The sensory input is correct, whereas its interpretation is delusional. The patient, for example, sees a dark cloud in the sky, which, for him, is proof, beyond doubt, that he will die the day after. The German psychiatrist and psychopathologist Werner Janzarik developed his theory of structural dynamics beginning in the s.
It is an interesting and underestimated approach to the understanding of psychotic disorders, beyond mere operationalism and beyond psychoanalytical interpretation. In mental life, healthy or disordered, Janzarik differentiated between structural components that are rather firm and longstanding, such as basic ideas and values, from their dynamic qualities, which mainly address the affective field. In healthy persons, the dynamic aspect is linked to certain structural components, which may have genetic or psychological origins or may just result from a learning process.
Klaus Conrad gave a masterful description of this psychopathological phenomenon in his book on Beginning Schizophrenia. He argued that sensory input will be subjectively altered and will become symbolical, frightening, or even threatening. The psychotic person will often have the impression of ideas or experiences being forced upon him or her by an external power. This will clinically be described as a delusional syndrome. Binswanger says that one must deal with human existence as a whole in order to understand its particular abnormalities.
Delusion for Binswanger is a pathological type of world design. World design is a term which reflects the organization of all the conscious and unconscious attitudes of a human being towards all that is sensible. Minkowski attempts to characterize mental disorder as some single fundamental disturbance trouble generator and he thinks that all such disturbances are spatiotemporal in nature; by this he means that the patient with a delusion of persecution is no longer able to perceive the chance nature of all that happens around him owing to a feeling of restriction of freedom and movement the spatiotemporal disturbance , and so refers it all to himself; thus in the delusion of persecution what the patient wants is not a feeling of benevolence towards him but a feeling of ease and freedom.
Rumke maintains that delusion is a product of an ill, not a normal person.
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He offers as proof that after their recovery patients claim they did not mean exactly what they said. He also believes that delusion is a secondary and less important phenomenon, and that what is of real interest to the psychiatrist is the inner attitude of the patient, his world design and his way of thinking, even though, as he states, phenomenology of this kind will never teach us to explain the illness, it only puts us in a position to understand it.
The strength of this intentional act may become so great that the ego fails to objectify it, i. Put simply, Kronfeld says that the delusional patient cannot distinguish between phantasy and reality; this has some conceptual similarity to the notion of projection: The anthropological approach and that of Daseinsanalyse considers the problem of delusions with regard to their specific relevance for the whole life of the deluded person.
Of course, this way of resolving the crisis itself creates more problems, and is even harmful, especially to communication with others. This is nevertheless a lesser evil for the sufferer, because it can allow a new stability of mental state, even though pathological. This framework of romanticism was nearly swept away around by a naturalistic attitude, which was allied to the natural sciences and biologically oriented general medicine and psychiatry, which became more and more successful.
Rather than going into detail on this specific issue, I want to address the re-discovery of the biographical approach to delusions in the early 20 th century. Early in the 20 th century two influential psychiatrists, Robert Gaupp and Ernst Kretschmer, focused on the correlation between biography and personality traits of people later diagnosed as deluded. The main hypothesis was that vulnerable and anancastic personality traits in combination with real and repeated insults will first lead to a dysphoric and suspicious attitude, and then, if no solution is found, to delusion-like ideas and, finally, to a delusion proper.
In contrast to the ideas of early psychoanalysis, this approach did not claim to explain the genesis of a delusion in the sense of causality, but to identify typical patterns of situations and conditions that lead to delusional states. The case that represents this approach most prominently is that of Ernst Wagner He was a teacher, living with his family his wife and four children in Degerloch next to Stuttgart in southern Germany. In the night from 3 to 4 September , he killed all five members of his family while they were sleeping and later shot or wounded at least 20 other persons and set fire to several houses.
He was examined for forensic purposes by Robert Gaupp, who found him not responsible for his deeds because of the chronic development of a delusional disorder, with the background of having both sensitive personality traits and distressing life events. Wagner was not sent to jail, but remained in several psychiatric hospitals for decades, where he began to write dramas and novels. For Freud and many of his early pupils, delusions—like the majority of psychopathological symptoms—were the result of a conflict between psychological agencies, the id, ego, and super-ego.
Delusion, briefly stated, is seen as a personal unconscious inner state or conflict which is turned outwards and attributed to the external world. He considered that latent homosexual tendencies especially formed the basis of paranoid delusions.
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Later, psychoanalytical authors gave up this very narrow hypothesis and suggested that delusions might be a compensation for any—i. There still is no comprehensive neurobiological theory of delusion formation or maintenance, although various empirical, conceptual and speculative arguments have been proposed, often resulting from the discussion of psychotic states occurring during neurological disorders Munro, In recent decades there has been significant progress in psychopharmacology, psychiatric genetics and functional neuroimaging in the study of psychotic and affective disorders.
These psychoses may or may not have had delusional features. So, all the neurobiological hypotheses that were suggested in connection with delusional syndromes must be read with the caveat that they might—at least partly—relate more to psychosis than to delusion, e. The clinical efficacy of antipsychotics in acutely psychotic patients with delusional and hallucinatory syndromes is an argument in favor of the hypothesis of dopaminergic hyperactivity in mesolimbic and mesocortical circuits, since these agents have in common their dopamine antagonistic properties.
As for delusions, however, this efficacy is typically limited to acute or subacute states, whereas chronic delusions, and especially the rare condition of paranoia, often, although not invariably, prove resistant to antipsychotic and other biological and psychotherapeutic treatments. A hypothesis proposed by Spitzer combines the aspect of disturbed dopaminergic neurotransmission in deluded patients with the concept of neural networks derived from computational science.
In computer simulation models, the artificial net will show properties that—in a far-reaching conclusion by Spitzer—resemble clinical features of deluded patients, e. In recent philosophical literature, there is an interesting line of thought concerning the qualitative status of subjective experiences that is important for the psychiatrist. The question is what precisely makes the difference between a statement of internal experience e. A delusion might be an attempt at explaining a hallucinatory experience.
Wernicke called such a delusion, delusion of explanation. However, even the early description by Lasegue in of delusions of persecution and of their common association with auditory hallucinations never firmly stated the temporal relationship between delusions and hallucinations. We cannot call upon any established knowledge in the field of study of hallucinations to help answer the question. French psychiatry does distinguish two types of hallucinations, one of which is, one might hold, more like a delusion than hallucination.
The two types are the true hallucination with full impression of the external nature of the sensation and the so-called mental hallucination where there is no impression of the external nature of the sensation, only a belief that one has seen something, or very commonly, that one has heard voices or noises or persons talking to one. The phenomenon of mental hallucination probably deserves a place amongst the other phenomena of delusion and hallucination.
The role of the hallucinatory types of experience is better discussed together with all the other so-called automatisms. De Clerambault holds that delusions are the reactions of an abnormal personality to automatisms. Briefly, his theory is an anatomical hypothesis that systematized chronic hallucinatory psychosis is based on anatomical processes in the brain due to infections, lesions, toxins, traumata or sclerosis.
These anatomical insults produce mental automatisms which mark the beginning of the psychosis. Contrary to prevalent beliefs de Clerambault maintained that at the beginning these automatisms were neutral in feeling tone. The patient tended to be puzzled by them but they were neither pleasant nor unpleasant.
De Clerambault also described these automatisms as non-sensory in character, to distinguish them from hallucinations [ Table 2 ]. A patient assailed by such automatisms may attempt to explain them as intentional and produce delusions such as delusions of influence, possession, persecution and so on.
In the absence of published studies of the frequency and nature of the relationship between the automatisms and delusional states, the automatisms remain as hypothetical causes of delusions.
As Maher suggested, a delusion is—contrary to the classical position—not a cognitive disturbance, especially leading to flawed conclusions from correctly perceived sensory input, but a normal cognitive reaction to unexpected, strange mental events, especially perceptions. In early stages of delusional or, more generally, psychotic disorders the patient may register distressing alterations in sensory qualities; e. Such deeply worrying strangeness of experiences is regarded as the starting point of a development leading from suspiciousness to vague paranoid ideation and, finally, to systematized delusions.
Since the s there has been an increase in psychological research on cognitive processes in deluded patients. In this line of thought, the traditional assumption of undisturbed cognitive functions in delusional disorder, i. In order to come closer to delusion-related phenomena themselves—as compared to the much broader psychosis-related phenomena—a number of studies compared patients with and without delusional ideation.
Such a process also led to a number of interesting therapeutic implications. Three approaches are worthy of mention. There can be no phenomenological definition of delusion, because the patient is likely to hold this belief with the same conviction and intensity as he holds other non-delusional beliefs about himself; or as anyone else holds intensely personal non-delusional beliefs.
Subjectively, a delusion is simply a belief, notion or idea. The fact that a delusion is false makes it easy to recognize but this is not its essential quality. A very common delusion among married persons is that their spouses are unfaithful to them. There is no recognized way of classifying delusions according to any phenomenological principles. The term primary implies that delusion is not occurring in response to another psychopathological form such as mood disorder.
According to Jaspers the core of primary delusion is that it is ultimately un-understandable. Secondary delusions are understandable when a detailed psychiatric history and examination is available. A delusion, whether primary or secondary in nature, is based on delusional evidence: Gruhle considered that a primary delusion was a disturbance of symbolic meaning, not an alteration in sensory perception, apperception or intelligence. Wernicke formulated the concept of an autochthonous idea; an idea which is native to the soil, aboriginal, arising without external cause.
The trouble with finding supposed autochthonous or primary delusions is that it can be disputed whether they are truly autochthonous. It is usually a strange, uncanny mood in which the environment appears to be changed in a threatening way but the significance of the change cannot be understood by the patient who is tense, anxious and bewildered. Finally, a delusion may crystallize out of this mood and with its appearance there is often a sense of relief. In this an abnormal significance, usually in the sense of self-reference, despite the absence of any emotional or logical reason, is attributed to normal perception.
Jaspers delineated the concept of delusional percept; and Gruhle used this description to cover almost all delusions. Schneider considered the essence of delusional perception to be the abnormal significance attached to a real percept without any cause that is understandable in rational or emotional terms; it is self-referent, momentous, urgent, of overwhelming personal significance and of course false. This is the symptom when the patient recalls as remembered an event or idea that is clearly delusional in nature, that is, delusion is retrojected in time.
These are sometimes called retrospective delusions. Delusional awareness is an experience which is not sensory in nature, in which ideas or events take on an extreme vividness as if they had additional reality. Delusional significance is the second stage of the occurrence of delusional perception. Objects and persons are perceived normally, but take on a special significance which cannot be rationally explained by the patient. Delusions are infinitely variable in their content but certain general characteristics commonly occur.
It is determined by the emotional, social and cultural background of the patient. Common general themes include persecution, jealousy, love, grandiose, religious, nihilistic, hypochondriacal and several others. It is the most frequent content of delusion. It was distinguished from other types of delusion and other forms of melancholia by Lasegue The interfering agent may be animate or inanimate, other people or machines; may be system, organizations or institutions rather than individuals.
Sometimes the patient experiences persecution as a vague influence without knowing who is responsible. May occur in conditions like: Manic, Depressive type, and Organic states: Persecutory overvalued ideas are a prominent facet of the litiginous type of paranoid personality disorder. Described by Ey may be manifested as delusion, overvalued idea, depressive affect or anxiety state. Various terms have been used to describe abnormal, morbid or malignant jealousy.
Enoch and Trethowan have considered the demonstration of delusion of infidelity in distinguishing psychotic from other types. Mullen has classified morbid jealousy with disorders of passion in which there is an overwhelming sense of entitlement and a conviction that others are abrogating their rights. The other two are the querulant who are indignant at infringements of rights and the erotomanic who are driven to assert their rights of love.
Delusion of infidelity may occur without other psychotic symptoms. Such delusions are resistant to treatment and do not change with time. Delusions of jealousy are common with alcohol abuse, they may also occur in some organic states, and are often associated with impotence, e. Husbands or wives may show sexual jealousy, as may sexual cohabitees and homosexual pairs. Morbid jealousy makes a major contribution to the frequency of wife battering and is one of the commonest motivations for homicide.
Erotomania was described by Sir Alexander Morrison as being: The respect the fixed and permanent delusions attending erotomania sometimes prompt those laboring under it to destroy themselves or others, for though in general tranquil and peaceful, the patient sometimes becomes irritable, passionate and jealous.
These have sometimes been classified as paranoia, rather than paranoid schizophrenia; these delusional symptoms sometimes occur in the context of manic-depressive psychosis. A variation of erotomania was described by and retains the name of de Clerambault Typically, a woman believes a man, who is older and of higher social status than she, is in love with her.
In this the patient may believe himself to be a famous celebrity or to have supernatural powers. Expansive or grandiose delusional beliefs may extend to objects, so leading to delusion of invention. Grandiose and expansive delusions may also be part of fantastic hallucinosis, in which all forms of hallucinations occur.
The form of the delusion is dictated by the nature of the illness. So religious delusions are not caused by excessive religious belief, nor by the wrongdoing which the patient attributes as cause, but they simply accentuate that when a person becomes mentally ill his delusions reflect, in their content, his predominant interests and concerns. Although common, they formed a higher proportion in the nineteenth century than in the twentieth century and are still prevalent in developing countries. Initially the patient may be self-reproachful and self-critical which may ultimately lead to delusions of guilt and unworthiness, when the patients believe that they are bad or evil persons and have ruined their family.
They may claim to have committed an unpardonable sin and insist that they will rot in hell for this. These are common in depressive illness, and may lead to suicide or homicide. These are the reverse of grandiose delusions where oneself, objects or situations are expansive and enriched; there is also a perverse grandiosity about the nihilistic delusions themselves. Feelings of guilt and hypochondriacal ideas are developed to their most extreme, depressive form in nihilistic delusions.
None of these factors are absolute but any or all may act synergistically to initiate and maintain delusion. Conrad proposed five stages of which are involved in the formation of delusions:. Freud proposed that delusion formation involving denial, contradiction and projection of repressed homosexual impulses that break out from unconscious. Later in de Clerambault, put forth the view that chronic delusions resulted from abnormal neurological events infections, intoxications, lesions.
Maher offered a cognitive account of delusions which emphasized disturbances of perception. He proposed that a delusional individual suffers from primary perceptual abnormalities, seeks an explanation which is then developed through normal cognitive mechanism, the explanation i. Also, delusion is maintained in the same way as any other strong belief.
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These are further reinforced by anxiety reduction due to developing explanation for disturbing or puzzling experiences. He postulated that delusions in schizophrenia arise from faulty logical reasoning. The defect apparently consists of the assumption of the identity of two subjects on the ground of identical predicates e.
Learning theorists have tried to explain delusions in terms of avoidance response, arising specially from fear of interpersonal encounter. Luhmann defines that information, message and understanding connects the social systems with the psychic ones. If the psychic system fails to recognize the message of information correctly or is unable to negotiate between understanding and misunderstanding message, it detaches itself from the social system to which it is normally closely connected.
This detachment releases the possibility of unhindered autistic fulfillment of desires and uncontrolled fear may appear as delusions. Acute delusions are the result of an increased activity of the euromodulators dopamine and norepinephrine. This not only leads to a state of anxiety, increased arousal and suspicion, but also to an increased signal to noise ratio in the activation of neural networks involved in higher order cognitive functions, leading to formation of acute delusions.
Alteration in the neuromodulatory state not only causes the occurrence of unusual experiences but also modify neruroplasicity which influences the mechanism of long term changes. So chronic delusions may be maintained by a permanently increased neuromodulatory state, or by an extremely decreased noradrenergic neuromodulatory state Black wood et al. It refers to the capacity of attributing mental states such as intentions, knowledge, beliefs, thinking and willing to oneself as well as to others.
Amongst other things this capacity allows us to predict the behavior of others. Frith postulated that paranoid syndromes exhibit a specific ToM deficit, e. Since deluded patients in symptomatic remission performed as well as normal controls at ToM tasks, ToM deficits seem to be a state rather than a trait variable.
Delusions driven by underlying affect mood congruent may differ neurocognitively from those which have no such connection mood incongruent. Thus, specific delusion-related autobiographical memory contents may be resistant to normal forgetting processes, and so can escalate into continuous biased recall of mood congruent memories and beliefs. Regarding threat and aversive response, identification of emotionally weighted stimuli relevant to delusions of persecution has been seen. It assumes that the probability-based decision-making process in delusional individuals requires less information than that of healthy individuals, causing them to jump to conclusions, which is neither a function of impulsive decision-making nor a consequence of memory deficit.
The findings in reasoning abilities in delusional patients are only subtle and one might question the strength of their causality in delusional thinking. Bentall and others proposed that negative events that could potentially threaten the self-esteem are attributed to others externalized causal attribution so as to avoid a discrepancy between the ideal self and the self that is as it is experienced. An extreme form of a self-serving attributional style should explain the formation of delusional beliefs, at least in cases where the delusional network is based on ideas of persecution, without any co-occurring perceptual or experiential anomaly.
During the course of illness, the preferential encoding and recall of delusion-sensitive material can be assumed to continually reinforce and propagate the delusional belief.
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The emergence of symptoms assumed to depend upon an interaction between vulnerability and stress. Therefore the formation of delusion begins with a precipitator such as life event, stressful situations, drug use leading to arousal and sleep disturbance. This often occurs against the backdrop of long-term anxiety and depression. The arousal will initiate inner outer confusion causing anomalous experiences as voices, actions as unintended or perceptual anomalies which will turn on a drive for a search for meaning, leading to selection of explanation in the form of delusional belief [ Figure 1 ].
The earlier works like Hartley suggested that vibration caused by brain lesion may match with vibrations associated with real perception. Ey believed delusion to be a sign of cerebral dysfunctions and Morselli listed the metabolic states for delusional pathogenesis.
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Jackson suggested pathogenesis of delusions due to combination of loss of functions of damaged part of brain. Cummings found that a wide variety of conditions can induce psychosis, particularly those that affect the limbic system, temporal lobe, caudate nucleus. He also noted that dopaminergic excess or reduced cholinergic activity also predispose to psychosis. He suggested that the common locus is limbic dysfunctions leading to inappropriate perception and paranoid delusion formation.
Prediction error theories of delusion formation suggest that under the influence of inappropriate prediction error signal, possibly as a consequence of dopamine dysregulation, events that are insignificant and merely coincident seem to demand attention, feel important and relate to each other in meaningful ways. Delusions ultimately arise as a means of explaining these odd experiences Kapur, ; Maher, The insight relief gained by arriving at an explanatory scheme leads to strong consolidation of the scheme in memory.
In support of this view, aberrant prediction error signals during learning in patients with first-episode psychosis have been confirmed experimentally. Furthermore, the magnitude of aberrant prediction error signal correlated with delusion severity across a group of patients with first-episode psychosis.
However, there are important characteristics of delusions that still demand explanation: Normal associations can extinguish if they prove erroneous, normal beliefs can be challenged and modified. But delusions are noteworthy for the fact that they remain even in the absence of support and in the face of strong contradictory evidence. We believe that this striking clinical phenomenon can be explained within the same framework by considering key findings from the animal learning literature, a literature that has been formerly invoked to explain chronic relapse to drug abuse; extinction and reconsolidation.
If delusion formation may be explained in terms of associative learning then perhaps extinction may represent the process through which delusions are resolved. Extinction involves a decline in responding to a stimulus that has previously been a consistent predictor of a salient outcome. Prediction error is also central to extinction. It has been suggested that negative prediction error a reduction in baseline firing rate of prediction error coding neurons leads the organism to categorize the extinction situation as different from the original, reinforced, situation and it now learns not to expect the salient event in that situation.
This learning focuses on contextual cues, allowing the animal to distinguish the newly non-reinforced context from the old, reinforced one. Extinction does not involve unlearning of the original association, but rather the formation of a new association between the absence of reinforcement and the extinction situation.
Extinction experiences the absence of expected reinforcement invoke an inhibitory learning process which eventually overrides the original cue response in midbrain dopamine neurons. Individuals with psychosis do not learn well from these absent but expected events, nor do they consolidate the learning that does occur. But there is more to delusion maintenance than persistence in the absence of supportive evidence: When confronted with counterfactual evidence, deluded individuals do not simply disregard the information.
Rather, they may make further erroneous extrapolations and even incorporate the contradictory information into their belief. So, while delusions are fixed, they are also elastic and may incorporate new information without shifting their fundamental perspective. Once a simple delusional belief is adopted with conviction, the subsequent course is very variable. The multidimensionality of delusional experience also has implications for the conceptualization of the temporal course of psychotic decompensation and resolution.
Individual dimensions of delusional experience often change independently of one another during the course of a psychotic episode, so that recovery can be determined by changes in one of the several dimensions Garety and Freeman, Jorgensen found three types of recovery, one with full and the other two with partial recovery of delusional beliefs. In patients with partial recovery, decrease in pressure precede, decrease in other dimensions.
For two-thirds there was no change in the degree or insight during recovery. Delusions are a key clinical manifestation of psychosis and have particular significance for the diagnosis of schizophrenia. Although common in several psychiatric conditions, they also occur in a diverse range of other disorders including brain injury, intoxication and somatic illness. Delusions are significant precisely because they make sense for the believer and are held to be evidentially true, often making them resistant to change.
Although an important element of psychiatric diagnosis, delusions have yet to be adequately defined. The last decade has witnessed a particular intensification of research on delusions, with cognitive neuroscience-based approaches providing increasingly useful and testable frameworks from which to construct a better understanding of how cognitive and neural systems are involved.
There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. It has been argued that aberrant prediction error signals may be important not only for delusion formation but also for delusion maintenance since they drive the retrieval and reconsolidation-based strengthening of delusional beliefs, even in situations when extinction learning ought to dominate.
Given the proposed function of reconsolidation, in driving automaticity of behavior it is argued that in an aberrant prediction error system, delusional beliefs rapidly become inflexible habits. Taking this translational approach will enhance our understanding of psychotic symptoms and may move us closer to the consilience between the biology and phenomenology of delusions. National Center for Biotechnology Information , U. Journal List Ind Psychiatry J v. Chandra Kiran and Suprakash Chaudhury. Author information Copyright and License information Disclaimer. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC. Abstract Delusion has always been a central topic for psychiatric research with regard to etiology, pathogenesis, diagnosis, treatment, and forensic relevance. Delusions, Etiology, Psychopathology, Phenomenology. This solution, according to the naturalistic perspective, will only be used until a strictly empirical neuroscientific approach has progressed far enough to replace mentalistic vocabulary with a neurobiological one.
In other words, mental events are not regarded as a distinct class of phenomena, either gradually or principally. This does not, of course, exclude neurobiological research strategies at all, but it does insist on the scientific significance of the subjective dimension. When one door closes, another always opens.
We seek out problems because we need their gifts. Where you stumble, there lies your treasure. Tame the dragon and the gift is yours. It tears away from us all but the things that cannot be torn, so that we see ourselves as we really are. What we can do is choose how to use the pain life presents to us. Let me not beg for the stilling of my pain, but for the heart to conquer it. We need not seek it out; we can all look back at moments when our lives were in utter chaos, desolation and despair. Growth comes when we respond to adversity by stretching just an edge beyond our talent and experience.
It turns what we have into enough, and more. It turns denial into acceptance, chaos into order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow.
Every minute tie has to be untied and something permanent and valuable recovered and assimilated from the dust.
All the love you created is still there. All the memories are still there. You live on in the hearts of everyone you have touched and nurtured while you were here. The important thing is not to allow yourself to be stranded in the desert. The experience of grieving cannot be ordered or categorized, hurried or controlled, pushed aside or ignored indefinitely.
It is inevitable as breathing, as change, as love. It may be postponed, but it will not be denied. You cannot now realize that you will ever feel better… and yet… you are sure to be happy again. It is part of the ritual, if you will, of putting sadness in perspective and gaining control of the situation. Grief has a purpose. Grieving is part of the tempering process. It means that on the journey we will need safe pathways so that remembrance, which may be painful, is possible.
We need to grieve in order to do this. The pain we have not grieved over will always stand between us and life. Grieving is not about forgetting. Grieving allows us to heal, to remember with love rather than pain. It is a sorting process. One by one you let go of the things that are gone and you mourn for them. One by one you take hold of the things that have become a part of who you are and build again. First, each loss launches us on an inescapable course through grief. Second, each loss revives all past losses. Third, each loss, if fully mourned, can be a vehicle for growth and regeneration.
It depends so little on the circumstances; it depends really only on what happens inside a person. I am grateful for every day… and that makes me happy. You become happy by living a life that means something. Waste no time and effort searching for peace and contentment and joy in the world outside. Remember that there is no happiness in getting, but only in giving. Happiness is a perfume you cannot pour on others without getting a few drops on yourself. They think it comes from doing something on a big scale, from a big fortune, or from some great achievement, when, in fact, it is derived from the simplest, the quietest, the most unpretentious things in the world.
No self-centered person, no ungrateful soul can ever be happy, much less make anyone else happy. Life is giving, not getting. First of all, happiness must be shared. It is quiet, seldom found for long in crowds, most easily won in moments of solitude and reflection. It comes from within, and rests most securely on simple goodness and clear conscience. It is not something we see, like a rainbow, or feel, like the heat of a fire. Happiness is something we are. Both attitudes are within our power so that a man is happy so long as he chooses to be happy, and no one can stop him.
Happiness is the spiritual experience of living every minute with love, grace, and gratitude. The healthy and strong individual is the one who asks for help when he needs it. Let the process happen. Trust that nature will do the healing. Know that the pain will pass, and, when it passes, you will be stronger, happier, more sensitive and aware. Through the careful hand-holding of your own spirit, through recognizing, honoring, and expressing your feelings, by nurturing your body as the vessel that holds your spirit in the web of life, you will discover that you have, without your consciously knowing it, developed the inner sturdiness from which you can function on your own behalf.
This interior growth is a miracle of intimate compassion, a seedling of loving yourself that will bloom, in time, into the capacity for truly loving others. Your spirit, as surely as your body, will try to heal. The question you must ask yourself is not if you will heal, but how. Grief and pain have their own duration, and when they begin to pass, you must take care to guide the shape of the new being you are to become.