Abraham is an elderly male presenting with symptoms of acute psychosis. Physical exam, taken upon admittance, is normal. Psychiatric evaluation shows severe mental and behavioral distortion. Below is a transcript of the evaluation (P= Psychiatrist, A= Abraham).P. “So what brings you here today?” A. “The Lord God spoke to me.” P. “And what did God say?” A. “He told me to leave Ur.” P. “And go where?” A. “I don’t know. God didn’t tell me that part.” P. “Do you hear God talking to you often?” A. “Not really. This was the first time I heard Him so clearly.” P. “Alright. Now after God spoke to you, what happened?” A. “Well I told Sarah what the Lord God said, and I started to pack up. Told her just what He told me, that the Lord would build us into a great nation.” P. “I see. And how did Sarah react?” A. “She was startled, obviously. But when I said we could bring some of our extended family, she seemed better.” P. “And why do you think that God wanted you to go to a different country?” A. “Because he told me to. He said he would make me into a great nation, that he would bless me and my descendents, and make my name great.” P. “Do you have any children?” A. “No.” P. “But you said that God would bless your descendents and build you into a great nation. Do you and Sarah plan to have children?” A. “I don’t understand that part, either. Sarah can’t have children and we’re both too old for that anyway.” P. “Do you still believe that God was speaking to you?” A. “Yes.”
Patient exhibits strong signs of psychosis, including delusions of grandeur and reduced capacity to recognize reality. Recommend treatment with antipsychotics, and need for increased patient awareness of disorganized thought processes. Talked with patient’s wife about the condition, explained the dosage of medication and need for increased vigilance toward mental wellbeing. Patient agreed not to make any big decisions until treatment takes effect. Patient will indefinitely postpone moving his family.
Patient also agreed to follow-up with psychiatrist in two weeks to discuss medication and other long-term prevention and self-care methods in the event of a repeat severe psychotic event. Prognosis is good. Patient has sufficient family support and shows initial compliance with treatment plan.
Which is it: FAITH or PSYCHOSIS? Sometimes it can be hard to tell…
“By faith Abraham, when called to go to a place he would later receive as his inheritance, obeyed and went, even though he did not know where he was going” (Hebrews 11:8).
(This post was inspired by Genesis 12 from the Bible, The God Delusion by Richard Dawkins, and The Christian Atheist by Craig Groeschal.)