Delusion, Trauma & Reality
Notes from the Trauma-nator
Most of us like to believe that we see situations objectively.
We don't.
Every one of us interprets what is happening through the lens of our history, expectations, fears, relationships and previous experiences.
Usually, we can step back, reconsider, take in new information and change our minds.
Sometimes we can't.
What Is a Delusion?
Clinically, a delusion is a strongly held belief that is not supported by reality and remains firmly held even when convincing evidence contradicts it.
That is different from:
being mistaken
being in denial
having poor judgment
interpreting something through old trauma
believing someone we love
being manipulated
having a strong opinion
experiencing dissociation
Those things may interfere with our ability to see a situation clearly, but they are not necessarily psychosis or delusion.
How Can an Otherwise Functioning Person Lose Perspective?
Our brains are designed first for survival, not perfect objectivity.
When something overwhelming happens, especially when we feel powerless, the brain may organize itself around surviving the situation.
We may:
minimize what is happening
disconnect from feelings or memories
rationalize another person's behavior
ignore information that feels threatening
become hyper-alert for danger
interpret present events through past traumatic experiences
cling tightly to an explanation because the alternative feels unbearable
Trauma can also involve dissociation—a feeling of disconnection from thoughts, memories, emotions, the body or surroundings.
That is different from delusion, although either can interfere with our perception of reality.
The Trauma-Bond Problem
When fear, attachment, dependency, intermittent kindness and mistreatment become intertwined, it can become extraordinarily difficult to evaluate a relationship objectively.
A person may find themselves thinking:
“Yes, this happened—but he didn't mean it.”
“She only behaves that way because she loves me.”
“Everyone else has misunderstood him.”
“If I were different, this wouldn't happen.”
Sometimes the person who challenges the relationship begins to feel like the enemy, while the person causing the harm feels like the safest person in the world.
That doesn't necessarily mean someone is delusional.
It does mean that attachment, fear and trauma can dramatically affect judgment.
What About Folie à Deux?
Folie à deux is an older French term meaning roughly “madness shared by two.”
Today it is usually discussed as shared psychosis or shared delusional beliefs.
It is rare.
It describes a situation in which people in a close relationship come to share the same actual delusional belief. Traditionally, one person has an established delusion and another person becomes convinced of it.
This is much more specific than two people simply reinforcing each other's unhealthy ideas.
A SIMPLE REALITY CHECK
When you wonder whether you are seeing something clearly, don't immediately ask:
“Am I crazy?”
Ask better questions.
1. WHAT DO I ACTUALLY KNOW?
Separate facts from conclusions.
Fact:
“He didn't answer my calls for six hours.”
Interpretation:
“He must be having an affair.”
Those are not the same thing.
Write down what you can actually observe.
2. WHAT ELSE COULD EXPLAIN THIS?
Try to identify at least three possible explanations.
If only one explanation feels possible, especially when you are frightened or angry, your nervous system may be narrowing your thinking.
3. WHAT WOULD I THINK IF THIS WERE HAPPENING TO SOMEONE I LOVE?
Trauma and attachment can create enormous blind spots.
Imagine your daughter, son, best friend or grandchild describing exactly what you are experiencing.
What would you tell them?
4. WHAT EVIDENCE WOULD CHANGE MY MIND?
This may be the most important question.
Ask yourself:
“Is there any evidence I would accept that could prove my belief wrong?”
If the answer is nothing could change my mind, stop and become curious about that.
5. AM I ONLY GETTING INFORMATION FROM ONE PERSON?
Isolation makes reality-testing harder.
Talk with people who are:
outside the situation
emotionally steady
willing to disagree with you
not invested in a particular outcome
You are not looking for someone who automatically agrees with you.
You are looking for another set of eyes.
6. WHAT IS MY BODY DOING?
Before deciding what something means, notice whether you are:
terrified
enraged
exhausted
panicked
dissociated
sleep-deprived
overwhelmed
A nervous system in survival mode does not evaluate information the same way a settled nervous system does.
Regulate first.
Then reconsider.
7. HAS THIS BELIEF CHANGED MY BEHAVIOR?
Pay particular attention if a belief is causing you to:
withdraw from everyone
stop sleeping
become increasingly suspicious
repeatedly check or monitor someone
feel that ordinary events contain special messages for you
feel certain that people are conspiring against you
hear or see things other people don't
become frightened enough to hurt yourself or someone else
Those are reasons to get professional help rather than trying to solve the question alone.
HOW TO GET YOUR PERSPECTIVE BACK
Slow down.
You do not have to act on every thought simply because the thought feels true.
Regulate your nervous system.
Breathe, sleep, eat, move your body and get physically grounded before making major decisions whenever possible.
Write down facts separately from interpretations.
Seeing them on paper can be surprisingly revealing.
Look for disconfirming evidence.
Don't only collect information that proves you right. Deliberately ask:
“What evidence suggests I might be wrong?”
Consult someone independent.
Choose someone who will tell you the truth rather than someone who will simply validate your position.
Resolve the trauma underneath the reaction when possible.
When old traumatic material is repeatedly activated, resolving the underlying traumatic memory can help the present become the present again instead of continually being interpreted through the past.
And sometimes, get professional help.
A sudden major change in someone's ability to distinguish what is real—particularly when accompanied by hallucinations, intense paranoia, severe sleep loss, substance use, medication changes or unusual behavior—deserves medical or mental-health evaluation.
THE QUESTION ISN'T:
“Am I crazy?”
The better question is:
“HOW DO I KNOW THAT WHAT I BELIEVE IS TRUE?”
Being willing to ask that question is not weakness.
It is one of the healthiest forms of reality testing we have.
Teresa Descilo, MSW, MCT
International Trauma Resolution & Resiliency Center
TeresaDescilo.com