Paranoid atmospheres

Paranoid atmospheres: Psychiatric knowledge and delusional realities

Jann E Schlimme

“In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist’s “gaze” and knowledge of delusions.”

"Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge and, consequently, prevent the development of dogmatic attitudes."

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“I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge.”

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"In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person."

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"To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere."

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"As I already said, the subjective experience of the person at hand is the starting point for psychiatry. Listening carefully and with empathy helps build a good relationship with the patient, which will activate resources for coping with symptoms."

"These aims are a) the relief of the patient's suffering, b) the patient's contentment with his way of living – which includes especially the interpersonal dimension – and c) the patient being in charge of his life again."

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"The two last aims are contentious in the medical model, but not for a person-centered psychiatry when taking the first-person-perspective of the concerned person into account. It is this patient's perspective that I will focus on in my paper."

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"In other words: psychiatrists are interested in the etiology of mental disturbances of the person at hand from a third-person-perspective as well as from a first-person perspective (subjective experience, inner reality, wishes and values)."

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"With regard to this twofold assessment of psychiatric exploration it is not surprising that a psychiatrist is somehow able to look deeply into another person's mind, maybe in certain aspects even "deeper" than the person himself."

"With respect to the necessity of looking behind the subjective experience of the patient and interpreting his symptoms as signs of an underlying psychopathological process,

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we can state the thesis, that there is a latent paranoid atmosphere in the relationship of psychiatrist and patient."

"What if the old man is in fact persecuted by an intelligence service and someone added a diuretic substance in his drink in order to provoke dehydration?

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Of course this sounds a little odd, but it shows the importance of the question: how can a psychiatrist be so sure about the distinction between delusional and non-delusional realities in his day-to-day business?"

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