Should We Stop Talking About Delusions?

by Lisa Bortolotti, Ph.D., a professor of philosophy at the University of Birmingham and the author of Why Delusions Matter and Delusions and Other Irrational Beliefs.

Terms such as delusions or conspiracy theories express a disapproving attitude. Suppose I am convinced that a celebrity I have never met is in love with me. My belief may be considered delusional. To call such a belief delusional is to say not simply that it is false—that I am mistaken about the celebrity’s feelings—but that something is wrong with my belief and with me.

If I say I believe that hurricanes are caused by a device the government is using to manipulate the weather, I may be called a conspiracy theorist. To call me a conspiracy theorist is to suggest that something is wrong with me and my belief as well. What is wrong?

Delusional beliefs and conspiracy theories seem both highly implausible to others and unshakeable. For instance, if you challenge my belief that a celebrity is in love with me based on the fact that you have never seen the two of us together, I might respond that he does not want his wife and fans to know about me. If you argue against my theory about hurricanes based on the fact that the government does not have the technology to control the weather, I might insinuate that they do have the technology but do not want us to know about it.

Given the negative connotations, terms such as “delusion” and “conspiracy theory” are often, and understandably, avoided to prevent stigmatizing already vulnerable people. Instead, beliefs such as those I mentioned may be called unusual or non-mainstream. However, changing our vocabulary will do little to address the stigma. People with beliefs deemed “unusual” or “non-mainstream” can still be excluded from opportunities to share knowledge and contribute to decision-making. In adopting this attitude, I wish to suggest, we miss something important both about the nature of unusual beliefs and about how we all form beliefs much of the time.

Are delusional beliefs harmful and pathological?

The idea that the delusion carries only harms and no benefits should be resisted. While delusions can be distressing, disrupt people’s lives and relationships, and motivate self-destructive behavior, not all delusions present in those ways, and even those that do may also have a protective function. Much of the harm experienced in relation to delusional beliefs stems from interpersonal and societal reactions, the loss of credibility, the stigma, and the exclusion that inevitably follows.

Are delusional beliefs pathological? Progress is being made in understanding how delusions and conspiracy beliefs develop. Numerous factors that play a role in the development of delusions have been identified and are being explored, including cognitive biases, psychological needs, and computational mechanisms. But there is no consensus on whether the relevant processes are dysfunctional. The processes likely to be responsible for the formation of clinical delusions and conspiracy beliefs are not dissimilar from standard belief formation processes and are subject to some of the same influences. Delusions, in other words, are not that unusual.

How should we think about delusions?

One strategy is to take distance from misleading negative assumptions about delusions and embrace what may be seen as their redeeming features: Delusions are meaningful. Moreover, they can be interpreted as a response to trauma and adverse experiences. We can view them as perspectives on the world worth investigating, not just random fabrications wildly detached from reality. Adopting this redemption strategy is worthwhile, because it undermines a simplistic view of delusional beliefs as mere “glitches in the brain”.

But there is a more radical strategy we can pursue: We can accept the idea that we have something to learn from delusions. The reason why delusional beliefs appear as glitches in the brain—as empty noises, harmful, detached from reality—is that we are wedded to the idea that people pursue true and rational beliefs for the sake of truth and rationality. Against the background of this idealized picture, delusions seem like a mystery and an aberration to eradicate.

But our psychological reality is quite different. We don’t just follow the evidence; we believe things for a wide range of reasons. We cherish some beliefs because they make us feel stronger. We endorse some beliefs to secure our friends’ approval. We sometimes commit to a theory without sufficient evidence because we cannot cope with the uncertainty. In this more realistic picture of belief, delusions are not the exception but the norm. They are part and parcel of our constant process of negotiation with reality.

Far from being a sign that our agency is irremediably compromised, delusions help us make sense of events that are elusive, uncertain, and potentially threatening. And we arrive at those beliefs with some of the same drives and methods that make science possible, including our fascination with causal explanations.

Seeing delusions and conspiracy theories as continuous with other beliefs has two important implications. First, no belief should be dismissed just because, in someone’s eyes, it is implausible and unshakeable. Delusions emerge from our psychological needs. There is much we can learn about each other and about the world as we experience it by engaging with each other’s delusional beliefs.

Second, as with the rest of our beliefs, delusions are not forever. While many delusions can play a positive role, over time the benefits are exhausted, and it is then best to replace delusions with beliefs that offer better explanations, particularly given that even delusions that have benefits can be a cause of stress, isolation, and harm. It is, therefore, important to seek an alternative despite the fact that renouncing a delusion may bring about a major shift in the speaker’s worldview.

Should we stop talking about delusions and conspiracy theories then? There are powerful reasons to do so, but my concern is that we risk missing out on the lessons that the use of those labels can teach us. Instead of changing the labels, maybe we can change the attitude that goes with them.