Seventy kinds of crap. I had this all posted up and then I accidentally clicked on a link. When I got back to this page, all of my text was gone. If you want more details, please ask. Maybe I’ll be up for rewriting my whole post later, but I’m too frustrated now.
Basically, deciding the difference between a delusion and an eccentric thought is a very difficult and extremely subjective decision. Deciding the difference between an obsession and an enthusiasm can be just as difficult and subjective. I’m not going to even touch what happens when you include the more charismatic branches of religions into the mix.
It’s much easier and much more objective to evaluate someone’s behaviors and reactions to these thoughts than it is to evaluate the thoughts themselves. Check out this list of warning signs of mental illness:
If several of the following are occurring, a serious condition may be developing.
*Recent social withdrawal and loss of interest in others.
*An unusual drop in functioning, especially at school or work, such as quitting sports, failing in school, or difficulty performing familiar tasks.
*Problems with concentration, memory, or logical thought and speech that are hard to explain.
*Heightened sensitivity to sights, sounds, smells or touch; avoidance of over-stimulating situations.
*Loss of initiative or desire to participate in any activity; apathy.
*A vague feeling of being disconnected from oneself or one’s surroundings; a sense of unreality.
Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or “magical” thinking typical of childhood in an adult.
Fear or suspiciousness of others or a strong nervous feeling.
*Uncharacteristic, peculiar behavior.
*Dramatic sleep and appetite changes or deterioration in personal hygiene.
*Rapid or dramatic shifts in feelings or “mood swings.”
I highlighted the two warning signs that point to delusions and paranoia, so you can see that they are NOT removed from the evaluation altogether. But having delusions is not enough to cause enough concern to warrant a full evaluation on their own.
Many people have what some people would consider to be delusions. People believe in ghosts, or alien abductions, or ESP, or astral travel or Bigfoot. People think that they have special relationships with celebrities that they don’t really have. People may feel like dolls or photographs of people are watching them. People believe all kinds of things!
But if they can live a fairly normal life and these delusions don’t get in the way of their functioning, they aren’t “sick” enough to need treatment.
But it’s a general rule that while you may find an unusual case or two where someone has classic delusions associated with schizophrenia with no loss of quality of life, it’s extremely rare. Most people with a large number of severe delusions are suffering in many other ways.
Many people who suffer from delusions refuse to believe that their beliefs are delusions. It’s very difficult to convince someone like that to seek treatment because of their delusions alone. I think most therapists have given up the old tactics of getting someone to admit hat they are suffering from delusions and only declaring them competent when they stop having the delusions. It’s pointless. And it involves possible delusions that may not be considered delusions because of the religion they practice, it may infringe on their personal liberties.
While it’s almost impossible to force someone to admit that they may have a delusion, it’s not impossible to evaluate them based on the other criteria. It may be fairly easy to get them to admit that they aren’t sleeping well or feel anxious. It’s easier to develop a relationship as a therapist if you approach the other symptoms and leave the delusions themselves alone for the most part.
Wow. I guess I could rewrite my post.