What Is Reality?
Among those of us with mental illness, some of us may experience psychosis at times. In the simplest terms, psychosis involves a disconnect from reality. That begs the question, though, what exactly is reality, and who gets to define it?
There are a lot of ways of conceiving of reality, which may be influenced by the field of philosophy and various others. A term often used in philosophy is ontology, which is the philosophical study of being. I remember having a hard time wrapping my head around this in grad school.
Part of the theory base for my master’s thesis was social constructionism; from that perspective, reality as we experience and understand it is socially constructed. That means that our experience of mental illness goes beyond simply the biological effects of the illness and is shaped by what we’ve learned from our social community’s understanding of what mental illness is and what it means to have mental illness. That’s not to say mental illness doesn’t exist, but it would be impossible to separate from social constructs. To me at least this makes a lot of sense.
Realism is the idea that there is an underlying, immutable version of reality. Where this starts to falls apart in my mind is that even if there is a concrete reality at some level, does that even matter when perception of that reality is an inherently subjective experience? What I perceive in the environment, even when fully compos mentis, is going to be quite different from what my guinea pigs perceive in the same environment. If something is reflecting green wavelengths but I perceive it as blue and the guinea pigs perceive it as grey, are any of us right or wrong?
That brings me to another concept I didn’t really get in school — epistemology. Epistemology looks at how we know things, and an epistemological question might be whether the world we perceive is the real world itself or an internalized copy. Epistemological dualism is the view that our conscious experience is not in fact a direct representation of reality.
To head in a different direction, quantum physics involves uncertainty principles and superpositioning and all of those things well beyond the grasp of most of us. Quantum physics is the source of the Schröedinger’s cat thought experiment, in which a cat is seen as simultaneously dead and alive to match on a larger scale what is seen with superpositioning of quantum particles. Although this is just a thought experiment, where would the reality lie?
So, if no one can agree on what reality is or isn’t, how does one evaluate the lack of connection to reality that would represent psychosis? Part of it is concordance with other people’s perceptions. Not everyone’s going to agree, but there should be some element of similarity. Another element is the meaning attached to the perception. In psychosis there is often tremendous meaning attached to what would otherwise seem to be a relatively minor sensory stimulus.
While a medical model of reality may be more concrete than philosophical approaches, philosophy probably feels a bit vague for most of us. As long as we’re perceiving the world through our fallible human senses, reality will probably always be an elusive concept, and psychosis will always be a fallible construct.
To quote the wise words of Lisa Turtle from Saved by the Bell: “But I ask, if I think not, am I not? I think not. Don’t you think?”
Originally published at http://mentalhealthathome.org on April 26, 2019.