Delusional thinking: Keeping thoughts in perspective

“If one man conquers an Army, and another conquers himself, the latter is the greatest of the conquerors.”

Ancient Chinese proverb

Young children live in a world of delusion. “Magical thinking,” the inability to distinguish what is real from unreal; are part and parcel to their brain development…the structuring of those neurons and associated synapses being developed…the development of cognitive/reasoning processes.

This is most evident when we watch and listen to young children as they play with, and talk to their toys…dolls and action figures; and they play the “let’s pretend” with others. It is all a part of normal child development that most adults can relate to. These stages of development of the child is well known to the toy companies, TV shows, video games, and the theme parks; as the young children interrelate with the people in animal costumes’, the princesses, etc.

The children relate to all that being real. Yet their brains are soaking up information like a sponge, and they outgrow the magical, delusional thinking; for the most part by the time they reach adolescence.

As adolescence comes about, cognitive structuring of the brain continues, and the delusionary thinking continues in another way. Now, since the “magical thinking” has gone away; the young person becomes over concerned about their social interaction and their self-appearance…”am I dressed right?” “Does my hair look alright?” etc.

During the adolescent stages of development the deluded thinking is most exemplified by their social interaction with their peers, and peer pressure. “But Mom, everybody is doing it!” “Everybody has one, why can’t I?” They further become deluded about their future and their abilities …so very typical of the teenage years. As one parent client of mine with a teenage son once remarked, “He is driving me nuts!” Adolescent children can indeed be most challenging for the parent.

As an adult most of us are aware that we develop reasoning to the point of knowing just what is rational and irrational, what is delusionary versus non-delusionary thinking. It is only when the delusions become a troublesome part of one’s life that Delusional Disorders develop…thoughts go awry.

Delusion, a word that has its origin from the Latin word “deludere,” translates in English to “play or trick.” Psychologically a delusion is our mind “playing tricks on us.” As children, when asked what they want to be when they grow up; they may say they are going to be a doctor, lawyer, astronaut, etc.; without the comprehension of what it takes to reach that point.

As adults we sometimes have delusions also; what we are going to do with the money when we win that lottery, making a million dollars, etc; “putting the cart before the horse.”

Most people have deluded thinking at times, but then our rational brain takes over…bringing us back to reality. But for some people their deluded thinking becomes fixed, they develop a Delusional Disorder.

Whereas a delusion is a false belief or opinion about something, a delusional disorder is a fixed, dominating, persistent, false mental perception resistant to reason. It is a false belief regarding the self or persons or objects outside the self that persists despite the facts. Although delusions are very often displayed among major mental illness, such as Schizophrenia, the person with a Delusional Disorder diagnosis may not display the symptoms associated with Schizophrenia or other major mental illnesses.

The types and diagnostic criteria for determining if one has a delusional disorder are found in the Diagnosis and Statistical Manual for Mental Disorders (the DSM). There are essentially 6 types of Delusional Disorder: The Erotomanic Type is specified by the delusions that another person, usually of higher status, is in love with the individual. With the Grandiose Type the person has delusions of inflated worth, power, knowledge, identity, or special relationship to a deity of famous person. The Jealous Type has delusions that the individuals’ sexual partner is unfaithful. The persecutory type is when the person has delusions that the person (or someone to whom the person is close to) is being malevolently treated in some way.

The person with a Somatic Type has delusions that the person has some physical defect or general medical condition. In the Mixed type the person has more than one of the types present, but no one theme predominates.

In my work in both in-patient and out-patient facilities, I quite often encountered persons with Delusional Disorders. I remember one young man who believed that the government had planted a special transmitter in his brain and was monitoring his thoughts (Persecutory Type).

I recollect the woman who believed she was the daughter of a Queen…even demanding people bow down in her presence (Grandiose Type). Another man believed that a famous singer was in love with him, and wrote letters to the person (Erotomanic Type). Another woman I encountered had a belief that she had an incurable brain tumor, despite evidence reputing the belief (Somatic Type).

With Delusional Disorders, as is the case of any mental illness, the exact causes are not known; but research suggests that the disorder arises due to certain abnormalities in certain areas of the brain, genetics, and environmental reasons. The condition is usually treated with antipsychotic medication prescribed by a Physician, usually a Psychiatrist. Cognitive Behavioral Therapy, Reality Therapy, or Change Therapy (changing ones thoughts to change actions) is also usually conducted by a licensed mental health professional.

Utilizing both modalities together has some satisfactory results; the medication helps to restore the natural balance of neuro chemicals in the brain, and the counseling helps in developing ways and means of coping with the disorder. Due to the person having poor insight and quite often not recognizing that a problem exists, he/she may be very difficult to treat. It is rather unfortunate that many people with a Delusional Disorder do not seek out help, for without the treatment the disorder can be a lifelong, chronic process; and even though having treatment episodes, recidivism is high.

In our society today, there are many people who exhibit deluded thinking; but not necessarily a Delusional Disorder. We all need to keep our thoughts in perspective in order to live wholesome, meaningful lives…to be the greatest of the conquerors. Until Next Time, Stay Healthy My Friends!