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In the brain, the amount of the neurotransmitter dopamine affects the process of salience acquisition and expression. During an acute psychotic state, schizophrenia is associated with an increase in dopamine synthesis, dopamine release, and resting-state synaptic dopamine concentrations.10 Kapur suggests that in psychosis, there is a malfunction in the regulation of dopamine, causing abnormal firing of the dopamine system, leading to the aberrant levels of the neurotransmitter and, thus, aberrant assignment of motivational salience to objects, people, and actions.11 Research supports this claim.12 The altered salience of sensory stimuli results in a conscious experience with very different contents than would normally be there, yet those contents are what constitute Mr. B’s reality and provide the experiences that his cognition must make sense of. When considering the contents of Mr. B’s conscious experience, his hallucinations, his efforts to make sense of his delusions are no longer so wacky, but are possible, though not probable, explanations of what he is experiencing. With this in mind, the behavior that results from his cognitive conclusion seems somewhat more rational. And despite suffering this altered brain function, Mr. B continues to be conscious and aware of his existence.
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Michael S. Gazzaniga (The Consciousness Instinct: Unraveling the Mystery of How the Brain Makes the Mind)