[quote author=ozziemate link=topic=924.msg4699#msg4699 date=1248512047]
And what do you believe is the patients state of mind leading up to onset of such symptoms as auditory hallucinations?[/quote]individuals are unique and the development of psychosis will be unique to that individual, there are certain recognised precipitating factors, but not everybody that develops a psychotic illness will experience those precipitating factors. for some people their symptoms are spontaneous without any precipitating factors. to use my own illness as an example the precipitating factors was an attempted murder on myself, my fear was founded in reality people did want to kill me, my paranoia grew from people wanting to kill me to everybody wanting to kill me. my delusions and hallucinations developed around this idea that i was marked for death. during this time i never once questioned my own sanity. my psychosis began to develop after two years of living in this state of fear. schizophrenia was diagnosed in the third year.you are missing something of immense proportion to the subject. at this point the patient is already ill. persecution and intimidation fears are in response to the symptoms of psychosis. using auditory hallucinations as an example. A patient hearing voices is not hearing voices because they fear they are going mad. they hear voices and then they may fear they are going mad. speaking generally of course not all cases will be as clear cut as that. other patients may hear voices and believe they are in communion with god. fear of madness as far as i am aware is not a recognised feature of psychotic disorders. it is a recognised feature of the anxiety disorders.
this is true but the degradation you speak of is not necessarily "the of fear of losing ones mind".Normally a person just doesn't go from being "normal" and healthy of mind to hallucination with out some degradation.
paranoia can devleop for many reason besides those that you present here.It is proposed that that initial degradation is caused by the onset of paranoia, due to either no advice, bad advice, over emphasis on sensational medical opinion and statistics and so on....leading eventually to the state where the mind is now over loaded with the stresses associated and starts to express itself vividly not only in an auditory fashion but also often in a visual fashion.
i dont dispute the fact that fear is a preciptiating factor, what i do dispute is fear of losing ones mind being THE factor, which is what you seem to be suggesting in your posts above.Also it is as I said in the maintenance of a healthy mind that fear plays a significant role in keeping things in check so to speak. It is when this fear based maintenance becomes extreme due to fears and stresses that paranoia sets in leading to severe situations such as those you have described.
So yes at this stage the horse "fear" is well before the cart...and as yet I have not found reason to change my opinion.
i do agree with this only to the point where you say fear of losing the mind, if you have ever worked with patients during acute phases of pscyhotic illnessess you will recognise that they do not have any fear of losing their mind. most often they do not believe there is anything wrong with them. the psychotic patient does not have insight into the fact they are ill. they believe that their delusions and hallucinations are real. this is fundamental aspect of the definition of psychosis.Also as a nother angle....
Most "normal " people constantly suffer minor glitches in their perceptions and think nothing of it. Hear sounds that don't have any reality to them and generally treat them as inconsequential and like wise with visual errors of perception.
I am suggesting that when a person starts to consider these routine and insignificant errors with emphasis we can start to see paranoia and fear of losing your mind set in to the point where the whole tapestry of mental order can be fragmented.