A brief discourse on Delusion.

Benj96

If someone has a suspected delusion and is asked if they think it is a delusion they have two options:

1). They concede that it seems to be a delusion - in which case they agree with the doctor or person asking. This tends to be taken as confirmation that it’s a delusion.

2). They deny it’s a delusion, to them it seems perfectly reasonable and logical. But because they are suspected to be deluded this again seems to confirm their delusion?!

How can this be? It’s like a catch 22 situation. If a madman agrees he’s mad he’s mad, even he recognises it! (should this not actually show sanity?), if he denies his madness well that’s because he’s clearly mad right?

Lastly “delusion” is based on a persistent and incorrect “deviation” from “reality” or a contradiction with logic. But who is dictating what “reality” or “logic/rationale” is or could possibly be in the future?

We only have “current logic/ rationale”. We have noted several paradoxes and contradictions in logic so far both in maths eg. “Banach-tarski” paradox, concepts “grandfather paradox” and linguistics “the liar paradox”. Contradictions in our logic system seem to be rampant and appear in most if not all disciplines so either a) we don’t yet understand reality well enough to eliminate paradoxes/ contradictions or b). They are indeed fundamental to reality.

So to wrap things up, if someone has an outlandish or bizarre idea that the vast majority of others find difficult to comprehend, should we not be more careful and slow to ascribe a diagnosis. How many geniuses have we admitted to psychiatric institutions for their big ideas? Especially if it’s one that is metaphysical, epistemological or deontological in nature.

It’s worth noting that in some cultures insanity, madness and delusion don’t exist as concepts.

Secondly I will acknowledge there is some distinction to be made between those delusions that say ...involve aliens trying to kidnap your tv and those where someone feels they have transcended into some Gaia type unanimity with the world and want to give up their worldly possessions. Both are unusual but some delusions appear to be more tolerable and/ or wholesome than others despite lack of proof/ evidence or logic.

universeness

Many have delusions, periodically, not constantly. So it makes sense to suggest a person may be delusional if they only have periodic 'Joan of Arc.' type experiences.
Some may call the different types of multiverse proposed by Mark Tegmark, delusional but at least its based on some actual physics.
An individual might only think they are indestructible when they are totally drunk or on LSD etc.
You might only see angels when you eat the mushrooms of magic or when the planets Jupiter and Saturn are in alignment.
My father had 5 years of mental decline before he died. He saw many things that were not there because of multiple brain infarctions (brain lesions in which a cluster of brain cells die when they don't get enough blood.) Otherwise, he mainly appeared and acted quite normally.
Some humans will even roleplay delusional states if it suits their purpose. For example, a person who can communicate with the dead if you pay them enough.
I think the reality of 'delusions' are much more nuanced than your OP suggests.

Tom Storm

So to wrap things up, if someone has an outlandish or bizarre idea that the vast majority of others find difficult to comprehend, should we not be more careful and slow to ascribe a diagnosis — Benj96

In my experience, working in the area of mental illness and addictions for 30 years, diagnosis is not undertaken in a hurry (countries and jurisdictions may vary in approach). In most cases here people are not given a diagnosis for some time, on the basis that we don't know enough about them or their situation.

Delusion is an umbrella term for a wide range of presentations, including psychosis (usually via schizophrenia/bipolar disorder or drug induced) - where the person looses sense of reality, may experience auditory hallucinations, can't make sense of the world and struggles to communicate - to a more fixed and coherant delusional system where someone thinks they are working for the 'secret police' or for a deity. In some of these instances, people can become a serious risk to self or others if they feel this delusion is being contradicted or threatened. Or if the delusion is that someone is in love with them or they are here to save the world.

One person I met recently is living on the street and thinks he is protecting a particular government building from an atheist army. If he determines an atheist is nearby he becomes abusive and threatening. He is living in almost constant torment and fear of persecution from God for not working hard enough. Delusions are a continuum and many people who live with aggressive voices and command hallucinations and paranoia are very relieved to be able to control these symptoms with medication.

Generally someone has to be known to be experiencing delusions for one to six months before an ongoing assessment process will provide a (often provisional) diagnosis. Where a person's delusional system is nonbizarre and they just have 'odd' ideas, but present no clinical risk to the community and where psychosocial disfunction is not impaired, psychiatric services will take very little interest in them and generally regard them as 'eccentric.' Having 'outlandish ideas' does not generally qualify as delusional except in common parlance.

Agent Smith

Delusions are restricted to opposition/denial of known facts. For instance to say the earth is flat is delusional.

Controversial topics can't/shouln't be used to diagnose delusional disorders. To say that the mind is nonphysical isn't a thought disorder.

As for contradictions, it isn't a sign of madness, but it is definitely a symptom of poor ratiocination; so long as the person accepts that s/he believes a contradiction and mends his ways so to speak I see no issues.

True paradoxes (true contradictions) can be a major problem because they trivialize the concept of truth - that's what logicians say anyway (vide relativism/perspectivism - anekantavada). Not necessarily though - there's paraconsistent logic, designed for damage control (re ex falso quodlibet) in re (true) paradoxes. The idea seems to be quarantine and analysis of paradoxes if and when they arise. Psychologists/shrinks might wanna take a similar approach (too much effort?).

In addition, (true) paradoxes, if they exist, can be interpreted, from existing paradigms of thought, as the world, the universe itself as quite mad. The notion that peopls lose touch with reality (insanity) is then rendered meaningless, oui?, especially if sanity means avoiding contradictions.

Chew on that...

:smile:

Bird-Up

Great answer from Tom Storm.

Personally, I think delusions only exist in past-tense, when you are talking about a first-person perspective. After receiving new information, a belief/truth can become recategorized as a delusion; at which point the person no longer subscribes to the notion that it is authentic.

If someone says "I know it's a delusion but I still believe it", then I would disagree that they mean it literally. Delusions remain invisible while you have them. The best you can do is to look for warning signs that something you believe is suspicious.

Should we ostracize people for having uncommon beliefs? Certainly not. But the other side of the coin is encouraging people to pursue their beliefs indefinitely without any reality checks. That would also be a poor choice; one that is inherently incompatible with the idea of humans living together.

Agent Smith

I don't understand pharmaceutical therapy for delusions.

Clearly, a delusion is a false belief and one way of disabusing someone would be to disprove the false belief, oui? That is to say we need to argue with the person who is deluded.

If drugs can have the same effect as a good refutation argument, something's off, oui? I can't quite put my finger on it though, it's just a feeling.

A person X claims s/he is god! We sit down with him, argue and prove to him/her s/he's not! S/he no longer believes s/he's god.

A person Y too believes s/he's god. We put him/her on some antipyschotics! Promptly Y stops thinking s/he's god.

In a sense the antipyschotic medication = disproof, an argument!!! :chin:

Bird-Up

In a sense the antipyschotic medication = disproof, an argument! — Agent Smith

Or proof that human beliefs do not depend entirely on logic. If someone is feeling intense sensations of anxiety, they will eventually have to rationalize it as the existence of something terrible somewhere. If someone is feeling intense sensations of euphoria, they will eventually have to rationalize it as the existence of something wonderful somewhere.

Logic can only go so far when it comes to inhibiting notions in our brain.

Agent Smith

↪Bird-Up

PSR!

Angelo Cannata

It’s like a catch 22 situation. If a madman agrees he’s mad he’s mad, even he recognises it! (should this not actually show sanity?), if he denies his madness well that’s because he’s clearly mad right? — Benj96

It is simply relativism: everything is relative, you can have relative certainties, but not absolute, ultimate ones.

Hanover

Delusions are restricted to opposition/denial of known facts. For instance to say the earth is flat is delusional. — Agent Smith

There is often dispute over "known facts," which makes it difficult to call someone delusional just because they might be proceeding under a very different worldview and might be accepting justifications that you would never hold acceptable.

For instance, that the world is only a few thousand years old, that it was created in 6 days, that there was a flood that wiped out all living creatures except those housed in a protective ark, that the earth is in the center of the universe are all beliefs very much contrary to what I take to be "known facts," but I don't think a believer in those are delusional. I think they're wrong, but I also don't think they are mentally ill.

If someone believes that God spoke directly to them and warned them to watch out for the demons masquerading as small children who are out to destroy them, then that person would have delusions of grandeur, delusions of persecution, and paranoia, all of which I would have no difficulty as declaring as delusions. That mentally ill person though is far different from the guy who holds to antiquated beliefs imposed by an insular and likely unsophisticated social group.

Agent Smith

Spot on! However that leaves us with no way of defining "delusion". All the familiar landmarks have been declared invalid. Perhaps we're all sane, no one's really non compos mentis; either that or we're all cuckoo! Would you rather be thought of as sane or insane? Both perhaps, you know, just to add that zing to our lives?

Bylaw

If someone has a suspected delusion and is asked if they think it is a delusion they have two options:

1). They concede that it seems to be a delusion - in which case they agree with the doctor or person asking. This tends to be taken as confirmation that it’s a delusion.

2). They deny it’s a delusion, to them it seems perfectly reasonable and logical. But because they are suspected to be deluded this again seems to confirm their delusion?!

How can this be? It’s like a catch 22 situation. If a madman agrees he’s mad he’s mad, even he recognises it! (should this not actually show sanity?), if he denies his madness well that’s because he’s clearly mad right? — Benj96

It doesn't show the person is sane, but it might be a rational conclusion on that person's part. I am saying that we tend not to be binary, completely utterly sane with all rational beliefs, and totally utterly psychotic all the time. So, just because someone recognizes that they were deluded it does not mean they are simply in a box: sane. Further there are mixed reactions. One might say 'I understand it sounds crazy, but I believe it.' Or 'I get it, you weren't there, if you were, I think you'd be on my side or open to it.' There could be all sorts of other reactions that do not fit in a binary schema.

And here I am not assuming the person is deluded or that they are not. We don't know in this abstract situation whether they are correct or not, or believing on good grounds or not.

So to wrap things up, if someone has an outlandish or bizarre idea that the vast majority of others find difficult to comprehend, should we not be more careful and slow to ascribe a diagnosis. How many geniuses have we admitted to psychiatric institutions for their big ideas? Especially if it’s one that is metaphysical, epistemological or deontological in nature. — Benj96

Yes, I think we should be careful, especially if the diagnosis has large consquences. But usually not much is done if the person is getting along ok in life. They take care of their hygiene, hold down their job, don't hit people and so on. But, yes, I wish people were less smug and sure of things in reaction to unique beliefs and what others say they have experienced. The sexual abuse of children was considered some outlandish extremely rare activity, restricted to very odd people and the poor. So, accounts were considered delusional or intentionally false per se. That caused a lot of pain. Not that every account need be accepted. But the assumption of incredible unliklihood was not really grounded on anything. It was more political and cultural.

A brief discourse on Delusion.

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