Induced Insanity

INDUCED INSANITY, a psychiatric disease that develops under the influence of the mental illness of another person, wherein the most characteristic symptom is the patient's repetition of the delusions expressed by this initially ill person. Induction consists precisely in the transmission of a delusion to another person. The French described this form under the name folie à deux. One must distinguish from true induced insanity: 1) cases where two persons close to each other fall ill simultaneously with identical forms of mental disorder, and they may also have similar delusional ideas (folie simultanée); such cases are encountered in familial schizophrenia, in manic-depressive psychosis in the form of identical and simultaneous attacks in twins and other close relatives, and in hysterical diseases that have developed in two or more persons under the influence of the same causes (e.g., during an earthquake); 2) cases where the mental illness of one person serves as the final push for the development of an independent mental illness in another person, for example, in manic-depressive psychosis and hysterical reactions, where the symptoms of the first disease may provide pathological material for the second. The mental illness of one person may also serve for another person as the event that, like a key (Schlüsselerlebnis), opens the way for further pathological (paranoiac) development of the personality; of course, echoes of the first patient's delusion will be found here as well. True induced insanity belongs to the group of psychogenic reactions and is the concluding link in a long chain of various forms of mental induction, the majority of which belong to the norm. In general, mental induction represents one of the most widespread phenomena in the field of human relationships. The perception of another's opinion without independent critical processing is one of the simplest and most frequent types of induction. It is based on the feeling of faith. Strong affects are especially contagious; by sharply narrowing the sphere of consciousness, they condition the extremely easy transmission of the representations and ideas associated with them. The spread of prejudices, panic rumors, national enmity, sectarian teachings, etc., is based on this. The submission of the weak to the strong also contains elements of induction. The transition from norm to pathology occurs without a sharp leap. It is not always possible to distinguish the delusion characteristic of ignorance from a true delusion. When a mentally ill person induces their delusion in another person and the latter gives the delusion a more or less understandable interpretation, such induction can be considered as not yet going beyond the bounds of mental health. If, however, independent delusional experiences appear in this person, then induced insanity results. Most often, a delusion of persecution is induced, less often a delusion of grandeur (in particular, religious delusion). It is quite natural that a systematized (paranoiac) delusion has an inducing effect; it is expressed convincingly and persistently; the delusional constructs have a certain internal logical connection; the delusion is more or less plausible. All this gives such a delusion a suggestive power. Thus, the inducing persons are most often paranoiacs and litigious individuals. It is true, however, that the transmission of highly absurd delusions also occurs. In induced delusion of persecution, the clinical picture usually develops in such a way that the patient infects one of their closest associates with their delusion. The latter not only begins to believe in the reality of the hostile intentions and actions against the patient, but also experiences fear, hears suspicious rustling, notices an unusual taste in food, sees oddities in people's behavior, and finds signs of impending danger. False memories are added to illusions and hallucinations. Both patients, by influencing each other, intensify the feeling of fear. Together they take protective measures, isolate themselves from people, lock themselves in the house more securely, sometimes commit suicide together, or, conversely, jointly take an aggressive position and conduct litigation. Among the various types of delusion of grandeur, religious delusion possesses the greatest inducing power. Around a patient who considers themselves a prophet or a new Christ, people group together who believe in their high calling, interpret their sayings, and tell of the miracles they perform. In these persons, hysterical mechanisms are easily brought into play: they experience states of ecstasy (“descent of grace”) with corresponding hallucinations (most often visual and olfactory), attacks of excitement with clouding of consciousness, impulsive actions, sexual excesses (“promiscuous sin”), and convulsions. The tension of induced religious delusion can reach extreme degrees and lead to mass suicide (self-immolation, self-burial). Sometimes religious delusion is induced in a few people, and sometimes real mental epidemics develop or entire religious sects are formed. At the basis of induction always lies an affect: in the case of a delusion of persecution, it is fear for the patient and then for oneself; in the case of a delusion of grandeur, it is dissatisfaction with life and a desire to approach a being of a higher order and receive a share of the blessings flowing from them. Induced insanity develops most easily among persons who are close to the mentally ill (relatives and friends), especially when living together. A predisposing factor is increased suggestibility and a tendency toward imitation. Therefore, the mentally deficient and psychopaths are especially prone to induced insanity. Hunger, exhaustion, alcohol, and also ignorance increase the inclination toward induced insanity. The course of the disease is favorable, but with a severe predisposition, induced insanity can lead, as already mentioned above, to an independent further paranoiac development of the personality. The prevention of induced insanity requires the internment of mentally ill persons capable of exerting a strong influence on those around them.