Stress can shut down reflective function, making imagined fears feel completely real.

Psychic equivalence causes people to mistake imagination for actual reality.

Trauma from imagined events may be more intense than from real-life traumatic experiences.

Our ability to look inward and monitor our mental processes goes by several names. Among them are the observing ego, meta awareness, and the one I like, reflective function. Whatever we call it, when it is working, it lets us sense what mode of processing we are engaged in.

When we are remembering something, if reflective function is working, we are fully aware that what we have in mind happened at some other time, and not now. Same with imagination. When we are imagining something, we know we are making it up. We know it is not real.

How Stress Impairs Reflective Function and Leads to Psychic Equivalence

But if we release enough stress hormones, our reflective function stops working. Our mind goes to its default position: perception. If we are remember something, we believe it is happening now. If we are imagining something we believe it is real. The renowned psychological theorist Peter Fonagy terms this psychic equivalence. When we go into psychic equivalence, we believe whatever is going on in our inner world (our psyche) is the same (thus equivalent) as what is going on in the world around us.

Some people have very limit awareness of their mental processes. Instead of going into psychic equivalence only when stressed, they are in psychic equivalence 24/7. They experience everything that goes on in their mind as perception. When they imagine something, they experience it as real. Psychologists call this disorder schizophrenia.

When I was in grad school, I worked with some patients at the Veterans Administration clinic in New York City. One of my clients was schizophrenic. He began having trouble determining what was real and what was imaginary. when he was on active duty in the Marine Corps. Things got very serious one day while sitting on a toilet. The way I would describe what happened is that he imagined a giant hand was reaching up from the drain, threatening to grab him and pull him down the drain. The way he put it was different. He didn't say........

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