Metacognitive Delusions: What They Are, Causes And Main Symptoms
We live in times where the concept of privacy is beginning to lose its meaning: People use social networks to report almost everything that happens in our daily lives, turning everyday life into a public event
However, we harbor a bastion that is impregnable to the gaze of others: intimate thought. At least to this day, what we think about remains private unless we deliberately reveal it.
Metacognitive delusions, however, act (for those who suffer from them) like a battering ram that tears down such an impenetrable wall, exposing the mental contents or making it easier for others to access them and modify them to their liking.
These are disturbances in the content of thought, which often occur in the context of psychotic disorders such as schizophrenia. His presence also coexists with a deep sense of anguish.
Metacognitive delusions constitute an alteration in the processes from which an individual becomes aware of the confluences that constitute their mental activity (emotion, thought, etc.), integrating them into a congruent unit that is recognized as its own (and different from that which others possess). Therefore, it is essential to identify ourselves as subjects with cognitive autonomy, and to be able to think about what we think and feel about what we feel.
In this regard, there are a series of delusional phenomena that can be understood as disturbances of metacognition, since they alter the ability to reason correctly about the nature of the mental product or about the attribution of its origin. For example, an individual may perceive (and express verbally) that what he is thinking is not his own creation, or that certain contents have been removed from his head through the participation of an external entity.
All these phenomena suppose the dissolution of the self as an agent that monitors and coordinates mental life, which becomes conditioned by the influence of “people” or “organizations” that are located somewhere outside and over which there is no control. or even knowledge. This is why they have often been categorized as delusions of passivity, since the individual would perceive himself (with anxiety) as the receptacle of another’s will.
From now on we will delve into the most relevant metacognitive delusions: control, theft, reading and thought insertion It is important to take into consideration that on many occasions two or more of them can occur at the same time, since in their synthesis there is a logic that can be part of the delusions of persecution that occur in the context of paranoid schizophrenia.
People understand our mental activity as a private exercise, in which we tend to deploy a discourse guided by will. However, a high percentage of people with schizophrenia (approximately 20%) state that they are not guided by their own designs, but are manipulated from some external source (spirit, machine, organization, etc.) through a mechanism. concrete and invasive (such as telepathy or experimental technologies).
It is for this reason that they develop a belligerent attitude towards some of their mental contents, through which a deliberate attempt to take away the ability to proceed from their free will is perceived. In this sense, delirium assumes an intimate dimension that denotes deep anguish and from which it is difficult to escape. Attempts to escape from him only increase the emotion, which is usually accompanied by a strong suspicion.
Delusions of control may be the result of an erroneous interpretation of automatic and negative mental contents, which are a common phenomenon in the general population, but whose intrusiveness in this case would be valued as subject to the domain of a third party. Avoidance of these ideas tends to increase their persistence and availability, which would intensify the feeling of threat.
Strategies to avoid this manipulation can be very varied: from assuming an attitude of suspicion towards any interaction with people in whom full trust is not placed, to modifying the space in which one lives with the inclusion of elements aimed at “attenuate” the influence on the mind (insulations in the walls, for example). In any case, it implies a problem that profoundly deteriorates the development of daily life and social relationships.
2. Thought theft
The theft of thought consists of the belief that a specific element of mental activity has been extracted by some external agent, with a perverse or harmful purpose. This delusion is usually the result of irrationally interpreting the difficulty in accessing declarative memories (episodic, for example), which are considered relevant or which may contain sensitive information.
Subjects who present this delusion usually report that they cannot speak as they would like because the thoughts necessary for their expression have been stolen by an alien force (more or less known), which has left their mind “blank” or without “useful” ideas. “. Thus, this phenomenon can also arise as a distorted interpretation of poverty of thought and/or emotion (alogia), a negative symptom characteristic of schizophrenia.
The theft of thought is experienced in a distressing way, as it involves the decomposition of the history of one’s own life and the gripping sensation that someone is collecting personal experiences. The privacy of one’s own mind would be involuntarily exposed, precipitating a deathly fear of psychological inquiry (interviews, questionnaires, self-records, etc.), which may be perceived as an additional attempt at abduction.
3. Diffusion of thought
Mind reading is a phenomenon similar to the previous one, which is included (along with the others) in the general heading of alienated cognition. In this case, the subject perceives that the mental content is projected outward in a way similar to that of the spoken voice, instead of remaining in the silence typical of all thoughts. So that, You may have the feeling that when you think, other people can immediately know what you are saying to yourself (because it would sound “loud”).
The main difference with respect to the theft of thought is that in the latter case there is no deliberate theft, but rather the thought would have lost its essence of privacy and would be displayed to others against its own will. Sometimes the phenomenon occurs bidirectionally, which would mean that the patient adds that it is also easy for him to access the minds of others.
As can be seen, a laxity of the virtual barriers that isolate the private worlds of each person is manifested. The explanations given for delirium are usually of an incredible nature (encounter with extraterrestrial beings, existence of a specific machine that is being tested on the person, etc.), so it should never be confused with the cognitive bias of mind reading ( non-pathological belief that the will of the other is known without the need to inquire into it).
4. Insertion of thought
Thought insertion is a delusional idea closely linked to thought theft In this case, the person assesses that certain ideas are not his, that they have not been developed by his will or that they describe events that he has never experienced himself. Thus, it is considered that a percentage of what is believed or remembered is not his property, but has been imposed by someone from the outside.
When combined with the subtraction of thought, the subject comes to feel passive with respect to what is happening inside. Thus, he would establish himself as an external observer of the flow of his cognitive and emotional life, completely losing control over what may happen in it. The insertion of thought is usually accompanied by ideas regarding its control, which were described in the first of the epigraphs.
Treatment
Delusions such as those described usually erupt in the context of acute episodes of a psychotic disorder, and therefore tend to fluctuate in the same individual, within a spectrum of severity. Classic therapeutic interventions contemplate the use of antipsychotic drugs, which chemically exert an antagonistic effect on the dopamine receptors of the four brain pathways available to the neurotransmitter (mesocortical, mesolimbic, nigrostriatal and tuberoinfundibular).
With atypical antipsychotics, the severe side effects associated with the consumption of this medication have been reduced, although they have not been completely eliminated. These compounds require the direct supervision of the physician, in their dosage and in their eventual modification. Despite the nonspecificity of their action, they are useful for reducing positive symptoms (such as hallucinations and delusions), since they act on the mesolimbic pathway on which they depend. However, they are less effective for negative ones (apathy, abulia, alogia and anhedonia), which are associated with the mesocortical pathway.
There are also psychological approaches that in recent years are increasing their presence for this type of problems, with cognitive behavioral therapy standing out in particular. In this case, delusion is considered as an idea that harbors similarities with non-delusional thinking, and whose discrepancies lie in an issue associated with information processing. The benefits and scope of this strategy will require, for the future, a greater volume of research.
