Delusion or reality?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.


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Sometimes delusions get people into trouble.

One problem area for mental health is distinguishing between delusions and reality. If

something is highly unlikely and yet despite mounds of evidence that can’t be true, that someone still firmly believes in its truth, it’s likely to be a delusion. Unfortunately, one person’s belief may be another person’s delusion. Disagreements about the truth often result in violence. After there’s been a violent incident, the question often arises why hadn’t someone spotted that person who was likely to become violent?

Identifying when someone is delusional is the first step. Figuring out when that delusion will lead that person to violence is a much more difficult task.

Defining delusions.

The technical definition of delusions is fixed beliefs which people are unwilling to change even when presented with evidence to the contrary. The harder it is to tell what is truth and what is delusion the more likely it is to result in violence. Religion and politics are two areas particularly prone to disagreements that lead to violence.

Here’s a list of the recognized themes of delusions.

  1. Someone’s out to get me, technically called persecutory delusions.
  2. Grandiose delusions, the person believes they are special and have exceptional abilities.
  3. Love and sex delusions are technically called erotomanic delusions, during which the delusional person believes someone is in love with them or wants them sexually.
  4. Nihilistic delusions involve the fixed belief that a major disaster will occur.
  5. Delusions regarding health and body functioning are called somatic delusions.

Is that delusion bizarre?

When other people in your culture don’t believe, something could happen, it would not be a normal experience for them. Common examples of beliefs that would be considered bizarre delusions include the idea that someone is beaming thoughts into your head or removing your thoughts. Some people also believe that an outside force is controlling them.

The problem with diagnosing delusions.

Delusions can occur in the course of several mental illnesses. There is also one specific category titled Delusional Disorder (F-22) which is a catchall for several distinct kinds of delusions which occur outside the course of another mental illness.

One type of delusion which results in a lot of problematic behavior is the delusional form of jealousy. Jealousy is a complicated topic; not all jealousy is delusional. But delusional jealousy, sometimes described as morbid or pathological jealousy, can result in stalking and interpersonal violence.

In upcoming blog posts, we will look at delusional disorder and then some of the varieties of jealous behavior, when is jealousy good for relationships, as well as how and when jealousy become dangerous.

Staying connected with David Joel Miller

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at

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