Faulty 'Reality Testing' Causes Dreams, Deja Vu and Delusions

Dreams and delusions have a common link of being associated with faulty reality testing in the brain's higher order cognitive skills making it difficult to come out of the delusions.

Dreams and delusions have a common link of being associated with faulty "reality testing" in the brain's higher order cognitive skills and this makes it difficult for the person to break free of their delusions, despite overwhelming evidence explaining the delusion isn't real.

In a new paper published in the journal frontiersin.org, University of Adelaide philosopher Professor Philip Gerrans says dreams and delusions have a common link – they are associated with faulty "reality testing" in the brain's higher order cognitive systems.

About Schizophrenia
Schizophrenia is a mental disorder characterized by symptoms of thought, behavior and social problems.

"Normally this 'reality testing' in the brain monitors a 'story telling' system which generates a narrative of people's experience," Professor Gerrans says.

"A simple example of normal reality testing is the person who gets a headache, immediately thinks they might have a brain tumor, then dismisses that thought and moves on. Their story episode 'I might have brain cancer' gets tested and quickly rejected.

"In someone who has problems with reality testing, that story might persist and may even be elaborated and translated into action. Such people can experience immense mental health difficulties, even to the point of becoming a threat to themselves or to others," he says.

Cognitive Decline Following Cardiac Surgery
Delirium is not a disease but a syndrome characterized by general disorganized behavior and attention deficits. It involves cognitive disorders, hallucinations, delusions, deranged sleep-wake cycle.

In his paper, Professor Gerrans discusses delusions triggered by feelings of familiarity and unfamiliarity, such as the "Capgras delusion" – the delusion of "doubles". One example is of a man who, after serious head injury following a motor vehicle accident, returned home from the hospital after a year only to state repeatedly that his family had been replaced by impostors.

"His family looked familiar but didn't feel familiar, and the story in his head made sense of that feeling. It didn't matter how much people tried to point out that his family was the same, in his mind they had been completely replaced by impostors," Professor Gerrans says.

Dreams Demystified
Dream theories and meaning of dreams abound while our dreams continue to intrigue us, puzzle us, even embarrass us, and we often wonder if our dreams have a bearing on something in our real life.

He says in the "Fregoli delusion", people think they're being followed by a familiar person in disguise as a way of coping with a feeling of familiarity evoked by seeing a stranger.

"People also experience feelings of familiarity and unfamiliarity in déjà vu – a sense that a new place is strangely familiar, and the reverse, jamais vu – a sense of extreme unfamiliarity evoked by a familiar place. However, such feelings do not lead to delusion in people whose reality testing is intact."

REM Behavior Disorder
REM Behavior Disorder (RBD) is a sleep disorder in which the person acts out dramatic or violent dreams during Rapid Eye Movement (REM) sleep.

Professor Gerrans says better understanding this reality testing system could help to improve outcomes for people living with such difficulties.

"Trying to treat someone experiencing these delusions by telling them the truth is not necessarily going to help, so new strategies need to be developed to assist them. Ultimately, that's the aim of this work – to help explain the nature of reality testing in order to help people find a way of working through or around their delusions so that the delusions no longer adversely affect their lives."

Source-Eurekalert