Schizophrenia

Schizophrenic delusions. You can’t reallybe the son of the emperor of Japan. Unless you just happen to be by birth. Congenitally, the son of the emperor of Japan.

One of our patients at Shuang-Ho Hospital, part of the TMU system. He believes it nonetheless, he believes that he is the son of the emperor of Japan. He suffers from schizophrenia and this is one of his delusions, one of his refractory false beliefs about his condition. He’s an interesting guy when you ask him. So what’s the basis for your belief, and he’ll tell us some interesting stories. So we have a japanese store in Taipei. It’s a department store it’s called SOGO. And the people at the store, they’re dressed up in uniforms that people tend to associate with Japan. And every morning, they’re out in front when thedoors open, and they say “おはようございます” good morning, and they bow.

So he tells us that he goesthere in the morning, and everyone bows tohim and speaks to him in japanese. Thereforehe must be the son of the emperor of Japan.

It’s delusion and we know that. One of the thingsthat we believe is happening in their brains, is also connected to consciousness. It seems that patients who suffer from schizophrenia, that they don’t so much have difficulty with regular perceptual or sensory processing. For example the visual information from the world.

But what happens is that they lack the ability toamplify that with their attention, and becausethey cannot amplify it with their attention, therefore that sensory information from the world it does not become conscious.

What we think is happening is this.

There’s a model of the brain that has been around for almost 200 years, certainly 160 or 170 years. And the model of the brain is called a bayesian model of the brain. The idea is that we need to have a lot of prior. Prior probabilities, prior expectations abouthow the world is. So let us suppose that somehow in your brain. You have accumulated a lot of information about the world and information about who you think you are. In this case, he thinks he is the son of the emperor of Japan.

The problem is I can go up to him, you can go up to him, anyone can go up to him and tell him. But there’s all kinds of counter evidence that you are not the son of the emperor of Japan. You’ve never been to Japan, you weren’t born in Japan, you have no japanese in your bloodline, in your family. It doesn’t seem to matter because once these prior expectations, these beliefs, these delusional beliefs are in place to change them, we need to get more and better information into your consciousstream. In order to change the expectations that you have of the world and of yourself.