When I was younger I worked for a while on a hospital psychiatric ward as an orderly. I distinctly remember this lovely former headmistress who was gripped by the unusual fear that her body was hollow and full of urine. She would sleep sitting up because she believed that if she lay flat the urine would flow up into her throat and she would drown. Any inclination towards the horizontal and she would begin to cough and splutter.
One afternoon, much taken with youthful confidence, I decided to reason her out of her bizarre belief system. She was clearly a clever woman, knowledgable about the world, and could complete the Times crossword in under an hour. So I sat beside her bed and tried to explain why these fears couldn't possibly be true. I got absolutely nowhere. Every question had a reasoned response. Her whole world-view seemed entirely consistent. There was no way of breaking it down. It was rigid and impenetrable. And therein lay her madness.
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