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From the Editor

Self-deception : A double-edged trait

Psychiatric disorders are extremes of self-deception gone awry across complex neural pathways.

Vol. 7, No. 7 / July 2008

Consider these common human tales:

  • A prominent politician who made his reputation combating prostitution loses his job after being discovered to have consorted with many "escorts." He believed he would never be caught.
  • A sociopathic man charms a young woman and convinces her he will love her forever. She is infatuated with him. He dumps her a month later.
  • A gambler is "convinced" his next bet will win back his previous losses and ends up losing his shirt again.
  • Voters elect a politician who promises to solve all their problems but are disillusioned a few years later when things have barely changed.
  • A woman with severe chronic fibromyalgia seeks the help of a shaman in her village in Haiti. He pain amazingly disappears for a few days before recurring.

The human brain has been both blessed and cursed during its evolutionary journey by developing the capacity for self-deception. Unlike other living things, humans are capable of massive self-deception—as these tales show.

Advantage: survival

Self-deception's upside is obvious, with established survival value. Hope, optimism, and self-confidence in dark times are antidotes to capitulation, despair, and inaction. Infatuation helps perpetuate the human species, and "eternal love" leads to other obligatory self-deceptions such as "till death do us part." Sometimes self-deception helps communities survive by promoting altruism, charity, and compassion for strangers.

For us in the health professions—especially psychiatry—self-deception's benefits for patients are well recognized: a remarkable healing capacity, an almost magical placebo effect from drug therapy or psychotherapy, and the advantages of positive transference toward the physician. Without self-deception, our patients could not respond to support and reassurance or resist hopelessness and the urge to give up and end their lives.

Disadvantage: suffering

But self-deception has a serious downside as well, from hubris and arrogance that end badly to blind faith and gullibility that lead to joining cults and "drinking the Kool-Aid," from unshakable belief in astrology or fanatical pursuit of a cause to believing in nothing and wasting one's life with nihilism.

The biology of self-deception also may represent the foundation of psychopathology, such as:

  • unremitting panic and anxiety associated with a firm belief in impending doom
  • bizarre, fixed, false beliefs of schizophrenia
  • grandiose delusions of bipolar mania
  • melancholia's profound and inconsolable sorrow, futility, and worthlessness
  • pervasive belief in one's repulsiveness by attractive women with dysmorphic body disorder
  • distorted conviction of obesity in skin-and-bones teenagers with anorexia nervosa
  • unshakable parasitosis of a delusional disorder
  • tortured and agonizing obsessions to perform meaningless rituals.

Psychiatric disorders are extremes of self-deception gone awry across complex neural pathways, encompassing emotions, thoughts, behavior, and cognitions. Human adaptation to stress or serious illness is often enhanced by the blissful escape of self-deception, but its curse can destroy lives and cause untold suffering.

So, are nonhuman creatures spared the double-edged sword of self-deception? If so, then why do dogs have unshakable loyalty, even when their owners abuse them? Maybe self-deception is not uniquely human after all.

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