Ideas of reference and delusions of reference describe the phenomenon of an individual experiencing innocuous events or mere coincidences [1] and believing they have strong personal significance. [2] It is "the notion that everything one perceives in the world relates to one's own destiny", usually in a negative and hostile manner. [3]
In psychiatry, delusions of reference form part of the diagnostic criteria for psychotic illnesses such as schizophrenia, [4] delusional disorder, and bipolar disorder with mania, as well as for the narcissistic and schizotypal types of personality disorder. [5] To a lesser extent, their presence can be a hallmark of paranoid personality disorder, as well as body dysmorphic disorder. They can be found in autism during periods of intense stress. [6] They can also be caused by intoxication, such as from stimulants like methamphetamine.
In Sigmund Freud's view, "Delusions of being watched present this power in a regressive form, thus revealing its genesis...voices, as well as the undefined multitude, are brought into the foreground again by the [ paranoid] disease, and so the evolution of conscience is reproduced regressively." [7] As early as 1928, Freud's contemporary, Carl Jung, introduced the concept of synchronicity, a theory of "meaningful coincidences". [8]
In 1946, Otto Fenichel concluded that "the projection of the superego is most clearly seen in ideas of reference and of being influenced....Delusions of this kind merely bring to the patient from the outside what his self-observing and self-critical conscience actually tells him." [9]
Jacques Lacan similarly saw ideas of reference as linked to "the unbalancing of the relation to the capital Other and the radical anomaly that it involves, qualified, improperly, but not without some approximation to the truth, in old clinical medicine, as partial delusion" [10] —the "big other, that is, the other of language, the Names-of-the-Father, signifiers or words", [11] in short, the realm of the superego.
Validation rather than clinical condemnation of ideas of reference is frequently expressed by anti-psychiatrists, on the grounds, for example, that "the patient's ideas of reference and influence and delusions of persecution were merely descriptions of her parents' behavior toward her." [12] While accepting that "there is certainly confusion between persecutory fantasies and persecutory realities", figures like David Cooper believe that "ideas of connection with apparently remote people, or ideas of being influenced by others equally remote, are in fact stating their experience" of social influence – albeit in a distorted form by "including in their network of influence institutions as absurd as Scotland Yard, the Queen of England, the President of the United States, or the BBC". [13]
R. D. Laing took a similar view of the person who was "saying that his brains have been taken from him, that his actions are controlled from outer space, etc. "Such delusions are partially achieved derealization-realizations." [14] Laing also considered how "in typical paranoid ideas of reference, the person feels that the murmurings and mutterings he hears as he walks past a street crowd are about him. In a bar, a burst of laughter behind his back is at some joke cracked about him", but felt that deeper acquaintance with the patient reveals in fact that "what tortures him is not so much his delusions of reference, but his harrowing suspicion that he is of no importance to anyone, that no one is referring to him at all." [15]
Ideas of reference must be distinguished from delusions of reference, which may be similar in content but are held with greater conviction. [16] With the former, but not the latter, the person holding them may have "the feeling that strangers are talking about him/her, but if challenged, acknowledges that the people may be talking about something else". [17]
From the psychoanalytic view, there may be at the same time "transitions...to delusions" from ideas of reference: "abortive ideas of reference, in the beginning of their development or, in schizotypal personalities, continuously, may remain subject to the patient's criticism...under adverse circumstances, by minimal economic shifts, however, reality testing may be lost and daydreams of this kind turn into delusions." [18]
It has been noted that a person "rigidly controlled by his superego...readily forms sensitive ideas of reference. A key experience may occur in his life circumstances and quite suddenly these ideas become structured as delusions of reference." [19] Within the "focus of paranoia...that man crossing his legs, that woman wearing that blouse—it can't just be accidental. It has a particular meaning, is intended to convey something." [20]
Persons with ideas of reference may experience:
In psychology, fantasy is a broad range of mental experiences, mediated by the faculty of imagination in the human brain, and marked by an expression of certain desires through vivid mental imagery. Fantasies are generally associated with scenarios that are impossible or unlikely to happen.
Psychoanalysis is a theory developed by Sigmund Freud. It describes the human soul as an apparatus that emerged along the path of evolution and consists mainly of three parts that complement each other in a similar way to the organelles: a set of innate needs, a consciousness that serves to satisfy them, and a memory for the retrievable storage of experiences during made. Further in, it includes insights into the effects of traumatic education and a technique for bringing repressed content back into the realm of consciousness, in particular the diagnostic interpretation of dreams. Overall, psychoanalysis represents a method for the treatment of mental disorders.
Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself. Paranoia is distinct from phobias, which also involve irrational fear, but usually no blame.
A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other misleading effects of perception, as individuals with those beliefs are able to change or readjust their beliefs upon reviewing the evidence. However:
Delusional disorder, traditionally synonymous with paranoia, is a mental illness in which a person has delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. Delusions are a specific symptom of psychosis. Delusions can be bizarre or non-bizarre in content; non-bizarre delusions are fixed false beliefs that involve situations that could occur in real life, such as being harmed or poisoned. Apart from their delusion or delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behavior does not necessarily seem odd. However, the preoccupation with delusional ideas can be disruptive to their overall lives.
Richard Bentall is a Professor of Clinical Psychology at the University of Sheffield in the UK.
Infatuation, also known as being smitten, is the state of a person being carried away by an unreasoned passion, usually towards another person for whom one has developed strong romantic feelings.
Paranoid personality disorder (PPD) is a mental disorder characterized by paranoia, and a pervasive, long-standing suspiciousness and generalized mistrust of others. People with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. They are eager observers and they often think they are in danger and look for signs and threats of that danger, potentially not appreciating other interpretations or evidence.
In psychology and psychiatry, scopophilia or scoptophilia is an aesthetic pleasure drawn from looking at an object or a person. In human sexuality, the term scoptophilia describes the sexual pleasure that a person derives from looking at prurient objects of eroticism, such as pornography, the nude body, and fetishes, as a substitute for actual participation in a sexual relationship.
Daniel Paul Schreber was a German judge who was famous for his personal account of his own experience with schizophrenia. Schreber experienced three distinct periods of acute mental illness. The first of these, in 1884-1885 was what was then diagnosed as dementia praecox. He described his second mental illness, from 1893 to 1902, making also a brief reference to the first disorder from 1884 to 1885, in his book Memoirs of A Nervous Illness. The Memoirs became an influential book in the history of psychiatry and psychoanalysis because of its interpretation by Sigmund Freud. There is no personal account of his third disorder, in 1907–1911, but some details about it can be found in the Hospital Chart. During his second illness he was treated by Paul Flechsig, Pierson (Lindenhof), and Guido Weber.
In psychology, intellectualization (intellectualisation) is a defense mechanism by which reasoning is used to block confrontation with an unconscious conflict and its associated emotional stress – where thinking is used to avoid feeling. It involves emotionally removing one's self from a stressful event. Intellectualization may accompany, but is different from, rationalization, the pseudo-rational justification of irrational acts.
Franz Gabriel Alexander was a Hungarian-American psychoanalyst and physician, who is considered one of the founders of psychosomatic medicine and psychoanalytic criminology.
In Freudian psychoanalysis, the ego ideal is the inner image of oneself as one wants to become. It consists of "the individual's conscious and unconscious images of what he would like to be, patterned after certain people whom ... he regards as ideal."
In psychoanalysis, resistance is the individual's efforts to prevent repressed drives, feelings or thoughts from being integrated into conscious awareness.
Identification is a psychological process whereby the individual assimilates an aspect, property, or attribute of the other and is transformed wholly or partially by the model that other provides. It is by means of a series of identifications that the personality is constituted and specified. The roots of the concept can be found in Freud's writings. The three most prominent concepts of identification as described by Freud are: primary identification, narcissistic (secondary) identification and partial (secondary) identification.
Grandiose delusions (GDs), also known as delusions of grandeur or expansive delusions, are a subtype of delusion characterized by extraordinary belief that one is famous, omnipotent, wealthy, or otherwise very powerful. Grandiose delusions often have a religious, science fictional, or supernatural theme. Examples include the extraordinary belief that one is a deity or celebrity, or that one possesses extraordinary talents, accomplishments, or superpowers.
Psychoanalytic sociology is the research field that analyzes society using the same methods that psychoanalysis applies to analyze an individual.
A persecutory delusion is a type of delusional condition in which the affected person believes that harm is going to occur to oneself by a persecutor, despite a clear lack of evidence. The person may believe that they are being targeted by an individual or a group of people. Persecution delusions are very diverse in terms of content and vary from the possible, although improbable, to the completely bizarre. The delusion can be found in various disorders, being more usual in psychotic disorders.
In psychology, narcissistic withdrawal is a stage in narcissism and a narcissistic defense characterized by "turning away from parental figures, and by the fantasy that essential needs can be satisfied by the individual alone". In adulthood, it is more likely to be an ego defense with repressed origins. Individuals feel obliged to withdraw from any relationship that threatens to be more than short-term, avoiding the risk of narcissistic injury, and will instead retreat into a comfort zone. The idea was first described by Melanie Klein in her psychoanalytic research on stages of narcissism in children.
Paranoid anxiety is a term used in object relations theory, particularly in discussions about the Paranoid-schizoid and depressive positions. The term was frequently used by Melanie Klein, especially to refer to a pre-depressive and persecutory sense of anxiety characterised by the psychological splitting of objects.
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