Thursday, September 3, 2015

The Psychology of Delusions

A delusion is a fixed, relatively immutable, persistent, false belief with no basis in reality.
Piotr Marcinski/Shutterstock
Source: Piotr Marcinski/Shutterstock
We talk often about "deluded" people: “The person on the talent show is clearly deluded about their lack of singing ability.” “That politician has delusions of grandeur.” “She's deluded if she expects to be promoted.” "You have to be deluded to believe anything salesmen say.”
A delusion is a belief held by an individual or group that is demonstrably false, patently untrue, impossible, fanciful, or self-deceptive. A person with delusions, however, often has complete certainty and conviction about their delusory beliefs. They resist arguments and evidence that they are wrong. 
People have illusions about smell (olfactory), taste (gustatory), temperature (thermoceptive), and touch (tactile). They may experience highly disgusting or very pleasant or unusual smells when meeting a particular person. They may find ordinary foods (oranges, chocolate, milk) have different tastes than others experience. They may find cool objects burning hot or warm objects frozen; traditionally smooth objects (like a balloon or cat's fur) may feel rough or uneven.
The most written about of all delusions, paranoia, has been shown to follow various stages: general suspiciousness; selective perception of others; hostility; paranoid “illumination” in which all things fall into place; and, finally, paradoxical delusions of influence and persecution. Delusions often totally preoccupy people and cause them considerable distress because they do not doubt their beliefs are correct. 
Delusions differ from illusions. We have visionary and auditory illusions; for instance, that the sun goes around the earth or that ventriloquists’ dummies actually speak. We have selective memories/illusions of happy childhoods. These are things that seem true to the senses or memory, but are known to be false or have no basis in reality.
There are some caveats: Some religious delusions are impossible to verify and hence falsify. Other delusions have a self-fulfilling prophecy, such as a jealous person accusing and attacking an innocent partner, who then leaves them for another. In that sense, these people cause their delusions to come true.
Novelists and playwrights often have interesting characters with delusions. Commonly portrayed are delusions that a person is totally controlling one's behavior or that one has committed a heinous or terrible crime or sin that merits severe punishment. There are characters who believe others to be mind readers, or that other's trivial and insignificant events, objects, or remarks have personal meaning or significance. Religious delusions have also been well-known down the centuries.
Psychiatrists may diagnose someone as having a delusion disorder under a number of very specific situations:
  1. A person must manifest one or more non-bizarre delusions for at least a month.
  2. The person has not met other behavioral criteria to be classified as someone with schizophrenia.
  3. Audio and visual hallucinations are not prominent, though tactile and olfactory hallucinations may be.
  4. Despite the person's delusions or their behavioral consequences, their psychosocial functioning is not essentially impaired enough to be considered particularly odd or bizarre.
  5. If the specific delusions impact a person’s mood, these fluctuations do not last very long.
  6. The disturbance is not the result of physiological or medical conditions, like the medication a person is taking.
Sometimes psychiatrists say it is difficult to distinguish from other disorders like hypochondriasis (particularly among those with little self-awareness); body dysmorphic disorder (preoccupation with imagined bodily defects); Obsessive Compulsive as well as Paranoid Personality Disorder.
The delusions of people with schizophrenia are often clearly bizarre, utterly implausible, not at all understandable; one might believe the brain has been replaced by that of another person or that one has shrunk to be three feet tall. On the other hand, non-bizarre delusions could be possible. For instance, people may feel they are being followed, photographed or recorded, that somebody is slowly poisoning them, that their partner is always cheating on them, or that their boss or neighbor is in love with them.
Some delusions cause people to make dramatic changes in their life: leave their job or partner, move from their house (or even leave the country), or dress very differently. The person with delusional disorder, however, appears normal when their delusional ideas are not being discussed.
People with delusions can become very moody, often causing their relationships and work to suffer. Interestingly, some cultures and groups have particular beliefs that may in other cultures be seen as clinically delusional.
It is a relatively rare disorder usually occurring later in life, particularly among people with relatives who have other disorders. Most appear argumentative and hypersensitive.  Many do not seek treatment and become, over the years, more and more isolated.
Types of Delusion
Psychiatrists have noticed five clear types of delusions:
  1. Erotomanic. These individuals believe someone is seriously in love with them, more in the Hollywood romance, even spiritual way, rather than in the sexual sense. It is often a famous person—a film star or famous athlete—but also can be powerful superiors at work. Whilst someone with this delusion can keep it a secret and do very little, others may expend a great deal of energy trying to contact their delusional lover via emails, visits, or stalking. (read more HERE)
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