, and the nurses make fun of them, saying that they have “medical student syndrome”.

Some of them insist that they are delusional – their delusion being that they have schizophrenia. The “delusion that one has schizophrenia” is not an appropriate symptom for a diagnosis of a psychotic disorder.

People with schiz OCD are often in a great deal of pain, but they are not psychotic at all, and, in general, they are not dangerous in any way whatsoever. The “delusions” are simply obsessions that are often vigorously resisted. Sometimes the person spends a lot of time checking to make sure the “psychotic thoughts” are not true.

Some of the thoughts that they get are, “They are poisoning me,” when being served food, “They are against me”, about anyone, especially a loved one, “This is a message for me”, if they see a piece of paper, etc.

The thought about being poisoned proved to be quite common, with many OCDers reporting it. They all said that they went ahead and ate the food anyway. I do not think someone who really thought they were being poisoned would go ahead and eat the food.

Proper diagnosis is essential in these cases, as a number of clinicians are diagnosing these folks as psychotic. They are not psychotic; they have OCD. It is very important to distinguish between obsession and delusion. The bizarre, psychotic-like nature of the obsession does not mean it is a delusion.

An obsession is defined as the following:

Obsessions as defined by (1), (2), (3), and (4):

1. recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress

2. the thoughts, impulses, or images are not simply excessive worries about real-life problems

3. the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action

4. the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.

If the “psychotic thought” or “delusion” has the qualities above, it is an obsession. A person with a true delusion simply accepts the thoughts as absolute fact, with a conviction so deep that you cannot change their minds even if you argue with them all day and night. They believe it the same way that you believe your name is whatever your name is. Furthermore, delusions are never resisted.

I have known psychotic persons who had delusions and hallucinations; it is simply impossible to try to argue them out of their false ideas and sensory illusions. Typically, persons in the midst of a psychosis do not have the slightest clue that they are ill.

It is true that in the early stages of psychosis or even schizophrenia, the person often has some level of awareness and insight. This is especially true of more educated persons who know a lot about mental illness.

I recall a poignant case where a young man experienced the early stages of schizophrenia, went to the library and researched his symptoms and diagnosed himself with schizophrenia. However, soon afterwards, he became full-blown psychotic and all insight was lost.

The lack of awareness of being psychotic makes it difficult to get these persons to take medication. Often they have to be convinced to take medication via subterfuge.

It is also true that schizophrenics who are on anti-psychotics and are getting a good response sometimes have excellent insight.

I have lived with psychotic persons for months on end, have spent months befriending and socializing with a schizophrenic and have talked with other schizophrenics who were actively psychotic. I have never met a psychotic individual who had the slightest bit of insight into their condition.

All of my efforts to talk psychotic individuals out of their delusions or convince them of the false nature of their hallucinations have been fruitless. It is a mystery to me how anyone can claim to do psychotherapy with an actively psychotic person.

Persons with schiz OCD are being diagnosed psychotic or even schizophrenic. Let this post serve as a warning that differentiation between obsession and delusion is of profound importance, as proper diagnostics is an essential pillar of treatment. Incorrect diagnosis poses numerous risks to clients, including exposure to dangerous drugs, damage to self-esteem, confusion, etc.

Persons with schiz OCD often have a history of other forms of OCD, such as HOCD (obsession with being gay), POCD (obsession of being a pedophile), harm OCD (obsession of being a rapist or murderer), germ OCD (obsession about contamination), etc.

A man I know with schiz OCD just got back from a visit to a psychiatrist who diagnosed him as “a little bit psychotic” and tried to put him on anti-psychotics.

She gave the following reasons why he was psychotic: because harm OCD and schiz OCD were not “typical” forms of OCD, and, if he was worried about going psychotic, it must be because he is going psychotic. She also said that most psychotic people have insight into their illness – in fact, the very definition of psychosis precludes insight.

Nevertheless, although anxiety disorder does not lead to psychosis, and OCD in general does not progress to psychosis, sometimes OCD presents as the leading edge of schizophrenia, usually in a young person. In such cases, full-blown schizophrenia occurs within about two years after development of OCD. OCD and schizophrenia can also co-occur, strange as it may seem.

And some persons who seem to be suffering schiz OCD may be experiencing the onset of schizophrenia. In cases where a person with schiz OCD is regularly actually hearing things, further investigation is warranted.

However, it is likely that a person in the early stages of schizophrenia will experience their strange thoughts as ego-syntonic instead of ego-dystonic – that is, the thought will not be immediately marked as crazy and vigorously resisted, but will instead be embraced as verifiable reality.

Perspective is important. The main problem here is OCDers being diagnosed as psychotic, not the other way around.

Little has been written about the treatment of schiz OCD. A man I interviewed experienced an almost 100% loss of schiz OCD on Anafranil, one of the best anti-OCD drugs out there. He also told me that other SSRI’s have been successful in preventing relapse. When schiz OCD is very bad, medication may be necessary. A successful response to SSRI’s will typically vindicate the OCD diagnosis.

Little has been written on the cognitive-behavioral therapy (CBT) of schiz OCD. One sufferer told me that the strategy of accepting the thought and just letting it pass on through without debating it seems to be helpful. Resistance is often counterproductive, as it often just strengthens the obsession.

There is a serious dearth in the literature and understanding of schiz OCD. This post will hopefully spur more articles on this poorly-understand type of OCD.

Here and here are a couple of more articles on schiz OCD.

*Fred Penzel suggested to me that actual pure-O OCD is quite rare. He is correct. What he means is that most pure-O types engage in reassurance seeking, checking and mental compulsions. Sure they do.

On the other hand, OCD’ers seem to want to distinguish between the more ruminative types who do not have overt rituals (no one who knows me would think I have OCD because I do not wash my hands all day or turn lights off and on 20 times). Furthermore, clinicians also seem to want to make this distinction. I was told I was a “classic obsessive” – implying rumination and lack of overt rituals.

OCD Versus Psychosis OCD with Psychotic Features

This is another in a series of articles on psychiatric diagnosis. This one will focus on the interface between OCD and psychosis. Keep in mind that there is a now a dx called “OCD with psychotic features.” Here are five cases of OCD with psychotic features. As you can see, these people believe in some really strange stuff! They are also very, very ill.

Case 1

Z suddenly developed rituals at age 17. While watching television he looked up and saw a man’s face at the glass kitchen door and heard a voice say: “Do the habits and things will go right”. He came to believe in a ‘power’ that could bring him luck if he could retain it within his possession through ritualising.

He bought an electric guitar which he felt contained the ‘power’ and would turn the controls ritualistically. He often saw a ‘black dot’ the size of a fist leave his body and enter some object around him. When experiencing the loss of the ‘black dot’ he felt compelled to ritualise to regain the ‘power’ that he believed was contained in it.

At age 19 he began to believe that a workman possessed a second ‘power’ for evil and began a second set of rituals to ward off this evil power while striving to retain the good one. He believed absolutely in the ‘power’ and feared disastrous consequences for himself and his family should he fail to retain the good and repel the evil power.

Before his admission to hospital, obsessions and compulsions affected every area of his life. Before performing any action he felt compelled to imagine the letter ‘L’ and the phrase ‘X away, power back’ for up to 20 minutes. He felt unable to sit on chairs or walk on grass or leaves, and slept with his feet uncovered for fear of the ‘power’ being transferred to some object from which he might be unable to retrieve it.

On leaving home he constantly retraced his steps to place his foot on a crack in the pavement or a leaf that he felt he had trodden on and so lost some of the ‘power’. If he saw the black dot leave his body (about 20 times a day) he had to touch the object it had entered and superimpose the letter ‘L’ and the phrase ‘X away, power back’ in his mind until he saw the black dot return.

From age 18, Z also had recurrent depression, hopelessness and suicidal urges, with deliberate self-harm (overdoses and wrist-slashing) when he was in a depressed mood. He said he harmed himself to appease the power or as a wish to die “when everything was perfect” after a day of ritualizing.

Case 2

Y developed beliefs about a ‘power’ at age 13. He felt that everyone had a certain ‘quality’ or ‘goodness’ which was stored in the brain as a ‘power’. He believed that other people drained the power from him and replaced it with their own rubbish (feces and urine). The exchange of power was triggered by an image in his mind of a face or object. When it happened he felt distressed, ‘dirty’ and ‘horrible’.

He could only regain the power by doing complex rituals. He imagined the person’s face and that he had detached their head from their body and sucked the power from the major vessels of their neck or from their eyes. He then transferred the power back into himself by banging his palm on a particular spot on his forehead, and breathing out repeatedly. This made him feel relieved and ‘good’, but as the events recurred up to several times a minute the relief was short-lived.

He felt ‘compelled’ at times to get revenge on people who stole his power by drawing with his finger on a wall a deformed and ugly representation. If he touched anything he left a ‘power’ trace behind and so had to touch it repeatedly to get the ‘power’ back. Y’s belief in the experience was absolute. He knew it might seem strange to others but believed that if they experienced it, they would understand.

From age 17 he also had recurrent depression, hopelessness and suicidal urges requiring hospital admission.

Case 3

At the age of 8, X had transient counting rituals associated with fear of harm coming to others. When she was 15, after a relative died, she feared that harm would befall her family and friends unless she completed specific tasks. She thought a supernatural ‘power’ inserted unpleasant thoughts into her mind, e.g. “if you read that book a relative will die”.

She believed unshakably that the power was supernatural, but could not explain it. To appease the ‘power’ and the thoughts, she developed complex counting rituals pervading her daily activities. She also did ritualistic hand-washing and checking. She avoided specific numbers, colours and clothes and counted from 0 to 8 on her fingers and toes throughout the day.

She repeated rhymes, avoided multiple numbers she associated with death or harm, and brushed her hair hundreds of times a day. She felt unable to resist the rituals, as her belief in negative consequences was absolute. Before she was admitted to hospital, rituals took all of her time until she fell asleep.

X had two episodes of moderate depression at age 25 and 34, both associated with worsening of her OCD. She had never harmed herself.

Case 4

At the age of 7, W developed fear of harm coming to relatives. He engaged in hand-washing and touching rituals to prevent this. Gradually he began to believe that ‘spirits’ or an outside force ‘reminded’ him to carry out his rituals lest harm should result. He associated the numbers 13 and 66 with harm and, if he saw them, believed they were placed by an external force to remind him to carry out his rituals.

He defended his belief absolutely but said he could not be 100% sure “because one can never be sure about anything”. He was unable to resist his rituals, as his belief in the negative consequences of not doing so was absolute. His rituals centered around numbers, complex counting, and avoidance of specific numbers. At age 31 he developed fear of contamination associated with many rituals of avoidance and hand-washing.

Prior to admission he was homeless and had thrown away all his ‘contaminated’ possessions, carrying all he owned in two carrier bags.

Case 5

For 20 years V had had a fear of being transported into another world. At age 17 he worried that reflections in mirrors represented another world, and had complex checking rituals involving mirrors. This gradually spread to all reflective surfaces. He believed that turning on electrical switches, using the television remote control or hearing car engines turned on could cause him to be ‘transported’ and constantly checked to make sure this had not happened.

He believed that if he ate while in another world, he would be forced to stay there, and so either avoided eating, or ate with complex rituals, or induced vomiting. Other rituals involved switching electrical switches on and off and wearing particular clothes. The ‘other’ world was tangibly the same as the real one, but ‘felt’ different – he felt that friends and family, although appearing the same, were ‘different’ and might have been replaced by ‘doubles’. The symptoms gradually worsened, occupying all of his time prior to admission to hospital.

When he was 27 he suffered severe depression requiring in-patient care, and again at age 30. He had no history of self-harm.

Just Kill Yourself and Get it Over With

Seriously, you sick bitch.

Borderline personality disorder, apparently. She’s a cutter.

I knew some cutters once. They actually formed a club called Oakhurst Cutters. Bunch of stupid, sick, fucked up young White women. She told us that at a table with a bunch of other people and started laughing. I stood up, pointed at her, told her she was a sick bitch, and walked away. In modern society, that’s considered impolite. I think it’s impolite to use your own living body as a med school cadaver, sorry.

Why don’t we just line these people up and shoot them and get it over with? I’m not serious, but that’s what I often think about these BPD types. Just line em up and shoot em!

 

This Is Not Schizophrenia

Repost from the old site.

This is not schizophrenia. Let’s look at some symptoms here that a fellow is reporting in a weight-lifting forum. Many of the commenters are replying that the guy has “the beginnings of schizophrenia”, “mild schizophrenia” “schizophrenia”, etc, etc ad nauseum. Let’s take a look at his symptoms:

At night, no matter what I do. Not every night it always happens during the week when I have to work the next day, I cannot fall asleep. Music, TV, RX pills, Tylenol PM, melatonin. Even taken together, mixed and matched, I cant fall asleep sometimes. And my body is tired, but my brain wont shut up. And I’m not even thinking about anything important. Sometimes, just fucking music is playing.And it will keep my up, not sleeping 2-3-4 nights in a row. By the 3rd day, I feel delirious, and I didn’t want to train the other day, cause I was afraid I’d hurt myself from how slow, and tired my body felt. I’m trying not to smoke as much pot lately, cause I’m cutting, losing weight.

It’s effecting my home life, my job, my training, my relationships. Someone asked me if it was because I was depressed. I really don’t have much to be depressed about. I have a good job, I make good money, I get laid, my own place. If I’m depressed, I don’t know why.

It’s almost like I’m “tripping” is how much sense it doesn’t make -like when you’re on acid and your mind is racing and none of it applies to anything, or means anything. Random craziness.

I hear voices (not like telling me to kill or anything) but just random babbling and the voices change like they’re inhaling helium. It doesn’t make any sense. Other times, random songs play through my head and I cant shut them off. I can only control them by putting other songs in, but that causes me to strain my brain and think hard when I’m trying to relax my mind.

My head sometimes gets heavy too, like it weighs like 50 lbs, and my equilibrium gets off balance sometimes. Like a concussion.

OK, the guy is unable to control the thoughts in his head. Thoughts, crazy thoughts, random nonsense, just races through his head with little or no control over it at all. Songs, uncontrolled and unbidden, pop up in his head unbidden and play by themselves in his head.

He can’t shut any of this bullshit off, and the only way to stop the music is to substitute one stupid song for another. I am assuming the “voices” he is hearing are voices in his head, not outside of his head. Fortunately, you can hear all the voices in your head as possible without being mentally ill, though it really isn’t ideal.

It’s crucial to realize that psychotics who hear voices actually hear them with their ears, not in their minds. We all “hear voices” in our heads. Our “inner voice” is a voice inside of our heads. The idiot media and popular does not do us any good by refusing to differentiate these symptoms. Psychotic voices heard with one’s ears are transformed into “voices in his head”.

Obviously, if it’s sane to one one “inner voice”, it’s not psychotic to have more than one, or an unlimited number, though it’s not exactly ideal. You could even have animal sounds in your head.

Hang on.

OK, I just made some animal sounds in my head. There was a cow and a monkey and now there’s a lion. Does that make me schizophrenic? Come on.

If you follow the discussion, you will note that many of his friends on there tell him that he is developing schizophrenia. I do not believe he is doing any such thing, and this is not a symptom of incipient schizophrenia anyway.

I’ve been around folks in the prodrome of schizophrenia, and while their functioning was still ok enough, they were hallucinating (hearing voices) a significant part of the time. No amount of argument could convince them that the voices were not actually real, nor would they believe me when I said I didn’t hear them. This is a pretty typical picture of incipient schizophrenia.

Keep in mind that the vast majority of schizophrenics hear voices. In fact, if you don’t hear voices, I wonder if you really have schizophrenia.

What’s also interesting is that, terrifying and weird as these symptoms are, a number of the commenters admit that they have experienced them – they say they have had strange, out of control, unbidden random thoughts and music in their heads before. So, while it’s not optimal, this stuff seems to be pretty common.

What’s the diagnosis for out of control, random, unbidden thoughts and songs in your head? I say nothing. There’s no DSM dx that has a criteria like that as a sole criteria.

Just like “having a weird look in your eyes” does not give you a mental illness dx either. There are all sorts of folks walking around with all kinds of weird and crazy looks in their eyes. While it’s disconcerting, it’s not necessarily indicative of mental illness. There is no DSM dx for “has a weird or crazy look in their eyes.”

You need to be nuttier than just that. What gives people weird looks in their eyes if they aren’t nuts? Who knows? God knows what goes in people’s minds. But as long as your speech and behavior remains normal, you’re not mentally ill.

Why am I writing about this crap? I’m on a crusade to get people to quit being such morons about mental health. Even if we aren’t ill ourselves, it doesn’t help to give out false dx’s and go around accusing non mentally-ill folks of “being crazy”. It’s insulting, stupid and cruel.

Personally, I never refer to other humans with words like “weird”, “crazy”, “nuts”, etc.

Instead, I’m going to give you some specific description of their behavior, possibly with a potential dx. I can usually figure out what might be wrong with someone after spending a bit of time around them. I can almost always tell if they are psychotic or not, and usually if they are obviously dangerous or not.

Life’s tough for everyone and probably few of us make it out unscathed.

POCD Versus Pedophilia – Differential Diagnosis

Repost from the old site.

This is one of a number of posts I have written on mental illness. It deals with it from a diagnostic point of view that is probably most interesting to sufferers or clinicians, but may be interesting to some laypeople. I’ve been studying abnormal psychology for 30 years now, and experiencing it for 25 or so.

POCD is a subtype of OCD that is usually thought of as pure-O, or pure obsessional. Pure-O’s do not have the usual behavioral rituals that the hand-washers, etc. have; instead, they have cognitive rituals. It is necessary that there be more documentation on this subtype of OCD because unfortunately, quite a few people are suffering from it, and clinicians barely understand it.

Due to this lack of understanding, clinicians think sufferers are psychotic or suffer from pedophilia. Many clinicians have a poor understanding of OCD as it is, and this series is intended to enlighten them about different forms that the illness can take.

I’ve written some stuff on POCD on this blog, and therefore, I get sufferers coming to me with the condition. As I don’t have much issues with POCD these days, I’m capable of doing therapy with them online.

After talking to quite a few of them, it’s clear that it’s like any other type of OCD, since OCD sufferers, especially pure obsessionals, have a certain “sameness” about them such that you can nearly diagnose them on pure Gestalt alone.

I can tell pretty quickly after talking to someone whether they are suffering from OCD.

One thing to get clear on is that POCD will apparently never be acted on. I’m not aware of anyone acting on any of these obsessions.

There is another type of OCD called Harm OCD, and I have talked to a few of those folks too. Two of them were convinced that they were serial killers. I quickly figured out that they had OCD and were completely harmless. People with harm OCD never do anything violent, and people with POCD never molest kids.

Once you know this, you can talk to them about all their scary thoughts with worries.

I might have a hard time doing therapy with an actual pedophile or a psychopath who really wanted to kill people. As a general rule though, these types do not feel there is anything wrong with them as they enjoy being this way, and they never seek help.

The usual POCD sufferer is a young man around college age or so, but many sufferers are young women too. A few are older, but this is much less common. Sexual obsessions in general seem to hit young people the hardest of all for some reason. Most people with harm obsessions are also young people, mostly males, though once again, some are females.

OCD is a fear-based illness. It will latch onto anything in society that is frightening.

Nowadays, with Child Molester Mass Hysteria on the rampage and everyone worried about “pedos” and “predators,” it’s only logical that people with OCD would find this the perfect fear. What could be more terrifying than the fact that one may be a pedophile? Not much. Hence, POCD.

We have also seen a marked increase in fears of AIDS among OCD sufferers. AIDS is salient in our society, it’s terrifying since if you get it, you’re about dead, so OCD will latch onto it.

The best way we can do differential diagnosis here between POCD and pure pedophilia is to link to some websites.

First of all, a fellow I have been talking to has posted his history online here. He’s given me permission to link to it. It’s five pages, but if you read it, you should start to get a feel after a while about what this illness is all about.

Note the chronic doubting, the omnipresence of fear, the uncertainty about feelings and whether they are real or not, the questioning of everything from one’s thoughts, feelings and history all the way to the actions and thoughts of others.

What’s going on here is a hyperanalysis of the individual’s history, thoughts and behaviors along with continuous checking of “scientific sources,” followed by more rounds of unproductive doubting and worries. As you can see, nothing ever gets resolved here. The worries and doubts just go round and round. Once one gets settled, a new one comes up. This is truly a case of one’s mind actually chasing its tail.

In this case, he is trying to prove whether or not he is a pedophile. He finds evidence, questions the evidence, checks, cross-checks and tests the evidence, then starts all over again.

There is atmosphere of wondering, uncertainty and doubting to the point where the person can start doubting his own perceptions. Thoughts and feelings can seem like they are actually occurring, and the person becomes uncertain about what is really happening and what is just in their mind.

I talked to one woman who had lesbian fears during conversations with other women. I asked, “You get lesbian thoughts and this bothers you?” She said, “No, I worry that I’m going to say lesbian stuff to her. Then after the conversation is over, I wonder if I made lesbian comments to her.” As we see, the person doubts their actual perceptions and wonders if things occurred that are did not even occur.

This doubting of one’s own perceptions is actually quite common in this disorder and is almost pathognomic.

Unfortunately, it looks very strange, and clinicians often misdiagnose it as psychosis.

In this post, he says he can hear what people are thinking. That’s a schizophrenic symptom, but when I questioned him about it, he said he just watched people very closely and thought he could figure out what they might be thinking, but he didn’t really hear it with his ears. He admitted it wasn’t really possible for him to know exactly what was in someone’s thoughts.

When I heard that, I knew he did not have schizophrenia or a psychosis. Once again, though, we see internal thoughts and external perceptions being confused, common in OCD.

I wasn’t impressed with the others in this thread, one of whom was accusing him of being a pedophile. An administrator, a clinical psychologist, finally gets it on page 4 and says he has sexual obsessions.

In this post, he says he is losing his attraction to women, and the attraction to kids seems to be increasing.

There is another sexual obsession called HOCD (homosexual OCD) that works much the same way. The person goes into horrible worries, thinking in a similar manner as this guy, that they may be gay or bisexual. In severe cases, they think that they are losing their attraction to the opposite sex and getting a new attraction to same sex. HOCD is very common; much more common than POCD.

As it’s not possible to turn gay, bi or pedo against one’s will, this is the common denominator in all sexual obsessions and is pathognomic.

Gay, bisexual and pedophilic persons do not feel as if alien forces are turning them into something they do not wish to be. They are what they are. The attraction, wanted or not, feels normal, natural, right, correct, real. They may worry about the way society will treat them, but it isn’t a question of being transformed into something you are not.

He is also masturbating to pedophilic fantasies, but I’m not worried about that. He’s doing this as some sort of checking behavior to “see if he’s really a pedophile” or to “get it out of his system.”

People with HOCD often do the same thing. They search out gay porn on the Internet and masturbate to it to “test their reaction.” Then they go find some straight porn and masturbate to that to “test their reaction” to that. Then they endlessly compare reactions to try to figure out if they are gay or not. Typically, the testing never reveals any significant answers, so it just goes on and on.

This is called checking and it’s also pathognomic of OCD.

The truth is that in males, sexuality is fixed by age 15. That means straight, gay, bi or whatever, you can’t change after that. What turns you on, turns you on. Behavior can change afterward, but not attraction. In females, it’s different, but no female turns gay or bi against her will.

In one post , he tries to argue with the OCD by saying “I’m not a pedophile” (thought compulsion). His mind argues back, of course, by saying the opposite and telling him he is one.

This is also pathognomic of OCD.

OCD acts like a gremlin in your mind. It contradicts you and tells you stuff you don’t even believe in and makes you confused.

The truth is, that’s not really an internal dialogue, it’s just OCD talking back and being contradictory. The result can be endless wars in the mind whereby one uses thought compulsions to try to contradict obsessions. For some strange reason, these don’t seem to work very well, and the OCD often just fights back even harder with more intense contradictory statements.

Although masturbating to pedo fantasies may seem disturbing, I’m not worried about it in this case. Humans, especially young males, are polymorphously perverse, and can get turned on by just about anything.

A pedophile in general has a true preference for kids and does not have much interest in adults. They have been this way since early adolescence. It doesn’t probably doesn’t come on after age 15 or so, and neither do most other paraphilias. The root of all paraphilias, like the root of all sexual orientation, seems to be in the birthing storms of the teenage years.

My take is that OCD is lying to this guy. As you can see, he also has HOCD. He’s suddenly developed gay fantasies. How? By looking at some gay porn on the Net. In his case, both pedo and gay fantasies were fantasy-supercharged due to their forbidden and taboo nature, not due to any real attraction.

OCD is lying to him, telling him he’s gay and pedo and he’s losing his attraction to women. HOCD sufferers also feel that they are losing their attraction to the opposite sex and gaining a new one to the same sex, but this is just an illusion. How this strange illness does this I’m not sure, but I think it has to do with the way anxiety and fear work on the brain.

HOCD sufferers are also typically young people and most are males, but there are quite a few young females too. They usually are shy introverts, like most OCD sufferers, and often have little sexual experience. The extroverted obsessional exists, but is quite rare. People seem to grow out of this gay OCD thing with age, or at least move onto other obsessions.

Since homosexuality is salient in our society and a is popular meme in our culture and yet is not quite accepted, it’s a logical fear for OCD to latch onto. For many young people, homosexuality is just wrong enough and taboo enough that the fact that the thought that one might be gay or bi is quite terrifying.

If at some point, homosexuality and bisexuality become more accepted, OCD sufferers may stop worrying about being gay and start worrying about something else.

The nature of the OCD fears is not important. Depending on the era and society, OCD will latch onto whatever fears seem most terrifying for the time and place. The illness is mobile, and once one fear is conquered, a new one can be acquired.

HOCD is a particularly horrible type of OCD. I’ve been to boards on the Net full of sufferers, and many are seriously miserable, deeply depressed and contemplating suicide. For some reason, obsessionals, while often complaining of being suicidal, rarely seem to commit suicide. I think the fact that they are so fearful and inhibited keeps them from taking this final step.

For a glimpse of how real pedophiles think, and to tell the difference between POCD and pedophilia, check out this Wikisposure page that gives bios of numerous actual pedophiles that they are tracking. After you read through a number of the bios, you will get a common feel for what these guys are all about.

This, like all paraphilias, is not an anxiety disorder. The dominant emotion is not fear and doubt as in OCD. These guys aren’t going round and round about whether or not they are pedophiles. That they are is clear as air to them.

Pedophilia, like all paraphilias, is an illness of desire, of appetite. It’s like an addiction. They love it. This is what gets them off. They don’t want to change, they don’t want to get better, and the truth is they probably can’t anyway.

I assume that true pedophilia, once fixed in adolescence and cemented in adulthood, is incurable. What gets you off, gets you off. It’s not going to change. They can’t help it, but at the same time, society needs to be protected.

Thought Broadcasting and Thought Disorder: Pathognomic Schizophrenic Symptoms

Here.

This is a most unusual schizophrenic symptom that most folks do not know about. It’s probably quite rare to nonexistent in other disorders; in fact, I think it is pathognomic of schizophrenia or schizoaffective disorder. I doubt if you would see this symptom in a bipolar or unipolar depressed person.

As you can see if you read that post, this is a very terrifying symptom! It’s probably much misunderstood. For instance, right now, if I worked myself into an anxious enough frame of mind, I could imagine that my thoughts were being broadcast out to others. But that’s not what’s going on with these folks. Imagine of you could walking into a coffee shop full of people and suddenly all of your thoughts are being broadcast out loud to everyone in the room.

This is what you are going to experience. You will experience you own thoughts shot out into the environment, and they will sound as clear and as real as the voices of folks around you and other sounds in the environment.

In such a situation, schizophrenics often have a hard time believing that other people can’t hear their thoughts being shot out into the environment seemingly out of loudspeakers. As you can imagine, that’s quite a disturbing symptom! If I experienced a symptom like that, I’m not sure how I could go into public and try to function. It would be awfully hard.

They also often feel that they can hear other people’s thoughts.

Here is one guy’s experience:

This is a difficult concept for me in both experience and articulation to others…here is what can happen to me…I will be thinking some thoughts about something I am doing at the moment or something(s) I will do in the future…these thoughts are completely separate from my ‘voice’ hallucinations (??) ….and later in the day/week/month REAL PEOPLE (usually strangers) will come up to me & repeat these thought fragments or statements to me WORD FOR WORD!…

They aren’t generalized thoughts that most folks have in a day, but are specifically related to my own situation or something occurring in my personal realm…this has happened both in my own town and in several other locations (and other states!)…I’ve even had strangers say them from open windows of other cars at traffic lights, and even leave pieces of paper on the floor (ground) in my path with the EXACT thought or fragment on it!!…

What all this really is, I don’t know, but it seems to me to be a form of thought broadcasting (against my will)…very strange…

Whoa! I had to think about this one a bit! At first I thought the guy was psychic. Then I figured out what was going on. Those people are not really coming up to him and repeating his thoughts of earlier in the week word for word. This is a hallucination. Someone is walking up to him, and he hallucinates them saying his thoughts of earlier in the week.

Same thing with the folks at the traffic lights. They aren’t talking to him. He’s just hallucinating them talking to him.

The pieces of paper. He is just finding pieces of paper on the street and looking at them. Then he hallucinates the words of his thoughts on the paper.

Some schizophrenics experience their thoughts being broadcast out to others, sometimes insults, and then they hear the other people broadcasting angry response thoughts back to them. What a strange experience!

This case is very weird, and it was explained as so real that for a while I wondered if the guy was mentally ill. I thought he might have been psychic. He says he’s not mentally ill, just psychic, and he has not been diagnosed. All of those reactions are typical.

My own experiences began a long time ago when I noticed a conversation traveling circuits around a crowded room while remaining completely intact. It would jump from one group of people to another repeating itself, without any of those groups interacting on another dynamic. I watched this pattern loop through the room several times before I attempted to engage and alter it, rather than talking to its hosts directly.

This brought on a response I couldn’t have expected, in that suddenly a nonphysical intelligence began affecting the world around me, due to its sudden apparent sense of having been intruded upon.

Whoa! That’s really weird. Imagine being at a party. You hear a particular bit of a conversation.

“So anyway, Steve told me he really likes my hair. He was texting me but he said I didn’t answer. He doesn’t understand that it was 4:30 AM and I was out in the rain!”

Then the exact same bit of conversation, word for word, starts actually moving around the room, with different people repeating those same words above before it moves on to the next group of people. Then the conversation circles the room a few times. That would be a weird experience! I thought about this a bit and concluded that this could not possibly be actually happening. I mean, you could do it as a practical joke, but that’s not what’s happening. He is simply hallucinating this conversation going around the room.

Over years of having similar experiences of series’s of impossible coincidences, messages directed specifically to him, and the sense that this Entity was sending him missions of various sorts, he concluded that he was in touch with some psychic or mystical entity that he calls the “hivemind,” or universal consciousness. Granted, such a thing may exist, and for a while I thought the guy was psychic, but I doubt if he’s in touch with it, and I think he’s just mentally ill.

Over the years, I’ve been fascinated by the existence of this entity, and puzzled that so few (though they do exist) others are able to operate on a level where this entity has relevance. I have studied numerous metaphysical beliefs and philosophies attempting to find a corollary between it and something that was written down in history. I’m proud to say that I have found quite a few answers, but unfortunately most of them are not solid.

The entity appears to be some kind of “hivemind” entity that is in fact not conscious like we individuals are, and it seemingly does not interact with time in the same way we do. Nor does it recognize any concept of “self” due to its distributed nature. Despite all of that, it’s quite intelligent and has a decent sense of humor…For me, those moments all string together as “the entity” tries to talk to me. The message might take days to become complete and make sense, and the individuals, radio signals, television commercials, conversations on the street, cat acting funny, all of it…string together into one long coherent message…assuming I bother to listen. Furthermore, if I refuse to listen and try to block it out that’s when stuff starts going bad again.

The situation below is seriously bizarre, but I wonder what really happened.

I knew this pretty girl once who was dating a guy that represented authority to me. The guy was a lot like my father, and at the time he was being nasty to someone else so he could get what he wanted.

The girl is the focus here because of her role in that relationship. I met the guy through her in the first place, on the day I met her as well.

She was crashing his birthday party and needed a ride. Well, the message came through as the girl needing a ride again at a later time for a different scenario, but again I was the only driver available. The way she approached me about it was the message itself.

She kidnapped me and stole my car while I was sleeping in the back seat. The reason this is important about the authoritarian boyfriend is because she effectively took on his role in her own situation in order to put me in her role.

She had stolen my keys while I was asleep a few days before, and made a copy for herself. When I woke up halfway across the state from where I had parked, she explained that I could come along for the ride or wait for her to pick me up on the way back, but either way she was taking the car. I ended up driving. I would have taken her anyway had she asked, but she never asked.

This situation is so strange and is reported as if it really occurred, but I seriously doubt if it did, even though his description sounds so real.

The girl did not kidnap him and steal his car while he was sleeping in the back seat. Forget it. Simply did not happen.

Nor did she steal his car keys when he was asleep a few nights earlier and make a copy for herself. I don’t believe it. Forget it.

Nor did he wake up in the car halfway across the state from where he had parked it, with the girl driving and the girl telling him that she had stolen his car and he could either get out or go along for the drive. I simply do not believe that this occurred.

So what happened? I have no idea! But his story is so bizarre is simply strains credulity.

If you keep reading that guy’s posts (he’s not medicated), it seems like they are quite logical and make sense in a nice way, even though he is describing very strange things. But the more you read, the style of the writing itself starts seeming a little odd.

This is very typical of schizophrenic writing. At first it seems like normal speech or writing, but the more you think about it, the more there seems to be something wrong with it, though you can’t quite put your finger on it, and if someone asked you to explain why it’s strange, you could not really explain it very well in words.

This is usually called loosening of associations or formal thought disorder. Put another way, it is something like, “Talking without making sense,” but that doesn’t explain it very well.

Suppose I describe to you a series of wild and improbable adventures that I had that culminated with me going out into the woods, where bats flew out my butt and I was proclaimed King of Germany, Lord of the Jews, Prince of the Robert Lindsays and Warlord of the Race Realists at a huge feast which featured endless rounds of huge Subway sandwiches and mugs of near beer.

OK, that story is pretty weird, and no doubt it’s fiction, but it makes sense: it is intelligible and understandable. It has an intelligible story line with events described in a certain way so that everything fits together. The scenario is ridiculous, but it’s not incoherent.

Schizophrenic speech and writing is different. It is not intelligible in a very strange way. It is often almost intelligible, but not quite. For some reason, you can’t quite figure out exactly what it is the person is trying to say, and you can’t even figure out why or how it doesn’t make sense. That is thought disorder.

I believe that thought disorder is actually pathognomic of schizophrenia in a sense: that is, if you don’t have thought disorder, I don’t believe you have schizophrenia. Where there is schizophrenia, there must be thought disorder in most or possibly all cases.