Tuesday, January 21, 2014

Delusions..Allen Frances's Essentials of Psychiatric Diagnosis responding to the Challenge of DSM-5 (The Guilford Press, 2013)

........It is not the wrongness of the belief that defines a delusion, but rather it's being held in the face of universal consensual invalidation. Of course, this distinction is difficult to apply and can lead to some strange paradoxes. Galileo might accurately have fit this definition of "delusional", given the consensual state of scientific knowledge in 1600. And Jim Jones might not have been considered delusional, given the fact that his Jonestown cult provided consensual validation of his wacky and dangerous beliefs..........

This sentence gave me such a joyful Eureaka feeling, when I read it, I cannot express! I have been reading the definitions of delusions  since the last 30 odd years and until this wonderful definiton by Frances,  the definitions always stressed on the falseness of the belief('A delusion is a firm, fixed, unshakable false belief held by an individual' etc,etc,etc)
This description of delusion especially the fact that it is NOT THE WRONGNESS OF THE BELIEF THAT DEFINES A DELUSION, is so right and I am wondering why no one ever thought of it before...I thought of it but did not state publicly what I truly felt and this person Frances has done it!
This description of the delusion makes so many things easy and clear to me.
I can use this aspect of the delusion when I do CBT with clients ........
I can stop getting into arguments when I am accused of being delusional by thinking of this !
I can understand  better and empathize with delusional people...especially those who are not diagnosed with delusional disorder but those millions of people who are doing the same thing over and over again, with little success but strong beliefs.........Like a madcap I know who keeps buying arid agricultural land with high-interest-borrowed-money as he believes the value of this land will go up and up and up.

Normality and abnormality of human behaviour and  the criteria for mental health and illness in various cultures and situations is one area which has always facinated me.  I have written about my take on some aspects of mental illness in other articles of this blog. I will be writing more on delusions(my take on delusions...not regurgigated from other articles on the net or from texts) as delusions  facinate me; it is not the dramatic, exotic and obviously psychotic delusions that facinate me but  the subtle ones, which hover between non-delusional and delusional. The same behaviour falling at different points in the continum from  non-delusion to delusion, when it occurs in different cultures, times, places, genders, etc.
Let me give an example...
a girl of 15 refusing to step out of her house after 6 pm in Cairo as she is afraid of being attacked verbally or physically ..is she delusional or right or over cautious
This same girl of 15 has moved to  a small town in USA and is refusing to step out of her house after 6pm.

 I have written an article on judgement(What causes poor judgement? in 2012) which is sort of about delusions to some extent....poor judgements  are caused in part by delusions

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