Experiencing Delusions in Psychosis

18 Jun

Editor's Note

This transcript has been lightly edited for clarity, readability, and flow. Repetitions, filler words, and transcription artefacts have been removed while preserving the original meaning and perspective.

Introduction

When people think about psychosis, they often think about hallucinations. Voices, visions, and unusual perceptions tend to dominate public discussions.

Delusions are different.

They are not simply strange beliefs. They are experiences that can feel profoundly real, emotionally convincing, and deeply connected to a person's sense of self. They often emerge without warning, reshape how events are interpreted, and draw together elements of personal history, memory, fear, hope, and meaning.

In this video, I reflect on my own experiences of delusions across two psychotic episodes. I explore how delusions formed, how they changed over time, and why I believe they often draw upon significant experiences from a person's life. Along the way, I discuss ideas of reference, the role of personal history, the influence of culture, and the strange relationship between delusions and self-understanding.

This is not intended as a clinical account of delusions in general. It is a reflection on what delusions felt like from the inside.

Key Concepts

Delusions
Ideas of reference
Persecutory beliefs
Cotard syndrome
Truman Show delusion
Personal meaning
Psychosis and identity
Aberrant salience
Recovery
Lived experience

Watch the Video

https://www.youtube.com/watch?v=Nrukkk9Qjx8

Transcript

What Delusions Feel Like

One of the most important things to understand about delusions is that they don't usually feel like beliefs.

They feel like knowledge.

When I became psychotic for the first time, I woke up one morning absolutely convinced that I was going to be killed.

I didn't know who was going to do it.

I didn't know when it would happen.

I didn't have evidence.

But evidence wasn't the point.

The conviction existed at a deeper level than reasoning.

I knew it in the same way that I knew my own name.

It was embodied knowledge.

A certainty that seemed to exist throughout my entire body rather than simply in my thoughts.

The Persecutory Delusion

My first major delusion was straightforward in one sense and overwhelming in another.

I believed that people were planning to torture and murder me.

The details were vivid and terrifying.

Looking back, what strikes me most is not the content but the certainty.

There was no process of weighing evidence.

There was no internal debate.

The conclusion arrived fully formed.

The feeling came first.

The explanations followed later.

When One Delusion Becomes Another

Something fascinating happened during my admission.

While standing alone in a hospital chapel, I suddenly reconsidered the entire situation.

The persecutory delusion dissolved.

In its place emerged a completely different explanation.

I remembered applying years earlier to appear on a television programme hosted by Derren Brown.

Almost immediately, I became convinced that I had secretly been selected.

Everything around me suddenly made sense through this new framework.

The unusual behaviour of staff.

The strange sequence of events that had brought me to hospital.

The conversations I was having.

The forms I had been asked to complete.

All of it became evidence that I was participating in an elaborate reality television experiment.

The certainty remained.

Only the explanation changed.

The Primary Delusion and the Delusion Bucket

Looking back, my experience was that psychosis often involved a dominant narrative.

At any given time, there seemed to be one primary delusion organising everything else.

Around that central narrative sat numerous smaller delusions.

A brief conviction that I was dead.

A belief that I was about to become a father.

The idea that hidden messages were embedded in newspapers, television programmes, and conversations.

These subsidiary beliefs would emerge, persist for hours or days, and then disappear again.

The main delusion remained.

The supporting cast changed regularly.

The Cotard Experience

One evening I stood alone in my room under the ward lighting and became convinced that I had already died.

This resembles what psychiatrists call a Cotard delusion.

The feeling wasn't metaphorical.

I genuinely believed that I had crossed some boundary between life and death and was now wandering through a strange and confusing afterlife.

The conviction lasted for several hours before disappearing as suddenly as it had arrived.

At the time it felt entirely real.

The Escape Room

Much of my first episode revolved around the idea that I was trapped inside a giant puzzle.

I interpreted messages in newspapers.

Writing on ward walls.

Comments from staff.

Conversations between patients.

Everything appeared meaningful.

Everything seemed connected.

I became convinced that I was participating in a kind of reality television escape room and that the only way to leave was to decipher the clues correctly.

Looking back, I can see connections to my personal history.

Years earlier, a close friend and I had spent an entire night solving a complex online escape room game.

It was a memorable experience.

That memory appeared to have been incorporated into the structure of the delusion itself.

Why Personal History Matters

One thing I've noticed repeatedly is that delusions rarely emerge from nowhere.

The form may be unusual.

The logic may be distorted.

But the raw material often comes from real life.

Important memories.

Unresolved conflicts.

Personal fears.

Significant relationships.

Experiences that mattered.

Psychosis seems capable of drawing these elements together into new and often bizarre configurations.

The result is something that feels both deeply personal and profoundly unfamiliar.

Guilt, Identity, and Self-Discovery

During my admission, a psychiatrist once asked whether I felt guilty about anything.

My response was immediate:

"Do you want the whole list?"

That answer captured something important.

Much of the psychosis felt like an attempt to process years of accumulated emotional material.

Guilt.

Relationships.

Identity.

Fear.

Self-worth.

Questions I had avoided for years suddenly became impossible to ignore.

One example involved my sexuality.

During the episode, I became convinced that I had discovered something important about myself.

The reasoning that led me there was profoundly disorganised and delusionally influenced.

Yet when I look back, there was also a kernel of truth hidden within the confusion.

Psychosis did not create that aspect of my identity.

It merely brought it to the surface in a highly unusual way.

Delusions and Culture

Psychiatrists have long noticed that delusions often reflect the culture in which they occur.

The underlying themes remain surprisingly consistent across history.

People experience surveillance.

Control.

Persecution.

Special significance.

Thought broadcasting.

Thought insertion.

The details, however, change with the times.

Today someone might believe they are being monitored through technology or reality television.

A century ago the same underlying concerns might have been expressed through entirely different cultural symbols.

The structure remains familiar.

The content evolves.

Delusions as Meaning-Making

One reason I find delusions fascinating is that they often seem to function as meaning-making systems.

They provide explanations.

They organise uncertainty.

They connect events that would otherwise feel disconnected.

The problem is that the resulting explanations are frequently detached from reality.

That doesn't mean they are random.

Many of the themes embedded within my delusions reflected genuine concerns, conflicts, and experiences from my life.

The conclusions were false.

But the emotional questions being explored often felt very real.

A Word of Caution

Whenever people discuss meaning in psychosis, there is a risk of romanticising mental illness.

That isn't my intention.

Psychosis was terrifying.

It was disruptive.

It caused enormous suffering.

The fact that delusions may contain personally meaningful themes does not make psychosis desirable.

Nor does it imply that treatment is unnecessary.

The challenge is holding two ideas at the same time:

Delusions can be profoundly distressing and detached from reality.
Delusions can also draw upon genuine aspects of a person's history, identity, and emotional life.

I don't think those ideas are mutually exclusive.

Looking Back

When I reflect on my psychotic episodes now, I don't simply see bizarre beliefs.

I see a complicated interaction between biology, language, memory, culture, emotion, and personal history.

The delusions themselves were often false.

But the experiences drew attention to questions that were real.

Questions about identity.