Is There Such Thing as an ‘Economics-Based Psychotic Delusion’?

There is a somewhat well-known phenomenon called Jerusalem Syndrome that has gained some currency in popular culture (you can see some TV clips from the 1990s here). The folk legend goes something like this: people who are perfectly well-balanced psychologically take a trip to Jerusalem where they become psychotic; that is, they start producing severe psychiatric symptoms such as hallucinations, delusions and a general loss of contact with reality. The psychosis is, as one would expect, typically religious in nature.

Why do I say that this is a folk legend? Because it strikes me as being likely untrue. It seems far more likely that people experiencing incipient psychosis undertake a trip to Jerusalem as part of their delusion. The psychosis then becomes manifest when they arrive in the city. It is well-known that famous people who became psychotic often traveled to places of significance that they integrated into their delusions. The French playwright Antonin Artaud, for example, when he began to manifest serious psychotic symptoms came to believe that he had stumbled upon a walking stick that belonged in the past to Lucifer, Jesus Christ and St. Patrick. This prompted a trip to Ireland from which he left in a straightjacket.

The Jerusalem Syndrome brings up something that goes under-appreciated in popular culture but which psychologists and psychiatrists have long known: namely, that psychosis draws its material from the cultural material available at any given moment in time. One might say that the essence of psychosis is when certain themes from a person’s culture are pushed to their absolute extreme. Thus, for example, a devout Christian that becomes psychotic will begin to believe that they are the second coming of Jesus Christ. Many will even experience hallucinations of being crucified and so forth.

What is interesting about this, and what has been recognised by many since at least Freud, is that many cultural manifestations closely resemble psychotic symptoms. Religions and myths, for example, look extraordinarily similar to psychotic delusions — indeed, this has led some psychiatrists and philosophers to suggest that these cultural forms are often established by people experiencing what psychiatry now calls psychosis. For people interested in culture and the history of ideas this suggests that highly articulate psychotic delusions can often be extremely instructive in telling us where a society or a culture is at any given moment in time. It can tell us a lot about the underlying systems of belief that are present in society in any historical period.

Until the Enlightenment era psychosis mostly manifested as religious delusions. People that were then designated as witches and so on were often experiencing what would now be considered psychosis. (This is in contrast to people who were ‘possessed by demons’ who would be suffering from what would now be considered non-psychotic psychiatric symptoms and would be given the pre-modern version of psychotherapy: namely, exorcism). But when the Enlightenment began to spread through culture new types of delusions came with it.

The most famous and interesting of these was the case history of a man which is now known as the first description of paranoid schizophrenia. His name was James Tilly Matthews and he was a tea merchant from Great Britain who took part in the French Revolution. Matthews, who was clearly versed in the emergent sciences of his day, came to conclude that a gang of conspirators had constructed a machine called an ‘air loom’ which they were using to control his thoughts, feelings and behaviors (the picture at the top is Matthews’ drawing of the air loom). This was the first recorded delusion in which the fantasy of what would later be called an ‘influencing machine‘ appeared. In Matthews’ time he drew on the emergent discipline of engineering, today many people experiencing psychosis would likely draw on the computer sciences.

There is a very particular trait that ties the influencing machine to the old religious delusions. I shall quote from the Wikipedia page to highlight this:

The delusion often involves their being influenced by a ‘diabolical machine’, just outside the technical understanding of the victim, that influences them from afar. (My Emphasis)

Note that the influencing machine must not be understandable to the person experiencing the delusion. The delusion then becomes an effort to “endeavor to discover the construction of the apparatus by means of their technical knowledge”. In the past — and even today among more religiously minded people — delusions would involve some sort of connection with God. At first, as with the machine, the psychotic person is unable to quite grasp what God is communicating. He has some ineffable knowledge that the psychotic person must then ‘figure out’ — perhaps, for example, by undertaking a trip to Jerusalem. The psychotic episode then becomes that of figuring out what God is communicating (for a very famous instance of this see the Schreber case), just as in the instance of the influencing machine it is the process of figuring out how the machine works.

Now, why am I writing all of this on a blog about economics? For the simple reason that I have never seen a documented case of psychosis that involves metaphors derived from economics. And yet, I am certain that many of such cases exist. Indeed, they must. Discourse today, especially after the 2008 crisis, is so saturated with technical economic terms of reference that they have completely permeated popular culture. Books such as the absolutely awful Freakonomics have widely publicised ideas of rational choice and all that sort of thing.

But perhaps most of all: economics furnishes pre-made structures that can easily be integrated into delusions. For example, the idea of a utility-maximising agent who can effectively see into the future. This is an extremely similar concept to the idea of an omniscient God-figure — indeed, I think you can trace a direct lineage from Adam Smith’s ‘Hidden Hand’ (an explicit reference to Divinity), to Walras’ auctioneer, through Frank Ramsay’s central planner, right down to today’s rational agent with rational expectations. I have made this point many times before: contemporary mainstream economics discourse is the closest thing we have in academia today to a secular theology.

So, why haven’t we seen such a case emerge? Or does it exist in the literature and I have not been able to locate it? If it is indeed the former then I would imagine that people are simply not looking hard enough. But with the introduction of David Tuckett’s work into the field perhaps clinical psychologists might become more attuned to the cultural impact that ideas about economics are likely having. If anyone ever comes across anything like this please let me know. It would make for a lovely essay.