Recently, I have been placed in charge of a psychiatric ward of roughly 50 patients, all whom have one thing in common: they struggle with various forms of psychosis.
In a nutshell, psychosis is an inability to consistently tell what is real and what is not. Simply put, a “break in reality.”
With psychosis, fantasies, dreams, and imaginations all mesh together as one.
While the average person is able to tell when they are daydreaming, wishing, or imagining, a psychotic patient can’t always tell whether something is happening in their mind or if it’s real.
They see, feel, and hear things that are not really there. Things that others can’t hear. But the part of psychosis that I find the most interesting is in their unrealistic beliefs, also known as delusions.
We had one guy who believes he founded Microsoft and some other big companies, and that powerful people set him up and locked him away in the facility.
One guy believes he is a CIA undercover agent and that he has been abandoned here by his superiors. This guy has repeatedly put himself in harm’s way trying to run away.
One believes his mom is housed somewhere in the facility, which is an all male facility, by the way, and he is here to get her out.
The funniest part is when they tell you with a straight face:
“Sir, I know you may think I am lying.” Or, “I know you may think I am crazy, but I am really not.”
How can I not like this job?
Anyways, there are a number of therapeutic strategies that help them get a better grasp of reality, but one of my favorites is called R E A L I T Y T E S T I N G.
Simply put, reality testing is an easy way to assess what is real and what is not real by simply asking one question: “Where is the evidence?”
It is a psychological tool that anyone can use to check whether what you are thinking, feeling, perceiving, or believing matches what is actually happening.
For instance, one time we asked the undercover CIA guy, “Are you aware that the CIA does not carry out any missions on domestic soil?”
He paused. For a brief moment, something shifted.
To the guy who believes his mom is in this facility, we asked, “Why would your mom, a female, be housed in an all male facility?”
Usually, the question creates a crack in their delusions. You could see their brain latching on to reality… albeit temporarily.
….
Lately, I have been thinking about how us “normal people” can also benefit from reality testing.
After all, who among us has not once believed something so strongly, and then later found out it was false?
Who among us has not created a whole story in our mind without having any/enough evidence?
Reality testing gives us a way to pause and think.
Thankfully, with reality testing, we can always check for evidence.
Think your boss hates you? Where is the evidence?
You believe someone is ignoring you on purpose? Where is the evidence?
Are you worried sick that something terrible is going to happen? Where is the evidence?
Wondering if that special someone has feelings for you too? Where is the evidence?
The truth is, our brains are incredible servants, but bad masters. And when left unchecked, they can default to erratic interpretations so powerful that it distorts our reality and curates false narratives.
We always fear the unknown, believe things will not work out or become overly optimistic, suspect other people’s motives, believe stuff about people in our lives… all without any evidence.
However, no matter what scenarios your brain is cooking up, looking for evidence is how we stay grounded in reality. Because in the end, the evidence always wins.
Thanks for reading, If you are new here, I break down complex psychological principles into clear, relatable insights that people can use to improve their lives, and mental wellbeing