Jan 302022

Delusions are false beliefs not at all consistent with reality. Although such thoughts might appear to comprise a separate category from normal thoughts, the content of thought consists of a spectrum from very tight and logical all the way to delusions. The content of thought is best viewed as cognitive distortions given that it is very difficult to perceive the exact nature of reality, an ongoing struggle for scientists. Minor cognitive distortions include positive and negative spins on experience, attribution biases, and fantasy. Positive cognitive distortions commonly provide a powerful psychological defense capacity, such as self-enhancing spins on events, and favorable attribution biases. For example: “Even though I did not complete university, I’m smarter than most people who have done so,” and, “The reason why I did not do well on that performance evaluation is that my boss is a difficult pain in the ass with unreasonable expectations.” Moderate level cognitive distortions consist of more extensive fantasy involvement, magical thinking, and over-valued ideas. There are many examples, including superstitions, belief in fortune telling and horoscopes, and reliance on unproven mystical modes of healing. Religious beliefs also constitute moderate level cognitive distortions with obvious defensive value, because first, there is no objective evidence for such beliefs and science if anything indicates that they are false, and second, such beliefs comfort as when answers to psychologically disturbing concerns are provided, as in, “It is God’s will that this happened,” and “I will go to a nice afterlife.” Extreme level cognitive distortions constitute delusions as the beliefs are not at all consistent with reality.

When under stress more extensive cognitive distortions frequently emerge, particularly in people vulnerable to this occurrence. The Covid-19 pandemic has generated enormous stress for the majority of the population, evident in multiple ways including illness, death of family members and friends, social isolation and loneliness, loss of jobs, rising prices, a sense of insecurity, delayed or cancelled medical interventions, the list almost endless. Consequently, more extreme cognitive distortions qualifying as delusions are seemingly rampant, and particularly expressed by vaccine and/or mask resistors. Many such delusional beliefs have been expressed such as:

The pandemic is not real:Covid-19 is clearly a new virus that has been repeatedly detected in infected humans.

Covid-19 is really just a cold virus:viruses that cause the common cold include rhinoviruses, adenovirus, and select coronaviruses, but the Covid-19 coronavirus is novel causing infections that are much more serious for many people than those involving common cold viruses.

RNA and DNA vaccines are designed to control our genetics:these vaccines have been in development for decades with testing, and fortunately this process was far enough along that Covid-19 came at the right time. The nature of these vaccines is that they utilize our natural capacity for manufacturing proteins to produce proteins present on Covid-19, enabling the immune system to launch an antibody attack against the virus. No other occurrence, and certainly not control, transpires.

Vaccines are designed to reduce the population of the world: it has been said that the only thing that we learn from history is that we learn nothing from history, and those advocating such beliefs might want to visit historical data. Many infections that brought disease and death, such as smallpox, pertussis, diphtheria, mumps, measles, rubella, tetanus, and polio have been virtually eliminated due to vaccinations. Interestingly, the only one that has been totally eliminated is smallpox because the sole reservoir was humans; it could not hide in other animals. Sadly, if vaccinations for smallpox were to transpire in this era the disease might not have been eliminated due to vaccine resistors.

Masks do not help:surgical type masks have been shown to reduce the spread of pathogens including Covid-19. Those who doubt this might request that operating room staff do not wear masks during their surgery.

As a psychiatrist and psychotherapist, I recognize delusions and treat them, both with antipsychotic medication and psychotherapy. The basis of psychotherapy for delusions is normalization, appreciating that cognitive distortions comprise a spectrum, with the goal of shifting extreme ones into the normal range. This involves a three-component process. First, have the person provide high quality evidence, such as will hold out in court, for their belief. Second, have the person generate alternative beliefs to their preferred one, these beliefs diluting the delusional one and fostering greater cognitive flexibility. As a therapist do not challenge their belief, but instead take it as one possibility. Third, have the person try to test the delusional belief. For Covid-19 beliefs qualifying as delusions, those holding such beliefs need to provide solid evidence. At this point, most or all will seek sources of information that confirm their belief with no due diligence of the credibility of the source—a self-confirming bias. No reputable information source provides any evidence in support of Covid-19 delusions. Based on this outcome accept that the preferred belief is only one option and generate alternative possibilities, the more the better. For example, “I have received many vaccinations prepared in different ways and am still alive, so maybe this one will be okay,” “Many people have died of this virus so it must be real,” “Physicians who care for patients cannot possibly benefit financially or otherwise, and some have died, so it might be worth really listening to what doctors have to say.” Next, try and test the preferred belief. For example, talk to and observe vaccinated individuals to determine whether or not they are still alive, and if they have mutated into a different person. As with delusional patients, some can and will work with this process, while others will require antipsychotic medication. Hence, an option might be to provide free antipsychotic medication to those suffering from Covid-19 delusions!

Accepting that the various distorted beliefs surrounding Covid-19 comprise delusional level cognitive distortions provides an accurate framing of the problem. Appreciate that as with milder and moderate level positive cognitive distortions, these beliefs provide psychological defense against fears associated with the virus, and also larger fears such as those derived from not understanding the nature of science. Recognize that when under intense stress as most people are with the Covid-19 pandemic, more extreme defensive cognitive distortions emerge in those most vulnerable to this process. Then approach the problem with a focus on normalizing the belief, and if this fails then antipsychotic medication might well be warranted.

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