Imagine there's someone in your life you truly care for. A girlfriend, a boyfriend, a spouse, a child, a good friend, perhaps even a co-worker, who is, you know, a key employee.
What to do with these people that are amongst your nearest and dearest?
What to do if they are immured and immersed and entombed in a delusion? What to do if they have renounced reality, given up on it, and have chosen fantasy, deliberately, incrementally, imperceptibly or abruptly? Whatever the case may be, they end up being in a dreamscape. They end up being embedded in a domain or a space, which is inaccessible to information from the outside, to stimuli, to arguments, to other people, other people's opinions or other people's knowledge.
Delusions are rigid. Delusions are counterfactual. They defy the facts. Delusions are not open to any modification. They're immutable.
And so this creates a serious problem in interpersonal relationships and functioning.
Additionally, someone who is into fantasy, someone who is into delusions, is very vulnerable, very gullible, is open to abuse and exploitation. Financial abuse and exploitation, sexual abuse and exploitation, psychological abuse and exploitation, and all the other forms, even political abuse and exploitation. Ginger Coy coined the phrase political narcissistic abuse.
And so, what to do? Should you confront these people? Should you kind of shake them, don't wake up? You're wrong about this? It's totally fantastic, it's delusional, it's nonsense. Should you confront them with hard evidence of their own misperceptions? Should you elucidate how they have been misled to the position they're in right now? Should you act as an impromptu therapist, as a friend, as a reality tester, as an external regulator of emotions and moods.
I mean, what on earth can and should you do? What does clinical psychology have to say about all this? What's the best route forward?
Because delusions and fantasies, if they metastasize and take over a person can and do become very often dangerous, not only self-defeating, not only self-destructive, but absolutely positively. It is a moral obligation if you love someone, if you care for someone, or if you're just generally empathetic, it's a moral obligation to open the eyes of such deluded people, to try to substitute reality for fantasy, to try to drag them back into the world away from the surrealistic nightmarish or dreamscape that they're inhabiting right now. Wake them up, so to speak.
This awakening as a moral obligation has to be coupled with techniques, how to do it, and with strategies, what to do it for, with strategies what to do it for an overarching narrative that essentially says reality offers you more than fantasy and delusion and reality is likely to render you more self-efficacious. Reality is likely to guarantee that you will obtain favorable outcomes more reliably than if you are embedded in fantasy and in delusion.
This is the topic of today's video.
My name is Sam Vaknin. I'm the author of Malignant Self-Love, Narcissism Revisited, and a fantastic professor of clinical psychology. Not a delusion, alas.
Okay, Shfanim and Shoshanim and so and so forth.
First of all, we must distinguish between fantasy, delusion, theoryor working model, and dissociation.
A fantasy is basically a healthy thing. It's a kind of extended daydreaming.
In a fantasy, one can plan ahead. It leads to action via planning, so fantasies essentially are core elements in the anticipation of the future, the preparation for what's forthcoming, and the effectuation of chosen solutions and strategies.
It is only when fantasy becomes a defense, a psychological defense mechanism. It is only when fantasy gets out of hand that it veers away from reality and substitutes for it.
And then we have a kind of malignant fantasy. A fantasy that takes over all the mental apparatus and renders the individual inoperable in the space of reality, the realistic space.
We have this kind of fantasy in mental health issues, disorders, such as narcissistic personality disorder and borderline personality disorder, where fantasies or more precisely shared fantasies have taken over the individual and essentially eliminated the individual as an agent within reality.
In other words, these kind of fantasies remove the agency, they render the person non-agentic, and consequently much less self-efficacious.
Delusion is something completely different.
Delusion is much more structured. It's much more rigid.
As I said, it's not amenable to modification or reinterpretation. It's not open to outside countervailing information.
So delusion usually goes with very powerful confirmation bias.
And delusion is an organizing principle. It's a theory, it's an ideology, it's a kind of religion, if you wish.
And the delusion serves to explain every facet of reality and to make sense of one's own existence and personal biography.
So that's why delusions are very deeply rooted in the individual. They have hooks. They bait the individual into a symbiotic relationship.
And there is a merger and a fusion with a delusion. And the delusion becomes the only hermeneutic principle, the only explanation, explanatory principle.
And so it's impossible to get rid of it because what's the alternative? There's none.
In cults for example delusions are the operating system, the operating mechanism. Cults are very strong on delusions not so much fantasies.
And then there are theories about the world, and theories about other people. Theories about how other people work, what makes them tick.
These theories are known as theories of mind, and the process is called mentalization, first described by Fonagy.
There are also theories about relationships and theories about the world at large and these are known as internal working models first described by John Bowlby.
Theories and working models could be wrong. For, her child who has been exposed to abuse and trauma would definitely develop the wrong kind of internal working models and may be incapacitated when it comes to mentalization and the formation of theory of mind, theories of mind.
So this kind of child may have defective, partial, fragmented, counterfactual, delusional internal working models and theories about the world, about other people, about relationship, about oneself, and so on so forth.
So there is a confluence between disrupted or defective working models, internal working models and theories of mind and delusions.
It seems that early childhood adverse circumstances, abuse and trauma in a variety of ways, spoiling and pampering is also abuse. This kind of bad childhood experiences predisposed the individual to become later on in life delusional.
An example of a problematic theory of mind and a problematic internal working model is a conspiracy theory.
Conspiracy theory is wrong. They're also nonsensical. They're counterfactual. They leverage a trait known as conspiracism.
And they're an example of a theory of the world, theory of an internal working model that is actually delusional.
And finally, there's dissociation or repression of both. These are mechanisms intended to repress or reframe problematic mental content.
The mental content can be problematic because it conflicts with other mental content, creates dissonance, or because it is socially unacceptable, urges, sexual urges, other urges which are socially frowned upon, even criminal or because it is traumatic the experience of a trauma for example is problematic content and so on and so all these types of content they are repressed they're buried. They're buried.
And one of the main mechanisms of the funeral is dissociation.
Dissociation includes three types, amnesia, depersonalization, de-realization. I have a whole playlist on this channel, a playlist of trauma and dissociation, which I suggest that you watch.
But be that as it may we're beginning to see that fantasies and especially delusions have very deep roots usually in early childhood and they involve mechanisms which evolved psychologically to cope with reprehensible, obnoxious, unwanted, rejected, unexamined, unacceptable and frustrating content.
Why am I telling you this?
Because when you want to help someone who is in the throes of a delusion and yes delusions victimize people who are delusional are mentally ill. And they fall victim to their own delusions.
And so you want to help them. You want to help them.
When you want to help delusional people or people whose fantasy has become defensive and has replaced reality, you need to realize that you're not dealing with a surface phenomenon.
It's not like a preference for a brand. You know, I prefer this kind of coffee or this kind of shoes.
It's not something artificial or superficial or recent. It's not conscious, fully consciously adopted.
It's not like a person says, oh, starting on Wednesday, I would like to be delusional. Now let me review the field of delusions and choose one.
It's not the case. It's not a shopping experience.
And so it has very deep roots.
And if you try to help your loved one, for example, to stop being delusional, to emerge from the delusional, or reemerge from the delusional into sunlight and life and air and sociability and interpersonal interactions and love and flowers and I don't want to resurrect the person who is delusional, if you want to offer them an alternative to the fantasy, in case the fantasy has metastasized and taken over, then you need to be aware that you are tackling and dealing with core issues which may best be tackled in therapy. Maybe you're not qualified.
Fantasies and delusions, as I mentioned, have many functions.
One of them is to repress or reframe problematic mental psychological content including memories.
But they also, fantasies and delusions, they also provide meaning. They make life, render life meaningful. They afford, they provide a purpose, a direction. They make sense of things. They predict the future.
It's exactly like a scientific theory.
And so taking away the fantasy or the delusion is very dangerous unless you know what you're doing.
Because it leaves the individual with an existence that is meaningless, has no aim and direction and purpose.
And this is grounds for life-threatening effects and life-threatening ideation, suicidal ideation, and finally, life-threatening action.
Meaning, it's all about meaning.
You could survive in a concentration camp, in Auschwitz, in extermination camp, just by imbueing your life with meaning.
Ask Victor Frankl, Man's Search for Meaning.
Meaning holds you together, meaning allows you to overcome hurdles and obstacles and hardships to survive catastrophes the loss of loved ones.
I mean, meaning is the driver, is the car, is the engine, and is the fuel, all put together.
Take away the meaning from someone's life, and that life becomes untenable and non-desirable.
Meaning goes hand in hand with purpose, purpose goes hand in hand with direction, direction goes hand in hand with action planning, and your life suddenly makes sense.
Take away the delusion and the fantasy, without providing an ample functional substitute, you take away the meaning. Take away the meaning. You risk the life of that person.
Another function of delusions and fantasies is motivation.
Delusions and fantasies motivate you.
Ask any conspiracy theorist. Ask any narcissist who is engaged in the construction of his next or her next shared fantasy. Ask any borderline who is pursuing that single individual, that intimate partner who could regulate her moods and stabilize her affects, her emotions, and stabilize her labile moods.
Fantasies and delusions are a path. They are a trajectory. They're a road. And they beckon youto travel. They're a destination.
So they motivate, they're motivational. They're attitudinal, and they're motivational.
And finally, in highly specific mental health issues, such as borderline personality disorder, narcissistic personality disorder, antisocial personality disorder, paranoid personality disorder, bipolar disorder, and so on so forth, a few mental health issues, delusions and fantasies help the individual to maintain an inflated self-concept. A fantastic self-concept, a delusional self-concept, via the mechanisms of self-aggrandizement, which is a form of cognitive distortion, and self-enhancement.
So these are integral parts of the narcissist fantasy, for example.
And so you're beginning to see that fantasies and delusions are rooted in early childhood experiences and dynamics, unresolved usually, and provide an answer or a solution to multiple psychological needs.
This is a tree, not only with a canopy, but with deep roots.
You should be very careful when you confront this kind of construct.
When you attempt to deconstruct the fantasy, to expose the falsity of the delusion, however compassionately you do this, however gradually and incrementally, you are bound to provoke aggression.
The problem with aggression is that it could be externalized or internalized in the form of depression.
So when you confront a delusional person, a supporter of Donald Trump, for example, and you tell them, you know it's a delusion you're not grounded in reality it's really bad your divorce from the world even if you do this compassionately backed by a lot of evidence, incrementally, empathically, you're bound to provoke aggression.
And the aggression is frequently externalized, verbal aggression, even physical aggression, violence.
But in some cases the aggression is internalized, depending on upbringing and culture, society and so.
The aggression is internalized would lead to depression, suicidal ideation, in very extreme cases, suicide.
It's a dangerous game to take away people's fantasies and delusions when you have nothing else to offer them.
Reality testing, grounding, mindfulness are the conditions for functionality, being embedded in the present, feeling your body, grounded in reality, gauging and evaluating things, events, people, appropriately and correctly. These are preconditions for mental health.
You cannot be mentally healthyif your reality testing is impaired if you're not grounded in reality but with some kind of nonsensical delusion or idiotic fantasy or if you're not mindful if you're not in the present operating here and now if you are stuck somehow in the past or stuck somehow in the future, that's not good.
These are pathological conditions.
So it's true that you need always.
Reality testing, grounding in reality and mindfulness.
But these things are true only if reality itself is healthy and functional and not pathologized.
When you ask your patient or your spouse or your child or your best friend or your girlfriend or whoever, when you ask them to go back to reality, to return to reality, to revert, to revert to the world as it is, to give up on their fantasy defense, to give up on their protective bubble, delusional bubble, when you're asking them to give up so much, what are you offering instead?
A reality which is intolerable, which is harsh, which is unbearable, which is dystopian, who would want this kind of reality? Anomic societies, for example.
The rate of suicide in anomic societies is skyrockets, as Emil Durkheim observed, well over 100 years ago.
So sometimes fantasies and delusions are defenses against a reality which is even much worse than the delusionand much worse in the fantasy.
Sometimes it is mentally healthy to avoid reality.
To take a step back, to isolate yourself, to protect yourself by reframing and repressing and outright falsifying.
Because the alternative is that you will find yourself in this wasteland, in this horror film, in this place of terror, which is current day reality.
And so perhaps the technologies that encourage fantasy, such as social media, and perhaps the delusions we find ourselves more and more addicted to political delusions, cultural, social, and so on so forthand more addicted to political delusions, cultural, social, and so on so forth, perhaps they serve a purpose.
The purpose is to keep us alive until reality itself has changed and has become healthier, has become more functional, more livable, more acceptable, more bearable, more tolerable, a reality which allows one to thrive.
The truth is that reality as it is today doesn't.
And of course this raises a conundrum.
If people are delusional, if they live in Lala Land, in fantasy, in a dream scape, if they are dreaming all the time, how would they be able to operate in reality and on reality in order to change it for the better?
That's a conundrum and the answer is it's a problem.
If the only solution to a reality, which is anomic and dystopian, if the only solution is to escape that reality, then who would be left to change it for the better to improve it somehow and to allow us to return to reality, to give up on our delusions and fantasies in order to thrive and prosper and be happy or content at least in the world as it is.
When the world as it is threatening, when the world as it is hostile, when the world as it is unbearable and intolerable, who there would change it for us if we give up on the world if we withdraw draw the bridges and withdraw and avoid and go inwards and constrict our lives and isolate ourselves and avoid all types of interactions except within our demented minds if you construct technologies that create virtual bubbles that we can never exit what in the world will act as an agent of change or who will act as an agent of change?
And this is the terrifying plight of our generation.
There have been previous generations who have experienced hardships, much harder than ours. We are a bit spoiled.
There have been previous generations who have experienced hardships much harder than ours. We are a bit spoiled.
There have been previous generations that have adhered to fantasy. Religion is an example of a delusional mentally ill fantasy, God and other such nonsense.
But there's never been a generation to the best of my knowledge that combined all these strands into a giant collective pathology. I am not aware of a similar period in history.
And so this is really serious a serious menace when it comes to the very survival of our increasingly more delusional fantasy-immersed species.