This article is for all readers, but mental health professionals are particularly invited to consider the implications put forth here. Feel free to jump around.
Peak Oil is a very upsetting topic for most people, because the research on it is so darn convincing. Those that aren’t interested in doing that kind of research, however, might be quick to tell you that you’re “crazy” for thinking that way. I want to spend some time in the next few articles talking about psychiatric conditions you might get labeled with as you talk about Peak Oil, or some psychiatric symptoms you might be experiencing after learning about Peak Oil. Be aware that knowledge of Peak Oil is no guarantee of emotional or mental health, and can put significant strain on people. I’ll address two conditions today, namely, Delusional Disorder (DD) and Paranoid Personality Disorder.
Specifically, DD is defined by the presence of non-bizarre delusions of at least one month’s duration, and by the absence of hallucinations, disorganized speech, disorganized or catatonic behavior, flattening of affect (emotional expression), markedly impaired functioning (thinking clearly), odd or bizarre behavior, underlying medical condition, or physiological effects of a substance (i.e., drug use.). In other words, sufferers of DD are emotionally or physically unimpaired, and their only symptom is a non-bizzarre delusional framework.
Paranoid Personality Disorder (PPD, DSM-IV) is not considered to be a psychotic disorder; individuals are not delusional—they do not cling tenaciously to an elaborated false belief—nor have they experienced other psychotic symptoms. They are, however, very distrustful and suspicious of others, whose motives are interpreted as malevolent. The strategy employs vigilance, rather than deception, to cope with social difficulties. Think of a smoke detector set very low to sense any fire. PPD may be a response of “danger!” when little actual danger is presents itself. However, forewarned is forearmed.
By itself, DD is rare (0.01-0.03%), but when present with other symptoms, like depression and auditory hallucinations (hearing voices), it is not. In one population survey it’s prevalence was 3.3%, and in a large cross-cultural survey of 18,980 people, its prevalence was 1.9%.
In principle, delusional themes could relate to any ideas in our physical, material, cultural or social world, but they don’t. They aren’t random or arbitrary. Cross culturally, the vast majority of delusions, every common category of non-bizarre delusion relates in some way or other to either draw out some social benefit or to diminish or reduce the consequence of social deficits.
According to DSM-IV (APA 1994) virtually all non-bizarre delusions belong to one of five themes:
(1) Persecutory: Individuals believe that they are threatened by powerful others. These are the most common type of delusions and individuals with these delusions can give very convincing accounts of the reputed threat, behave consistently with the delusion and show signs of genuine fear and distress. (2) Erotomanic: Individuals believe that another person, usually of high status, is in love with them. Males with erotomanic delusions often attempt to rescue females from some imagined danger. The delusional person does not necessarily claim to be in love with the target. (3) Somatic: Individuals with somatic delusions, which are often difficult to distinguish from Hypochondriasis, are preoccupied with the fear or idea that they have a serious disease based on a misinterpretation of one or more bodily signs or symptoms. The fear persists despite medical reassurance. (4) Jealous: Individuals believe their mate to be unfaithful. (5) Grandiose delusions are one in which the individual believes they have been endowed with special powers that, if exercised, could do extraordinary things like cure disease, banish poverty, ensure world peace, etc.
Delusions are among the most difficult psychiatric conditions to treat. When delusions are separated from psychotic and other symptoms, contributing factors such as social exclusion and isolation emerges. One researcher argues that delusions are a universal psychological adaptation, and are found in all cultures. Another researcher makes the following cross-cultural generalizations about delusions:
1. Delusional themes (e.g., grandiose, persecutory) vary little, if any, across cultures, whereas the specific content (e.g., persecution by shamans) may be influenced by culture.
2. Culture-bound and secular delusional content are not mutually exclusive, but may coexist in the same individual.
3. Delusional content can be culture-bound, or secular, and yet still give rise to behaviors that are highly culture bound (such as building a religious shrine or undertaking amok-type violence).
Fear of the Bongo-Bongo
Hagen (1995) developed a theory that states that individuals facing severe social threats develop powerful delusional systems. These caused them to unconsciously deceive their fellow group members in order to receive social benefits that they had lost or been unable to obtain.
“For example, an individual experiencing a persecutory delusion—the Bongo-Bongo are trying to kill me—would display very convincing signs of fear and distress and be able to cite evidence of the truth of their claims. In a small, somewhat isolated band with genuinely hostile Bongo-Bongo neighbors, such a display could be convincing enough that fellow group members would cooperate with this individual against the Bongo-Bongo, a common enemy. Indeed, it is difficult to see why an otherwise normal individual displaying convincing, culturally consistent fear towards a known enemy would not be believed at least some of the time. And if they were believed, it is difficult to see why they wouldn’t at least occasionally obtain social benefits. Since external attacks are unlikely and exaggerated fears are easy to disprove in these contexts, delusional displays of persecution have little chance of success and in fact are usually maladaptive—they tragically tend to intensify social isolation rather than mitigate it. Although cooperative deficits should cause delusions in all societies, delusions will usually provide social benefits only in the now rare small, kin-based societies. Cults may be the exception. Cult leaders may be, in some cases, paranoid and/or grandiose individuals exploiting lonely and vulnerable people. ”
A “cooperative deficit” occurs when you need help and assistance from others, which is not forthcoming. The Peak Oil movement is preoccupied with how local communities could reconfigure their economic, social and political architecture in order to prepare for the larger collapse of the fossil fuel infrastructure. This can be understood as the ultimate “cooperative deficit”.
Paranoia & Life Crisis
The paranoid process begins with persistent interpersonal difficulties between the individual and his family, his work associates and superiors, neighbors, or other persons in the community. In addition, the person is faced with an actual or threatened loss of status, such as a death in the family, loss of a job or professional status, a promotion that didn’t come through, or a divorce. The person feels the event as “intolerable” or “unendurable” because no acceptable alternative presents itself. Example might include a man later in life is prevented from progressing up his corporation’s ladder, and knows he can’t start over, or an runner loses his legs in a car accident. All paranoid psychosis in one examination, was caused by an event that isolated the individual and made him feel like an outsider, either by making him unpopular within his own group (think: Whistle-blower), or by transplanting him to new and strange surroundings.
In contrast to other affective psychiatric difficulties (like depression), at the start of the illness, paranoid patients had low social class, had few or no surviving children, lived alone, or suffered from social deafness—all social resource variables. Paranoid patients were found to have had more difficulty than affective patients in forming and maintaining satisfactory interpersonal relationships, and had been more solitary, shy, reserved, and suspicious, and less able to display sympathy or emotional connections.
Researchers concluded that when many factors where combined, (such as being unmarried, having few close relatives, belonging to lower social class groups, or becoming deaf) and when these factors are expected to increase the chances of hardship, insecurity and loneliness in later life, the accumulated sense of deprivation and injustice might contribute to a condition leading to paranoid illness.
The opposite–being married, living with others, having frequent social contacts, working full-time, and belonging to high status social groups were important predictors of good outcome. Living alone, having few social contacts, and not working prior to admission, on the other hand, were by far the best predictors of poor outcome for this group of patients.
Exclusion, Societial Isolation & Deprivation
Those with cooperative deficits imposed on them by society increased the rate of delusions. Solitary confinement, for example—an extreme form of social isolation—has long been known to cause delusions at a rate of 58% in one study. Immigrants and refugees, who have often left family, friends, and other important social ties behind, and face discrimination and prejudice, may be at a disadvantage in attaining cooperative relationships. Numerous studies have found extremely high rates of delusional and paranoid symptoms among immigrant and refugee populations. Two studies showed rates of DD among immigrants to be 40-50 times that of the indigenous population, compared to only a 3 1/2 fold increase for schizophrenia or affective disorders. Powerlessness, victimization and exploitation were the causative factors of mistrust and thus paranoia. Low educational attainment, low social class, together with belief in “external locus of control”—the expectation that “outcomes of situations are determined by forces external to one’s self, such as powerful others, luck, fate, or chance,”—was strongly associated with “mistrust”, the feeling that it is safer to trust no one. Mistrust, in turn, was associated with “paranoia.”
One researcher concluded that:
- [I[t is this process of exclusion and isolation which leads to the development of the delusional framework and not the converse.
He notes that paranoia emerges in situations where “the goals of the individual can be reached only through cooperation from particular others, and in which the ends held by others are realizable if cooperation is forthcoming…”
In other words, a combination of real life circumstances that decrease one’s capacity to exert influence over one’s environment and intensified alienation create the breeding grounds for DD and paranoid problems. While most people would think that severe social failure would be a consequence of suffering delusions, the opposite is true. Severe social threats precede the onset of delusions, and are a likely cause of delusions.
When resources are severely taxes or limited, the two strategies of deception (DD) and vigilance (PDD) are used to minimize the damage.
The Desperate Lie
Delusions can be thought of as a sort of desperate “lie” or deception to rally the help of other people, solicit their cooperation, to boost one’s social standing or protect what one has. In persecutory delusions the lie is “help me to defend myself so we all won’t be killed.” In erotomanic delusions the deception is “I am so desirable, others of high status love and need me.” In somatic delusions, the deception plays on the social norms of helping the sick or the assumption that if one helps an ill person, the favor will be returned. In jealous delusions, the cognition increases vigilance and hopefully reduces the chance for infidelity. In grandious delusions, one attempts to boost one’s respect or admiration for the incredible power one possesses.
Vigilance: Looking Out for Number One
Just as delusions can be thought of as “lying,” paranoia can be thought of as intense vigilance. If one is persecuted and socially threatened, it makes sense to increase their vigilance toward the social environment. If one has few around them to care for them, serious illness is a greater risk, and therefore minor ailments must be paid close attention to. A person with few resources is at greater risk for losing one’s spouse, therefore jealous guarding may appear necessary.
Delusions: Not Kid’s Stuff
There are, of course, severe risks to those who are found to be lying, including greater social isolation and fewer future opportunities to get others to cooperate with you (think: the boy who cried ‘Wolf!’) and therefore, it is likely to be used in only extreme situations. Those in middle age are more likely to suffer delusions than children, or young adults. While children often fear imaginary dangers, very few people younger than 20 are diagnosed with DD and cases of DD younger than 15 are almost unheard of, although other psychiatric conditions are common in children. If DD is a type of “lying” to elicit support, few are likely to believe that children have powerful enemies, have famous people in love with them, or even have a spouse to feel jealous.
A Little Help from Friends & Family
Also interesting is that when a delusion becomes accepted and incorporated into the social network, the delusion itself appears to lift. For example, one study found that when a patient’s family accepted the delusion as ‘real’ (an evil demon) and took actions to unite against it (via prayer, for example), the delusion lost its force and the symptoms were alleviated. In another study of individuals in the Northern Aboriginal Reserve, members of the clan “close[d] ranks [with the patient] in indignation against the putative sorcerers.” Many anthropologists argue that sorcery and witchcraft accusations often reflect genuine political conflicts.
Paranoia and delusions are desperate attempts to either protect what limited resources a person has, or to elicit support from others. Sufferers claim to have important information and abilities, fears of external threat, illness, and intimate relations with high status individuals. They have highly guarded “secrets” that make them important and useful. In small, kin-based societies, it was much harder to confirm the truth of falsehood of such claims than it is today. Nevertheless, under times of severe stress, delusions and paranoia are attempts to make a bad situation better, even if only in the short term. These disorders arise from real life problems made worse by social deficits that interfere with the person’s abilities to reach out and get help from others. It isn’t all “in their heads.” Paranoid individuals do have enemies or at least not the extensive network of friends that are reassuring during the tough times.
Traditional treatment for these problems are powerful drugs that suppress delusions, have dangerous side effects, including sometimes irreversible brain damage, and do nothing to improve the person’s basic life situation. If paranoia and delusions are cross-culturally occurring phenomenon that could have a significant component of social support-seeking, we’d be wise to ‘first do no harm’ and attempt to assist the client in developing these avenues. As Hagen says “it is a scientific and ethical imperative to investigate possible functions for these deeply mysterious cognitive processes.”
We might, therefore, conclude that given the clear and present danger of Peak Oil, the fear about dramatic loss of control over many central aspects of our lives, and the feelings so many experience of the situation being “intolerable” with no presenting alternative, we would expect to see DD or paranoid features in some percentage of our community. The more proactive these people are in finding and getting active in Peak Oil or sustainability groups in their community, and the more friends and intimate partners who join with them in such pursuits, the quicker these symptoms are likely to be alleviated.
The paradox should be evident to the reader: It isn’t paranoia or delusions that “cause” one to accept the reality of Peak Oil, but rather it is the larger cultural refusal to admit to and actively try to mitigate the upcoming crisis of Peak Oil that causes the problem.
Hagen, E. (1995). Delusions as exploitative deception http://itb.biologie.hu-berlin.de/~hagen/papers/Delusions.pdf
Have you been feeling paranoid about Peak Oil, but afraid to share your thoughts? Worried that you are going “crazy?” You aren’t alone. Drop a line and tell us how things are for you, knowing what you know, at PeakShrink@peakoilblues.com.