Delusion as a symptom, symbol, and subjective experience

Abstract

Delusions are a key psychopathological phenomenon; therefore, within the biomedical model, they are most often associated with psychiatric categories, neurotransmitter imbalances and brain processes. However, due to their complexity and multifaceted nature, delusions cannot be adequately understood or treated through a psychiatric approach alone. This article offers a more comprehensive understanding of delusions and the possibility of a more holistic treatment by addressing them in three dimensions: (1) as a symptom within biomedical and neuroscientific paradigms, (2) as a symbol within psychoanalytic theories and literary art, and (3) as an individual‘s authentic subjective experience. This perspective transcends traditional dichotomies such as real/unreal and objective/subjective. It seeks to treat scientific discourse, artistic expression, and subjective experience as equals in the examination of delusions. It constructively integrates three distinct, legitimate sources and pathways to present delusion as a complex psychological phenomenon. Delusions are not merely cognitive distortions or erroneous thinking; they can also be profound and meaningful human responses to internal and/or external circumstances.

This article aims to take a holistic approach to individuals with delusions, to de-stigmatize delusions and mental disorders, and to humanize psychopathological phenomena — that is, natural mental phenomena which have been poorly understood, or understood too narrowly or one-sidedly, throughout history. This has led to them becoming alienated from the individual. Nevertheless, delusions persist in the human psyche due to their survival, adaptive and developmental roles. It is precisely because of their significance to humanity that they have probably endured for tens of thousands of years and across numerous generations. This article opens up the possibility of psychotherapeutic dialogue, complementing the clinical definition of delusions as erroneous perceptions and interpretations of reality with an understanding of their symbolic meaning and the subjective experience of those who have them.