This article is about a mental illness. For the album by Psyopus, see Ideas of Reference.
Ideas of reference and delusions of reference describe the phenomenon of an individual's experiencing innocuous events or mere coincidences and believing they have strong personal significance. It is "the notion that everything one perceives in the world relates to one's own destiny".
In psychiatry, delusions of reference form part of the diagnostic criteria for psychotic illnesses such as schizophrenia,delusional disorder, bipolar disorder (during the elevated stages of mania), as well as schizotypal personality disorder. To a lesser extent, it can be a hallmark of paranoid personality disorder. Such symptoms can also be caused by intoxication, especially with hallucinogens or stimulants like methamphetamine.
Sigmund Freud considered that ideas of reference illuminated the concept of the superego: 'Delusions of being watched present this power in a regressive form, thus revealing its genesis...voices, as well as the undefined multitude, are brought into the foreground again by the [paranoid] disease, and so the evolution of conscience is reproduced regressively'.
In his wake, Otto Fenichel concluded that 'the projection of the superego is most clearly seen in ideas of reference and of being influenced....Delusions of this kind merely bring to the patient from the outside what his self-observing and self-critical conscience actually tells him'.
Lacan similarly saw ideas of reference as linked to 'the unbalancing of the relation to the capital Other and the radical anomaly that it involves, qualified, improperly, but not without some approximation to the truth, in old clinical medicine, as partial delusion'—the 'big other, that is, the other of language, the Names-of-the-Father, signifiers or words', in short, the realm of the superego.
Main article: Anti-psychiatry
For the antipsychiatrists, validation rather than clinical condemnation of ideas of reference frequently took place, on the grounds for example that 'the patient's ideas of reference and influence and delusions of persecution were merely descriptions of her parents' behavior toward her'. Whilst accepting that 'there is certainly confusion between persecutory fantasies and persecutory realities', figures like David Cooper considered that 'ideas of connection with apparently remote people, or ideas of being influenced by others equally remote, are in fact stating their experience' of social influence—albeit in a distorted form by 'including in their network of influence institutions as absurd as Scotland Yard, the Queen of England, the President of the United States, or the B. B. C.'
R. D. Laing took a similar view of the person who was 'saying that his brains have been taken from him, that his actions are controlled from outer space, etc. Such delusions are partially achieved derealization-realizations '.
Laing also considered of the way 'in typical paranoid ideas of reference, the person feels that the murmurings and mutterings he hears as he walks past a street crowd are about him. In a bar, a burst of laughter behind his back is at some joke cracked about him' that deeper acquaintance with the patient reveals in fact that 'what tortures him is not so much his delusions of reference, but his harrowing suspicion that he is of no importance to anyone, that no one is referring to him at all'.
Delusions of reference
'Ideas of reference must be distinguished from delusions of reference, which may be similar in content but are held with greater conviction'. With the former, but not the latter, the person holding them may have 'the feeling that strangers are talking about him/her, but if challenged, acknowledges that the people may be talking about something else'.
From the psychoanalytic view, there may be at the same time 'transitions...to delusions' from ideas of reference: whereas 'abortive ideas of reference, in the beginning of their development or, in schizotypal personalities, continuously, may remain subject to the patient's criticism...under adverse circumstances, by minimal economic shifts, however, reality testing may be lost and daydreams of this kind turn into delusions'.
It has been noted that the character 'rigidly controlled by his superego...readily forms sensitive ideas of reference. A key experience may occur in his life circumstances and quite suddenly these ideas become structured as delusions of reference'. Within the 'focus of paranoia...that man crossing his legs, that woman wearing that blouse—it can't just be accidental. It has a particular meaning, is intended to convey something'.
Persons with ideas of reference may experience:
- Believing that 'somehow everyone on a passing city bus is talking about them, yet they may be able to acknowledge this is unlikely'.
- A feeling that people on television or radio are talking about or talking directly to them
- Believing that headlines or stories in newspapers are written especially for them
- Believing that events (even world events) have been deliberately contrived for them, or have special personal significance for them
- Believing that the lyrics of a song are specifically about them
- Believing that the normal function of cell phones, computers, and other electronic devices are sending secret and significant messages that only they can understand or believe.
- Seeing objects or events as being set up deliberately to convey a special or particular meaning to themselves
- Thinking 'that the slightest careless movement on the part of another person had great personal meaning...increased significance'.
- Thinking that posts on social network websites or Internet blogs have hidden meanings pertaining to them.
- Believing that the behavior of others is in reference to an abnormal, offensive body odor, which in reality is non-existent and cannot be detected by others (see: olfactory reference syndrome).
- In Mrs Dalloway, as a plane flies over a shell-shocked soldier, '"So, thought Septimus, they are signalling to me...smoke words"'. The author, Virginia Woolf, recorded in a memoir how she herself 'had lain in bed...thinking that the birds were singing Greek choruses and that King Edward was using the foulest possible language among Ozzie Dickinson's azaleas'
- In Margaret Mahy's Memory, the confused adolescent hero decides 'to abandon himself to the magic of chance. From now on his signposts would be words overheard accidentally, graffiti, advertisements, street names...the clues the city offered him'.
- The Naval Intelligence hero of Treason's Harbour reflects ruefully that 'after a while an intelligence-agent tended to see spies everywhere, rather as certain lunatics saw references to themselves in every newspaper'.
- In Vladimir Nabokov's short story Signs and Symbols, initially published in 1948, the parents of a suicidal youth suffering from a variation of this disease; "referential mania", decide to remove him from a hospital in order to keep a more watchful eye.
- ^Kiran C, Chaudhury S (2009). "Understanding delusions". Ind Psychiatry J. 18: 3–18. doi:10.4103/0972-6748.57851. PMC 3016695. PMID 21234155.
- ^Lawrence M. Porter, Women's Vision in Western Literature (2005) p. 117
- ^Andreasen, Nancy C. (1984). "Scale for the assessment of positive symptoms"Archived 2010-12-28 at the Wayback Machine.; The Movement Disorder Society.
- ^Sigmund Freud, On Metapsychology (PFL 11) p. 90
- ^Otto Fenichel, The Psychoanalytic Theory of Neurosis (London 1946) p. 430-1
- ^Jacques Lacan, Ecrits: A Selection (London 1996) p. 214
- ^Philip Hill, Lacan for Beginners (London 1997) p. 160
- ^Thomas J. Scheff, Being Mentally Ill (1999) p. 180
- ^David Cooper, The Death of the Family (Penguin 1974) p. 14 and p. 82
- ^R. D. Laing, Self and Others (Penguin 1969) p. 39
- ^Laing, p. 136
- ^P. B. Sutker/H. E. Adams, Comprehensive Handbook of Psychopathology (2001) p. 540
- ^Sutker/Adams, p. 540
- ^Fenichel, p. 444
- ^A. C. P. Sims, Symptoms in the Mind (2003) p. 129
- ^Iain McGilchrist, The Master and His Emissary (London 2010) p. 399
- ^V. M. Durand/D. H. Barlow, Essentials of Abnormal Psychology (2005)p. 442
- ^Eric Berne, A Layman's Guide to Psychiatry and Psychoanalysis (Penguin 1976) p. 205
- ^Quoted in Porter, Women's Vision p. 117
- ^Quoted in Hermione Lee, Virginia Woolf (London 1996) p. 195
- ^Margaret Mahy, Memory (London 1987) p. 23
- ^Patrick O'Brian, Treason's Harbour (London 2007) p. 19
- ^"Archived copy". Archived from the original on 2012-01-14. Retrieved 2012-01-04.
In people with bipolar disorder, mania and hypomania can comprise various symptoms, from reckless spending to sexual promiscuity. In addition, some more subtle symptoms may also occur, such as the belief held by some patients that everything occurring around them is related somehow to them when in fact, it isn't. This symptom is known as ideas of reference. An extension of those irrational beliefs, delusions of reference can cause patients to change their behavior significantly because of this mistaken belief.
These two symptoms—ideas of reference and delusions of reference—can affect people in very different ways. For example, a man might believe that secret messages about him are broadcast in a weekly television show, to the point where he records the programs and watches them again and again. Meanwhile, a woman might be convinced that all the notices posted on boards outside churches are aimed directly at her, which frightens her so much that she refuses to leave the house.
Some clinicians and researchers use the terms ideas of reference and delusions of reference interchangeably. Other sources differentiate between the two, saying that ideas of reference have less impact on the person's life as a whole.
Ideas of Reference vs. Delusions of Reference
Whereas ideas of reference are real events that are internalized personally, delusions of reference are not based in reality. However, ideas of reference may act as a precursor to delusions of reference.
Many people will experience passing thoughts or ideas of reference. For example, you go to a party and just for a minute honestly believe everyone is whispering about you. This is within the scope of normal human behavior unless it happens to you constantly.
It's when these thoughts cross the line outside of actual facts or events (when you believe people you don't even know are whispering about you, and you proceed to hide out at home because of this) that the thoughts turn into delusions.
The 3 Criteria for Delusion
Karl Jaspers, a German-Swiss psychiatrist, described the main criteria for a true delusion. They include:
- Certainty (the person is convinced the delusion is real).
- Incorrigibility (the person cannot be convinced otherwise or have the belief shaken in any way).
- Impossibility (the delusion is not real at all).
Some people have only occasional, random delusions of reference, while others have them all the time.
If these thoughts occur for more than one month and they involve events that actually could happen (such as being followed, infected with a disease, or loved at a distance), delusional disorder is the diagnosis. The key difference between delusions of reference and delusional disorder is delusions of reference are most definitely not real, while the thoughts in delusional disorder could possibly be real (although they're quite unlikely).
Other Types of Delusions
- Bizarre delusions have no possibility or basis to happen in reality.
- Delusions of control mean that a patient's thoughts, feelings, and actions are not his or her own, but instead originate from some external force or person.
- Depressive delusions are marked by a predominant depressive mood. These might include delusions involving a serious illness, poverty or spousal infidelity.
Treatment of Ideas and Delusions of Reference
Antipsychotic medications can help with delusions of reference, as can counseling and psychotherapy. Cognitive behavioral therapy is used to help people reframe their thoughts and explore logical explanations for their line of thinking.
Jaspers, Karl. "General Psychopathology." JHU Press, Nov 18, 1997
Kiran C, Chaudhury S (2009). "Understanding Delusions" Ind Psychiatry J. 18: 3–18.