Watson is a 58-year-old Swiss woman.
was brought to the emergency department by her family physician,
who explained that he had tried for years to convince her to see a
psychiatrist. This time he wanted to make sure that his patient
would be hospitalized and that she would receive proper treatment
at last. Mrs. Watson had called him in the middle of the night
complaining that the situation had gotten out of hand, that
"they" were really behaving quite badly now, and
that something had to be done to put an end to their tricks.
"They" were using some kind of invisible rays, laughing
all the time and making obscene comments as they sent electricity
into her genitalia and tried to get her sexually excited.
Watson's family physician explained that for the previous 3 years
his patient had been hearing voices almost continuously, but until
the present she had obstinately refused to take any drugs
or to see a specialist. She had always asserted
that the voices did not really bother her and that , because she
now lived all alone, she had come to enjoy their company.
Mrs. Watson was born and brought up in Paris. She had
worked as a typist until her marriage. Her husband was a railway
ticket collector. They had no children. There was no history of
mental illness in Mrs. Watson's family, and she had never been
treated for a psychiatric disorder.
patient's problems began about a year after her husband died of
lung cancer. She lived alone
, she no longer had any relatives in Paris, and she had no real
friends, as neither she nor her husband had ever cared much for
company . She noticed one day
that two voices in her head were commenting on what she was
doing . She became rather upset by this at first and decided that
it obviously had to do with the parabolic antenna that her
neighbors had recently installed not far from her window. She took
care to shut the blinds, but then she noticed that her radiators
seemed to have become charged with electricity. She asked her
physician to check whether she might have been contaminated by
some strange rays. He could find nothing wrong with her , and the
blood tests and other investigations , including a brain scan,
were negative. He advised her to see a psychiatrist, and when she
refused to do so, he gave her a prescription for haloperidol. The
drug made her drowsy, so she stopped taking it after a few days.
In the end, she decided to live with her voices, and because they
were polite and friendly, she stopped worrying about them after a
while and gradually grew accustomed to their company.
Mrs. Watson was oriented in time, place, and person . She got
angry at her voices, telling them from time to time to
"please stop it now ," but she talked in a perfectly
coherent way . She explained that she heard voices in her head and
that they usually limited themselves to commenting on her thoughts
and actions , or talked about her between themselves. At times
they gave her advice or even instructions, or they put thoughts
into her mind that she knew were not her own . However , because
most of the time these instructions
were quite sensible , she did not object to this .On a few
occasions the voices had been unpleasant , and she had to call
them to order. Mrs. Watson also reported that she frequently
strange sensations in her body , something
such as electricity , radio waves , or invisible rays , and
then she knew that "they " were experimenting on her .
Those sensations did not become particularly disagreeable until
the preceding few weeks before she came to the hospital.
Mrs. Watson was treated with 20mg of haloperidol for the
first 2 weeks . Her voices gradually
diminished in frequency and prominence
, and her somatic sensations disappeared completely.
began to accept that
her voices were related to an illness but seemed somewhat
disappointed when they stopped completely. She explained that ,
after all , the voices had been " good company " most of