Delusions of Grandeur
What is a psychotic?
The old joke has it that a neurotic knows that three and three make six - and worries about it... a psychotic knows that three and three make seven and is quite happy about it.
But it is no laughing matter. Psychosis is far more deviant and pathologically intense than neurosis: psychotics lose touch with reality as they act out their fantasies in life; they are usually quite barren of emotion, and appear shabby and disorientated. Since they do not differentiate between their own (subjective) reality and the real (objective) world around them, they do not understand that their behaviour is unusual or bizarre. It follows that the social restraints and behavioural rules applying to 'normal' people are non-existent for psychotics. They act out prevailing thoughts and feelings without inhibition. And with no pangs of guilt, shame or anxiety.
A psychosis is not simply an extension of a neurotic illness- neurotics do not ordinarily become psychotics. The dividing line between the two is stark and dramatic.
There are two main categories of psychoses. If a psychotic reaction is caused by some physical ailment, such as brain damage or biochemical imbalance, it is called organic psychosis. Functional psychoses, on the other hand, have their roots in a breakdown of behavioral function somewhere along the line. The functional psychoses include three well-known psychotic states: paranoid reactions, affective reactions and schizophrenic reactions.
Two psychotics were having a heated argument in their ward about which one of them was Moses. 'I know I'm Moses. God told me so!' said one with conviction.
A third patient, who had been looking on, cut in: 'Not true, not true. I never told you anything of the sort.'
No, still no laughing matter: these psychotics were suffering from delusions, which are characteristic of paranoid psychosis. In this instance it was delusions of grandeur.
Another type of delusion which is common in the paranoid state is that of reference. When this delusion takes hold, psychotics see everything that is happening around them as being aimed against them. For example, two old people sitting innocently on a park bench may appear to the tormented psychotic to be plotting his or her death. Delusions of persecution are similar to those of reference. 'Everyone dislikes me- they are all against me', complains the typical sufferer.
It is believed that those who have an overwhelming guilt about some kind of immoral behaviour are particularly prone to paranoiac persecution delusions. Other precipitators of paranoia are thought to be intense inferiority complexes and unrealistically high goals in life. Research has shown that paranoiacs generally come from higher socio-economic status levels than other maladjusted patients. They also tend to be intellectually superior.
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