Review title: Lying to ourselves
This is a thought-provoking study of the history of self delusions: a king whose body was made of glass, a woman who was already dead, a clock maker who had lost his head to the guillotine, several Napoleons, and a woman who was secretly being pursued by the King of England who is in love with her. As absurd as they seem to the reader today, and as they seemed to the doctors, police, and asylum attendants who heard and recorded their stories, to the men and women who lived them these stories were the truth they lived with every day.
Victoria Shepherd first started researching and writing about these cases--mostly from France and England and spanning from the 14th to the 21st century--for a BBC Radio series, and her writing is both grounded in the historical documentation and compassionately considerate of the mental anguish and compromised lives of those who suffered from these delusions. She points out that one key reason for the geographic clustering of most of these cases is that these two countries were at the forefront of modern reform in the diagnoses and treatment of mental illness in the 19th and early 20th centuries. The victims of delusion were no longer considered incurable criminals or demon-possessed heretics. Delusions had been "caught in a web of philosophical and religious treatises, medical theory and poetry; superstitious, humoral, Christian, and psychological perspectives." (p. 114) But now the existence of historical documentation of the cases covered here is proof that someone took their cases seriously, listened and recorded their stories, and attempted to understand the root cause and cure the victim.
From the clinical documentation and treatment common themes began to emerge. For example. "A delusion of conspiracy organises the enemy. gives a shape to ambiguity, a face to anonymous players and fears. It gives a person a job to do: a bad guy to fight." (p. 98). Shepherd describes some early attempts to talk or trick the patients out of their delusions, a few successful but most not, and later clinical approaches rejected the use of such ruses as unethical and potentially harmful.
At the end of this history, Shepherd concludes "You can't therefore reason someone out of a delusion by explaining why it's not true. It is their best chance of survival" (p. 305); to the person living with the delusion, the delusion is the truth and it is bound tightly to the reality of their life. Reading these case histories helps us to understand, sympathize, and advocate for mental health.