The case for purposeful as well as pathological delusions.

“In the movie "A Beautiful Mind," a fictionalized John Nash decides to stop taking his antipsychotic medication. Within weeks, he begins to see coded messages everywhere. They alert him to a secret mission of global significance. When he finally encounters the imaginary Agent in Charge, Nash says, “I was so scared you weren’t real.” With this line, the filmmakers hint that Nash’s delusions may have psychological benefits. They turn his boring academic existence into a breathtaking adventure. They give him a geopolitical mission of earth-shattering proportions.

Do delusions ever benefit those who suffer from them?

Consider what's known as Reverse Othello Syndrome. This is the delusional belief that one’s partner is sexually faithful, in the face of overwhelming evidence to the contrary. Why would someone ever form this idea? The discoverer of Reverse Othello thought he had the answer. He wrote that the delusion is “an active attempt… to confer meaning on otherwise catastrophic loss or emptiness.” The delusion might buffer our minds from an unbearable truth.

Philosopher Lisa Bortolotti calls such delusions “motivated delusions.” Along similar lines, psychologist Ryan McKay and philosopher Daniel Dennett describe the “shear pin” theory of delusion. Like a shear pin, a delusion might act as a little breakdown that stops a big breakdown from happening. Psychiatrist Rosa Ritunnano has also written on the purposeful character of some delusions.

Making Sense of a Strange World

Delusions may have other benefits, in addition to protecting us from hard truths. They might help us make sense of hallucinations or other strange perceptual experiences. They can give us an anchor of meaning when our perceptual experiences start to change.

Consider Capgras Syndrome, the delusional belief that a person you love has been replaced by a perfect imposter. Some think Capgras happens when the parts of the brain that recognize faces, and those that stir our emotions, aren’t talking to each other.

So, are delusions good for you? Maybe the truth is somewhere in the middle. Perhaps there are different kinds of delusions, some purposeful and others pathological. Further research can help us decide. But the disease model shouldn’t be our default assumption. We should learn how to adopt different perspectives on a complex reality. Being unable to step outside of old paradigms isn’t in the interest of science, and it’s not in the interest of people who seek professional help.

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Reflection: Do you agree that delusions have protective power? Why/Why not?

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