The gap between delusion and our everyday beliefs is narrow, say psychiatrists and philosophers of neuroscience.
Which of our everyday beliefs can be characterized as delusions? What’s the similarity between clinical delusion and common irrational beliefs?
Delusions, according to the psychiatrists’ diagnostic manual (the DSM-5), are not simply a case of being mistaken, as the everyday use of the term suggests. Nor are delusions hallucinations.1 A delusion is a profound and intensely held belief that seems barely swayed by evidence to the contrary. Delusions are beliefs that are very resistant to counter-evidence and counter-argument. Many intense and stubborn beliefs fall into this category.
Example of Everyday Delusion
Falling madly in love is a cliche’. So much so that we ignore that fanatical love is a delusion.
Leonard Shengold, in his book Delusions of Everyday Life2 gives examples of everyday delusions such as being in love.
Shakespeare’s Romeo pines for his unrequited:
Not mad, but bound more than a madman is;
Shut up in prison, kept without my food,
Whipp’d and tormented…(I:ii:55-57)
Romeo expresses his love in romantic [and fanatic] language:
When the devout religion of mine eye
Maintains such falsehood, then turns tears to fires!
I’ll go along no such sight to be shown,
But to rejoice in splendor of mine own. (I:ii:93-106)
“There is no delusional idea held by the mentally ill which cannot be exceeded in its absurdity by the conviction of fanatics, either individually or en mass”,3 declared psychiatrist Alfred Hoche.
Delusion as Fixed Belief
On delusion described in the DSM-5, Lisa Bortolotti, Professor of Philosophy in Cognitive Science writes:4
Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Their content may include a variety of themes (e.g. persecutory, referential, somatic, religious, grandiose).[…] Delusions are deemed bizarre if they are clearly implausible and not understandable to same-culture peers and do not derive from ordinary life experiences. […] The distinction between a delusion and a strongly held idea is sometimes difficult to make and depends in part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence regarding its veracity.
Four Important Characteristics of Delusion in DSM-5
In her Imperfect Cognitions blog, Bortolotti elaborates on four characteristics of delusion:
1) Many philosophers and psychologists have noted, when commenting on the DSM-5 definition, delusions need not be false, and being false is no longer a necessary condition for a belief to be delusional in the DSM-5 description.
2) Delusions do not need to be about external reality or to be based on incorrect inference. They could be about oneself and one’s own experiences, requiring little or no inference.
3) We may have no proof against the truth of a belief, even when the belief is wildly implausible, and this is reflected in…the [DSM-5] phrase “despite clear or reasonable contradictory evidence regarding its veracity”.
4) Most important, Bortolotti sees this distinction [in the DSM-5] narrows the gap between delusions and other irrational beliefs, suggesting that the epistemic features of delusions are not unique to pathologies of the mind, but characterize many of our everyday beliefs.
The difference between delusion and everyday irrational beliefs is complex. Many of our everyday beliefs may be delusional. The key distinction is the degree of intensity we hold a belief–despite counter-evidence or lack of evidence. Delusion in this context is the fanatical adherence to belief. Like Romeo, when we fall madly in love with our ideas we are deluded. Do we have clinical delusion or pathological beliefs? Ask psychiatric professionals. What matters here is not whether our beliefs and ideas are accepted by ourselves, a community, or are considered normal or bizarre. Delusion is not unique to what we would typically call mental illness. There is a narrow gap between our everyday beliefs and delusion.
Am I deluded here? How do you see delusion?
1 American Psychiatric Association, What’s the Difference Between a Delusion and a Hallucination? Accessed 21 Mar 2015.
2 Leonard Shengold, Delusions of Everyday Life, Yale University Press. 1995. 153-4
3 Hoche quote from Chandra Kiran and Suprakash Chaudhury, Understanding delusions, Industrial Psychiatry Journal, v.18(1); Jan-Jun 2009.
4 Lisa Bortolotti, Imperfect Cognitions. Blog post, Delusions in DSM-5. Accessed 21 Mar 2015