Posted by alexandra_k on December 20, 2004, at 1:23:07
In reply to DSM version sound, but,,,, posted by smokeymadison on December 20, 2004, at 0:20:21
I think I remember you contributing to the BPD thread - right? It is part of the criteria for that one that you can get a little bit psychotic (delusions included) in times of severe stress. I do this too - paranoia mostly, but sometimes grandiose.
>Would you consider this delusional? or perhaps just obsessional?
Welllll I am not a Dr. and one isnt' supposed to try to use DSM to diagnose without all that training... but my guess would be that it would probably be considered delusional in virtue of the BPD diagnosis and the provision there of the brief psychotic episodes. If you have been clearly obsessional about other things then maybe they might be more inclined to consider it obsessional - kind of in keeping with what they had already observed / noted. I think there is a great deal of controversy over the distinction (and indeed whether there is a hard and fast one) between over-valued ideas, obsessions, and delusions. I don't know too much about it really. I guess that because there are so many problems with definiton it may be best to consider utterances and how close they stand to some fairly typical exemplars. Considering someone is trying to kill you when they aren't seems fairly text-book paranoid, so my guess would be that delusional it is.
>everything my senses took in told me that i was in no harm, but in my head i was sure that i was going to die. he wasn't loud or threatening in any way, looking back on it, of course. i "snapped" out of it after a week. it just hit me how ridiculous i was being.
It is of considerable interest to me (and others) whether delusions are 'rationalisations' offered for certain kinds of anomalous experiences (e.g., strong feeling that someone wishes you harm); or whether the belief kind of occurs to one with a strong sense of conviction attached to it and that this results in the experience of a strong feeling that someone wishes you harm. The first is an 'empirical' or 'bottom-up' model, whereas the second is a 'rationalist' or 'top-down' model.
> sometimes i feel like i am being watched. i try to act normal, but i act as if someone is watching. it is just a feeling i can't shake.Does it seem to be a feeling, or a belief (firstly). Maybe these two things are impossible to disentangle though...
> is someone delusional if their BEHAVIOR is governed by a false belief while some small part of them, far in the back of their mind, knows that the belief that drives the behavior is false? i am starting from the premise that thoughts drive behavior. what is more important in diagnosing psychosis, the delusional behavior or the tiny thought that contradicts it?Some people act on their delusions, whereas others do not. Someone had the delusion that they were napolean, yet they did not attempt to order their troops around in the hospital. Closer to what I am talking about, some people with the Capgras delusion act on their delusion (e.g., one man decapitated his stepfather after becoming convinced he was a robot. He said that he did this in order to look for the batteries and microfilm in his head). While others do not seem to act in ways one would expect. Most people with the Capgras delusion show a suprising lack of concern as to where their loved one might have gotten to, and they do not report their disappearance to the relevant authorities.
It is hard to figure why some people act on their delusions whereas others do not. It is also of considerable clinical interest (with respect to protecting innocent people). So, anyway, I figure that diagnoses of delusions are made on the basis of comparing the UTTERANCES of subjects with some fairly standard exemplars of typical types of delusions within the context of the subjects overall presentation. Go with UTTERANCES rather than behaviour because many delusional people do not act out.
Hey, thanks for your thoughts :-)
poster:alexandra_k
thread:431767
URL: http://www.dr-bob.org/babble/write/20041210/msgs/431946.html