On House, mental illness and reality checks

I got a strange idea when I saw an episode of House today. It was about him being shot and put to sleep with ketamine during surgery. After this he finds himself going a little crazy, hallucinating and never really knowing when he is in the real world or in something his head made up. He then realizes that nothing of what he is experiencing is real, but he is still stuck in this twisted world, where he knows everything everyone is about to say, because technically he is the one saying it, until he takes such action that his doped up brain (he thinks) just cannot accept. Something that really defines the impossible and unreal. So he slices up a guy with a robot surgeon. He has now discovered that EVERYTHING since the accident (maybe a week earlier) has been a hallucination or a dream, and he wakes up lying on a bed rolling to the emergency, only seconds after he was shot.

At one point in the episode, he asks a fellow patient (or rather himself) HOW to know if he is in the real world or an imagined one. The other character didnt come with a very interesting answer, but I just wanted to shout to him "DO THE NOSE REALITY CHECK!!"

Could this RC not also work for the mentally ill? If they find themselves in a nightmarish reality that just cant be real, but it is and they are awake (but perhaps not fully "there", as in the same room) try a nose RC and see what happens?

t definitely wouldnt work for everyone, since some patients are fully concious and physichally and sensorically functional, but for those who gets stuck in daydreams and "wakes up" in a completely different place, kind of like a false awakening. It doesnt even have to be the nose RC (though I believe its the most useful) but any RC, whatever fits the illness and patient the best.

Am I completely nuts? Has this method been applied in mental illness treatment?

Interesting idea, but would it help them, really? Let's see; they're having a delusion, so they do an RC and they figure out that they are not dreaming...then what? They are still stuck with the delusion.

I'm just trying to figure out how it would be helpful to them; it sounded good at first.

I have no idea, either, but that was a really good episode. :)

It probably wouldn't work because most mentally ill people like that are awake, but hallucinating. That's much different than being asleep. They wouldn't be able to breath by holding their nose, but they might think they can and pass out... Who knows. I guess there isn't much they can do.

In virtually all cases, severely psychotic people are 100% convinced that what they are perceiving is real. You cannot even get them to consider the possibility that they are hallucinating and having delusions. They totally believe that the people putting them in the hospital and making them take medication are the ones who are screwed up. They are not phased by logic.