Reality testing for an individual suffering from schizophrenia needs to look like a prosecutor presenting a case to a jury. As in all trials by jury, the aim is to prove ‘beyond a reasonable doubt’ that a person did or did not commit the crime in question. In the absence of concrete evidence (i.e., DNA, CTV, witnesses etc) the prosecutor’s case is circumstantial. The prosecutor has a much harder time proving to the jury, beyond a reasonable doubt, that the defendant committed the crime.
The schizophrenic must challenge their delusions and hallucinations in a similar manner. The schizophrenic individual must become the prosecutor and the delusions and hallucinations must become the defendant. The schizophrenic individual must prove to a hypothetical jury, beyond a reasonable doubt, that the delusions and hallucinations either exist or do not exist.
For example, let’s say the schizophrenic individual hears voices. How can they prove beyond a reasonable doubt that these voices exist or don’t exist? They could ask someone who is with them at the time if they hear the same voice. If the other has no hearing difficulty etc and says that they do not hear the voice then that would be a tick in the ‘does not exist beyond reasonable doubt’ box. What if this single person is not enough to dispel the delusion/hallucination? The individual could record their surroundings and play the recording back. If no voice is heard on the recorder then that would be another tick in the ‘does not exist beyond reasonable doubt’ box.
What about a visual hallucination? Let’s say a schizophrenic individual sees a spider on the wall. The spider is black, has eight legs and is of a reasonable size for a spider. How can the schizophrenic prove beyond reasonable doubt that the spider is real and not a hallucination? The schizophrenic can google ‘spider types’ until they see a spider which resembles the spider on the wall. This would be a tick in the ‘exists beyond reasonable doubt’ box. They can ask another person in the room if they see the same spider. If the other agrees then that’s another tick in the ‘exists beyond reasonable doubt’ box. If the spider however was 2 metres big and glowing bright green, a google image of the spider is unlikely to come up. That would be a tick in the ‘does not exist beyond reasonable doubt’ box.
Here is an example from my own personal experiences. I believed that there were cameras and microphones in my house. I could not find the cameras and microphones. In the absence of concrete evidence, my case became circumstantial. Not finding the cameras and microphones did not tick my ‘does not exist beyond a reasonable doubt’ box. It was possible the cameras and microphones were planted in my absence and so well hidden that I could not find them. I chose to move out of that house and move into share accommodation. I believed that it would be much harder to have listening devices or cameras installed in this share house as most homeowners would not agree to such a thing and would most likely kick me out. Since I was never kicked out, my ‘does not exist beyond a reasonable doubt’ box was ticked. I was no longer concerned with the presence of cameras or microphones. The share house also had cameras outside so I did not have to worry about people ‘stalking’ me as I could prove on the cameras if there was anyone lurking around. This changed my belief that I was being followed and ticked my ‘does not exist beyond a reasonable doubt’ box.
The schizophrenic individual has to assess most if not all their perceptions in this manner. The ability to reality test does depend on the severity of the disease though as schizophrenia does impair cognitions. Reality testing can be learnt and achieved though which leads to a better standard of living.