Do you have any thoughts on why then does psychosis typically suddenly ‘kick in’ in late adolescence / early adulthood? (and why trauma correlates with it and tends to act as that ‘kickstarter’?)
Also any thoughts about delusions? Like how come schizophrenic people will occasionally not just believe in impossible things but very occasionally even random things like ‘I am Jesus Christ’ or ‘I am Napoleon’?
and why trauma correlates with it and tends to act as that ‘kickstarter’?
No idea. As for “kickstarter”, my first question is: is that actually true? It might be correlation not causation. It’s hard to figure that out experimentally. That said, I have some discussion of how strong emotions in general, and trauma in particular, can lead to hallucinations (e.g. hearing voices) and delusions via a quite different mechanism in [Intuitive self-models] 7. Hearing Voices, and Other Hallucinations. I’ve been thinking of “psychosis via disjointed cognition” (schizophrenia & mania per this post) and “psychosis via strong emotions” (e.g. trauma, see that other post) as pretty different and unrelated, but I guess it’s maybe possible that there’s some synergy where their effects add up such that someone who is just under the threshold for schizophrenic delusions can get put over the top by strong emotions like trauma.
Also any thoughts about delusions? Like how come schizophrenic people will occasionally not just believe in impossible things but very occasionally even random things like ‘I am Jesus Christ’ or ‘I am Napoleon’?
I talk about that a bit better in the other post:
In the diagram above, I used “command to move my arm” as an example. By default, when my brainstem notices my arm moving unexpectedly, it fires an orienting / startle reflex—imagine having your arm resting on an armrest, and the armrest suddenly starts moving. Now, when it’s my own motor cortex initiating the arm movement, then that shouldn’t be “unexpected”, and hence shouldn’t lead to a startle. However, if different parts of the cortex are sending output signals independently, each oblivious to what the other parts are doing, then a key prediction signal won’t get sent down into the brainstem, and thus the motion will in fact be “unexpected” from the brainstem’s perspective. The resulting suite of sensations, including the startle, will be pretty different from how self-generated motor actions feel, and so it will be conceptualized differently, perhaps as a “delusion of control”.
That’s just one example. The same idea works equally well if I replace “command to move my arm” with “command to do a certain inner speech act”, in which case the result is an auditory hallucination. Or it could be a “command to visually imagine something”, in which case the result is a visual hallucination. Or it could be some visceromotor signal that causes physiological arousal, perhaps leading to a delusion of reference, and so on.
So, I dunno, imagine that cortex area 1 is a visceromotor area saying “something profoundly important is happening right now!” for some random reason, and independently, cortex area 2 is saying “who am I?”, and independently, cortex area 3 is saying “Napoleon”. All three of these things are happening independently and unrelatedly. But because of cortex area 1, there’s strong physiological arousal that sweeps through the brain and locks in this configuration within the hippocampus as a strong memory that “feels true” going forward.
That’s probably not correct in full detail, but my guess is that it’s something kinda like that.
This post is really interesting!
Do you have any thoughts on why then does psychosis typically suddenly ‘kick in’ in late adolescence / early adulthood? (and why trauma correlates with it and tends to act as that ‘kickstarter’?)
Also any thoughts about delusions? Like how come schizophrenic people will occasionally not just believe in impossible things but very occasionally even random things like ‘I am Jesus Christ’ or ‘I am Napoleon’?
Thanks!
Yeah as I discussed in Schizophrenia as a deficiency in long-range cortex-to-cortex communication Section 4.1, I blame synaptic pruning, which continues into your 20s.
No idea. As for “kickstarter”, my first question is: is that actually true? It might be correlation not causation. It’s hard to figure that out experimentally. That said, I have some discussion of how strong emotions in general, and trauma in particular, can lead to hallucinations (e.g. hearing voices) and delusions via a quite different mechanism in [Intuitive self-models] 7. Hearing Voices, and Other Hallucinations. I’ve been thinking of “psychosis via disjointed cognition” (schizophrenia & mania per this post) and “psychosis via strong emotions” (e.g. trauma, see that other post) as pretty different and unrelated, but I guess it’s maybe possible that there’s some synergy where their effects add up such that someone who is just under the threshold for schizophrenic delusions can get put over the top by strong emotions like trauma.
I talk about that a bit better in the other post:
So, I dunno, imagine that cortex area 1 is a visceromotor area saying “something profoundly important is happening right now!” for some random reason, and independently, cortex area 2 is saying “who am I?”, and independently, cortex area 3 is saying “Napoleon”. All three of these things are happening independently and unrelatedly. But because of cortex area 1, there’s strong physiological arousal that sweeps through the brain and locks in this configuration within the hippocampus as a strong memory that “feels true” going forward.
That’s probably not correct in full detail, but my guess is that it’s something kinda like that.